Cover Story - November 2004


YOUR SPECIAL FOCUS: I replace hips and knees, mostly in elderly patients. In the past six years, I’ve done about 1,000 hip and knee replacements.

WHY DID YOU CHOOSE THIS SPECIALTY: Even as a kid, I envisioned being a doctor, but choosing this specialty was a very gradual directional change. Initially, I liked pediatric cardiac surgery, but it was so sad when kids died. I discovered that with orthopedics, there was tremendous potential for gratification. It doesn’t matter if you come to me young, old, fat or thin. I can take away pain, restore ability to walk. Everyone is happy.

WHAT ARE THE MOST EXCITING DEVELOPMENTS IN YOUR FIELD: The technology is constantly improving, making it safer for higher risk patients to survive surgery. When we operate on very fat people, wounds don’t seal, increasing the risk of infection. We can now make a natural tissue sealant using the patient’s own blood—we fire a spray, somewhat like Crazy Glue, into the wound, sealing it so it doesn’t drain. There are also new machines to salvage, wash, filter and return blood to a patient after surgery, which means you can replace both knees and, by the next morning, the patient will have lots of vigor.

We also have a better understanding of what it takes to have a longer-lasting implant as well as a better understanding of causes and types of arthritis and ways to treat it without resorting to surgery. Ultimately, we want to reduce the need for knee replacement.

YOUR MOST MEMORABLE CASE: I had a patient whose earlier hip replacement had gone terribly awry. The plastic liner had popped out and the metal ball inside the liner had pushed up, ate through the metal shell and ground its way into his pelvis. When I opened the fascia-the deep layer that covers the muscles-everything was black. Metal filings were all through the tissue of his buttock and thigh. I had to use a super high-speed metal cutting tool and spent two and a half hours to get it all out. It was a great result for the patient and a career moment for me.

any hobbies? I’m a major gardener with a greenhouse and rustic, picturesque gardens. I have designed shade gardens with hostas, astilbe, 3,000 impatiens, trumpet vines and wisteria all around my house—with different color schemes blooming all the time.

YOUR IDOL: When I was a resident at the Hospital for Special Surgery, the chief of orthopedics was Dr. Phillip Wilson, Jr. He was diligent to the extreme. The day before surgery, he would draw lines all over the X-rays, making a blueprint for surgery. Now, I do the same thing the day before surgery.

BEST ADVICE FOR PATIENTS: Don’t ignore arthritis symptoms because you are afraid of surgery. When it starts to hurt, see a doctor and make sure the doctor is committed to helping you avoid surgery if possible.