Orthopaedics and Rehab
Tracking hip surgery variables
January 26, 2017
A registry to track the variables that influence patient outcomes following minimally invasive hip reconstruction surgery is underway at UT Southwestern. The idea is to better equip physicians in advising patients and controlling factors known to negatively affect patient experiences – leaving them with only positive ones.
“When patients don’t do well, we want to find out why. Conversely, when the outcome is great, we want to determine the primary reasons for that too,” says UTSW orthopaedic surgeon and hip specialist Joel Wells, M.D., who launched the registry. “By tracking those variables, we can better predict an exceptional outcome versus one that might be disappointing for the patient.”
The registry could prove to be a valuable tool in enhancing what is a critical surgical procedure.
“Total hip replacement, whether standard or minimally invasive, is still one of the best surgeries we can offer,” Dr. Wells says. “A minimally invasive approach is kind of the icing on the cake. It’s really about the patients, helping them be more active and mobilize quicker.”
Not all hip surgeries are equal
Performing hip surgeries with minimally invasive techniques already has a well-established track record of shortening patient recovery times and causing less duress. But, as Dr. Wells notes, not all hip surgeries are equal, even if they’re called minimally invasive.
He adds that there can be a steep learning curve for surgeons who adopt minimally invasive techniques in the middle of their career. “Training is of utmost importance because the surgeon truly has to know the anatomy of the hip before performing a minimally invasive surgery,” he says.
To treat hip dysplasia, hip arthritis, and other deformities, Dr. Wells performs a variety of minimally invasive surgeries, depending on the patient’s needs and pathology. For hip reconstruction and replacement, he offers both a minimally invasive anterior and posterior approach.
He chooses the anterior approach whenever possible. For that procedure, Dr. Wells uses a special table, called a Hana table, and retractors that allow him to go between the tensor fasciae latae and the sartorius muscles, preserving the muscle and the internervous plane for even better patient outcomes.
Centralized care for hip patients
Dr. Wells and colleagues Kenneth Estrera, M.D., and Michael Huo, M.D., are part of a comprehensive hip center at UT Southwestern. “We’re a team that can take care of all aspects of hip pathology,” Dr. Wells says. “We can truly individualize patient care.”
The goal of the center is to provide care for hip patients at every point of their journey. The center’s offerings include:
- Complete surgical options
- Diet and nutrition
- Physical Medicine and Rehabilitation
- Casting and functional bracing
- Evaluations of conditions and injuries using state-of-the-art diagnostic tools
- Injury prevention information
- Medical management and nonsurgical treatments
- Rehabilitation services
- AlterG antigravity treadmill
- Compartment pressure testing
- Laboratory services
- Physical therapy
- Shock wave therapy
- Ultrasound-guided injections
Meet Dr. Wells
Assistant Professor, Department of Orthopaedic Surgery Comprehensive Hip Surgeon, UT Southwestern’s Orthopaedic Surgery Clinic
Medical Degree: Tulane University
Internship: Surgery, Brigham and Women’s Hospital
Residency: Orthopaedic Surgery, Harvard Orthopaedics and Massachusetts General Hospital
Fellowship: Joint Preservation, Resurfacing, and Reconstructive Surgery, Washington University in St. Louis
Former care team member for the Boston Red Sox and New England Patriots