A Speedier Recovery From Joint Replacement

Nonopioid local anesthetic, surgical techniques are at the core of protocol’s success.

A subcutaneous medication to help control blood pressure, a preventive for migraine headaches and a vaccine to stave off urinary tract infections are among the candidate treatments in the clinical trial stage of development.

The results of Kimberly’s outpatient knee replacement surgery “exceeded” her expectations.

Should any of those therapies reach the market, some of the credit will go to Kimberly Mai, a former hospital nurse who made the transition to clinical research 18 years ago and has come to appreciate her seat on the leading edge of medical science.

“I’m one of the many little ants who see the trial patients and make sure everything is going well, the patients are safe and complying with the trial protocols, and the study is running the way it should,” Kimberly explains.

“I love that I’m always learning rather intensively about disease processes and medications. I still get to do patient care, but with better hours. I wouldn’t say they’re banker’s hours, but they are better than what I had in hospital nursing.”

The improved work schedule is not the only benefit. She also likes that the job allows her to sit occasionally.

“Being a hospital nurse, you’re on your feet all the time,” she notes. “That can be tough. It was especially tough for me because I suffered a bad fall about 20 years ago, and all that time on my feet was the main reason I eventually had to have my knee replaced.”

Kimberly shattered her kneecap during that spill, and despite undergoing surgery to repair the damage, she has spent the better part of the ensuing years in agonizing pain. Eventually, she developed traumatic arthritis, which is caused by a serious injury.

“I was OK for about five years, but then the pain became so bad that even everyday life became difficult for me,” Kimberly explains.

“Even if I was just walking on a flat surface at work, I would get these sharp pains in my knee. Working out was even worse. I had to go from working out on an elliptical machine to riding a stationary bike, but even then I had to take pain medication to do that.

“I also like to hike when I’m on vacation and take walks on the beach, but I had to give all that up. It was so bad that I had days where, by the end of the day, I was in tears because of the pain.”

Kimberly had two subsequent knee surgeries, both arthroscopic cleanup procedures, but neither did much to alleviate her pain. The latter was performed in 2019, not long before she had the good fortune of meeting Phillip Clifford, MD, AAHKS, AAOS.

Advanced Technique

Along with Paulina “Mattie” J. Collier, MPAS, PA-C, Dr. Clifford is the co-founder of Outpatient Joint Replacement Center of America, a Tampa practice that specializes in a protocol for the surgical replacement of hip and knee joints in an outpatient setting.

This protocol eliminates the need for long postoperative hospital stays and allows for speedier recoveries.

Dr. Clifford explains that the medications and surgical techniques he employs are at the core of the platform’s success.

“One of the medicines we use is called Exparel®,” Dr. Clifford offers. “It’s a long-lasting, nonopioid, local anesthetic that can last two to three days. For knee replacement surgery, we also perform what’s called an adductor canal block.

That and the proper injection of Exparel allow the patient to get up and move around faster following surgery.

“As for our surgical technique, with our knee replacement surgery, instead of assaulting the muscle, we incise the capsule of the joint. That means less trauma and bleeding, and the less muscle trauma and bleeding you have, the better.”

Dr. Clifford performs hip replacement procedures in much the same way, through a small incision that allows for the preservation of muscle attachments. That allows the patient to get up and start moving hours after surgery without limitations.

“Dr. Clifford and Mattie are so good at what they do and are so much more advanced than others in this area.” – Kimberly

“Patients can return to normal activities almost immediately,” Dr. Clifford assures. “In fact, we encourage them to do just that. Another thing we do is spend an incredible amount of time educating each patient
before surgery.

“We spend 45 minutes to an hour getting patients ready for surgery and for what to expect and do afterward. When our patients go home after surgery, they know that we’ll be calling to check on them between 4 and 7 o’clock that night. It’s not them calling us; it’s us calling them. That level of patient care does not really exist in many places.”

Ahead of the Curve

Kimberly met Dr. Clifford shortly after he opened his practice in 2019 during a luncheon seminar at work. She had recently undergone the second of her two cleanup procedures and knew she was in need of a knee replacement.

“I spent a lot of time talking to Dr. Clifford and Mattie and was attracted by the fact that they do things on an outpatient basis,” Kimberly recalls. “I feel like everybody heals better at home, and there’s less risk of infection. A couple of months later, I went back and said, Let’s do this.

Kimberly had her knee replacement surgery shortly after that second meeting. She now says that through the surgery, she “exceeded” her goal of alleviating her pain and resuming the active lifestyle she was forced to abandon.

“Having this replacement surgery done by Dr. Clifford was the best thing I ever did,” Kimberly enthuses. “The entire experience was a pleasure because Dr. Clifford and Mattie are so good at what they do and are so much more advanced than others in this area.

“They started me out a week before surgery on a regimen to help manage my pain afterward, which was great. Then, I had my first physical therapy session right there in the recovery room. And now, I can do everything I enjoy doing without pain.

“I could not be more pleased, so meeting Dr. Clifford was an absolute blessing. I highly recommend him and Mattie and have already told several people, If you need replacement surgery, go see Dr. Clifford. He’s really up on everything.

Kimberly even has kind words for Dr. Clifford’s office manager, Kim Stinedurf.

“Kim is an integral part of what they do, making sure that all the patient’s needs are met,” Kimberly concludes. “And I want to add that I always felt heard by Dr. Clifford and Mattie. If I ever needed something, they took care of it.
“They always keep their patients first.”

© FHCN article by Roy Cummings. Photo by Jordan Pysz. mkb
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