An Outpatient Protocol For Hip Replacement

Innovative joint surgery means speedier recoveries and brief postop hospital stays.

Within days of undergoing a double hip-replacement, Michelle was working out at the gym again.

People have been known to find love in some very strange places. Few can say they found it in a place as strange as Michelle Perry, who met “her person” on a battlefield during a war games exercise in South Korea.

“It was in 1987, and the event was called Team Spirit,” Michelle remembers. “At the time, Team Spirit was the largest free-world military exercise around. It brought together all the branches of the US military as well as some other free-world players.

“It also brought me and the man who became my husband together. He was in the Marine Corps, and I was in the Air Force flying on EC130s while working in radio and communications. We met while playing war and were married about a year later.”

Michelle and her husband will soon celebrate their 35th wedding anniversary. When they do, 55-year-old Michelle will almost certainly raise a glass to her recent escape from a crippling yearslong ordeal with hip pain.

“My hip problems started about eight years ago, and at first I put up with it,” Michelle reports. “Then, a couple of years ago, the pain started to get worse, and soon it started to impact almost everything I did.

“Part of the problem was that the pain was constant, so it hurt no matter what I did. It hurt to walk, it hurt to sleep, it hurt to walk up and down stairs. It even hurt to stand up straight, so I was always bent over.

“I was a caterer for many years. There was an event I did in November 2021, and the pain was so bad at that time I was absolutely miserable. It was after that I decided I had to do something about this horrible hip pain.”

Despite a friend’s warning to avoid hip-replacement surgery, Michelle investigated that option. However, she was almost immediately put off by a conflict that developed between her and the orthopedist.

“I won’t name names, but this doctor had everything going for him on paper,” Michelle relates. “He was a teaching doctor, he used robotics and had five-star reviews across the board. But he wouldn’t tell me his success rate for operations without complications.

“I finally asked my insurance company if they could tell me what his ranking for that was. It turns out it wasn’t very good. After learning that, I asked my insurance company if they could recommend a doctor for me. They told me to go see Dr. Clifford.

Advanced Technique

Philip E. Clifford, MD, AAHKS, AAOS, and Paulina “Mattie” J. Collier, MPAS, PA-C, are co-founders of Outpatient Joint Replacement Center of America, which specializes in an outpatient protocol for the surgical replacement of hip and knee joints.

As Michelle learned, the protocol Dr. Clifford specializes in eliminates the need for long postoperative hospital stays and allows for speedier recoveries. The medications and surgical techniques used are at the core of the procedure’s success.

“I was very fortunate to have found Dr. Clifford because he is a phenomenal surgeon.” – Michelle

“One of those medicines is called Exparel®. It’s a long-lasting, nonopioid, local anesthetic that can last for two to three days,” Dr. Clifford explains. “And whether we’re replacing a knee or a hip, we always use a technique that requires less assault on the muscle.

“Our hip procedure, for example, is performed through an incision that is only three to four inches long. That small incision is what allows for the preservation of muscle attachments.

“It’s also important to note that during our hip procedure, we detach only one tendon from the hip, which is then repaired anatomically. This technique results in less trauma to the hip, less blood loss and a smaller chance the length of the leg will be changed.”

“But the best thing about our protocol is that there are no limitations after surgery. Whether it’s a knee or hip that’s being replaced, patients can always return to activities almost immediately. In fact, we encouraged them to do just that.”

Education and communication are also important factors in the protocol. Dr. Clifford says he spends more than an hour preparing patients and educating them on the regimen they need to follow afterward to ensure a successful outcome.

“Not only that, but when our patients go home after surgery, they know that between 4 and 7 o’clock that night, we call to check on them,” the doctor adds. “It’s not them calling us; it’s us calling them. That level of patient care does not exist in many places these days.”

Comfortable and Confident

Michelle, whose pain forced her to spend more than a year walking with a cane and sleeping in a recliner because she couldn’t lie down comfortably in a bed, first visited with Dr. Clifford in the spring of 2022. She was immediately impressed with his manner.

“The more I talked with Dr. Clifford, the more comfortable and confident I became,” Michelle remembers. “He really put me at ease because he took his time and answered all of the questions my husband and I had. And believe me, we had a lot of them.

“We asked Dr. Clifford about everything we could think of, and he never rushed us or rushed through an answer. He answered everything very thoroughly and sincerely and really showed us how incredibly compassionate he is.”

During his initial visit with Michelle, Dr. Clifford also confirmed a previous diagnosis that arthritis was the cause of her relentless hip pain and it had worn her hips down so much that both needed to be replaced.

“The best thing about our protocol is that there are no limitations after surgery.” – Dr. Clifford.

“One of my hips was so worn down by arthritis that the joint was actually squared off instead of round,” Michelle reports. “So, I agreed to have the surgery. That’s when I found out what an outstanding surgeon Dr. Clifford is.”

Dr. Clifford replaced the first of Michelle’s degenerating hip joints in early April. A couple of weeks later, he replaced the other. The surgeries brought Michelle the pain relief she had long wished for.

“I was up and walking right away and without pain in that hip after the first surgery,” Michelle enthuses. “I was so excited that I probably overdid it a bit those first few days, showing people how much better I could walk with just that one hip replaced.

“Then I had the second surgery, and the outcome was amazing. All of a sudden, I was able to do all those things I hadn’t been able to do before, all those things we tend to take for granted until we can’t do them anymore.

“I’m talking about little things that are a part of living a normal life, like standing in the kitchen and preparing dinner, riding a bicycle, or just walking from one room to another without pain. I’ll never take those things for granted again.

“And I will never take for granted all that Dr. Clifford and his staff have done for me. I was very fortunate to have found Dr. Clifford because he is a phenomenal surgeon. He is very thorough and detailed, and I can’t tell you how highly I recommend him to others.”

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