Hip, Hip Hooray

Procedure gets patients home hours after replacement surgery.

Anytime an infielder, outfielder or pitcher for the Tampa Bay Rays lands on the disabled list with an injury, it’s the job of Paul Harker to coordinate that player’s medical care and evaluate his progress as he works his way back to the field.

Photo courtesy of Paul Harker.

“Having my hip surgery at Outpatient Joint Replacement Center of America was one of the best decisions I ever made.” – Paul

A member of the Rays’ organization for 21 years, the 52-year-old Harker moved into his current position as the team’s major league medical coordinator in 2017 after spending the previous 12 years as the Rays’ assistant athletic trainer.

“I still travel with the team on occasion, but I’m now based out of Tropicana Field, where I work primarily with the players on the disabled list and those who have had surgery and are rehabbing,” Paul explains.

“On occasion, I’ll follow those players out on their rehab assignments, which mostly take place in Port Charlotte with our Class A minor-league team, the Stone Crabs. I also head up all the medical reviews for the amateur draft each year.”

Though he didn’t really get into baseball until after he graduated from college and took a job as a trainer for a minor-league affiliate of the Seattle Mariners, Paul was an athlete himself before he got into the business of tending to injured athletes.

He played football through his freshman year of college and remained physically active all through his time as a baseball trainer. That is, until about three years ago when aggravating right hip pain threatened to force him onto his own disabled list.

“It started sporadically,” Paul says of his hip pain. “The pain would come and go, and that continued for about a year. Then it became more persistent. The pain would last for two, three weeks, even a month, go away for a week or two and come back.

“Then last year, from the time spring training started and all the way through the baseball season, it was really hard to bear. I was taking a lot of Advil® and Aleve®, just trying to stay comfortable so I could do my job. But I was actually quite miserable.

“I was in so much pain that in June my wife called the Rays’ general doctor and told him what I was experiencing. A few days later, the doctor cornered me and said, Look, let’s just get an x-ray and see what’s going on here.

The x-ray showed some joint space narrowing, a sign of arthritis, but not enough to cause the kind of pain Paul was experiencing. After that, an MRI was taken, which revealed that Paul’s hip was so arthritic that he would need to have it replaced.

Where to have the surgery was Paul’s next question, and he got the answer from another doctor associated with the Rays who was soon to have his hip replaced by Philip E. Clifford, MD, AAHKS, AAOS, at Outpatient Joint Replacement Center of America in Tampa.

“This doctor is from Durham, North Carolina, the medical mecca of the South, and he said he wouldn’t have anyone other than Dr. Clifford do the surgery,” Paul says. “That says a lot, so I went to see Dr. Clifford and scheduled my surgery for right after the season.”

Since opening in spring 2019, Outpatient Joint Replacement Center of America has specialized exclusively in a protocol for the surgical replacement of hips and knees that eliminates the need for long, postoperative hospital stays.

“One of the factors that’s most unique about our protocol is the medicines we use,” Dr. Clifford explains. “One of those medicines is called Exparel®. It’s a long-lasting, non-opioid, local anesthetic that can last for two to three days.

“Another feature that’s unique about our protocol is the surgical technique we use. With our hip surgery, for example, we use a technique where we are not assaulting the muscle and detach only one tendon from the hip, which is then repaired anatomically.

“This technique results in less trauma to the hip and less blood loss. There is also a smaller chance the length of the leg will be changed. And there are no limitations after surgery. Patients can return to activities almost immediately and are actually encouraged to do just that.”

Hip procedures are performed through an incision that is three to four inches long.

That small incision is what allows for the preservation of muscle attachments, which is why patients are back on the move within a few hours.

“The most important thing we do is spend an incredible amount of time educating each patient before the surgery,” Dr. Clifford notes. “We spend 45 minutes to an hour getting them ready for surgery and prepared for what to expect and do afterward.

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

On the day of his surgery, Paul arrived at the surgery center at 6:30 a.m. By 10:45, he was on his way home, and by noon, he was walking on his own after he decided he didn’t need the walker he was given for stability.

“We also ordered a cane, but that didn’t come until the day after the surgery,” Paul remembers. “By then, I was walking around pretty well, so I ditched that, too.

“To give you an idea of how good the surgery went and how quickly you can recover from it, five days after I had the surgery, I was out mowing my lawn. And as far as pain goes, I never had to take a pain pill that was prescribed. Not one.

“I took a little Tylenol and a nerve medication called gabapentin for a bit, but I never needed the prescription pain medication. And now, let me say that if the rest of my body felt as good as my hip does I would have no complaints.

“I was back to normal living in a matter of days, and less than a month after the surgery, my wife and I went on a cruise, and I was up and down the stairs and walking all over that ship with no issues at all.”

Almost a year after his surgery, Paul says he probably should have addressed his hip issue much sooner. He wonders, though, if his outcome would have been as good had he not learned about Outpatient Joint Replacement Center of America.

“Without question, I recommend Dr. Clifford to anyone who is facing hip-replacement surgery,” Paul says. “Surgery was long overdue, but it all worked out for the best. In the end, having my hip surgery at Outpatient Joint Replacement Center of America was one of the best decisions I ever made.”

Print This Article