Hip Replacement Protocol Hastens Recovery

Of the hundreds of pairs of ballet shoes that Ashley Caputo wore during her brief run as a ballerina, one remains. Those well-worn slippers serve as a testament to a dream that took flight early but faded before it reached the heights Ashley hoped it would.
“For a time, I was the best dancer in the small town where I grew up in the Poconos,” says Ashley, a Hazelton, Pennsylvania, native who apprenticed with the nearby Wilkes-Barre Ballet Company and danced lead with the Luzerne County Ballet Company.
“We did shows like Swan Lake and The Nutcracker, but that wasn’t going to earn me a living, so I went off to college. By the time I was 20, I earned my bachelor’s degree in dance and French.”
A competitive dancer during her youth, Ashley traveled as a dancer for several years, but later turned her attention toward a nursing career that resulted in her becoming a yoga instructor, meditation instructor and hypnotherapist.
Ashley’s interest in hypnotherapy stems from her youth, when she used it to help her overcome a dance-related injury. She turned to hypnotherapy again many years later to rid her of a “phobia” she developed following a car crash.
“I was rear-ended by a drunk driver and ended up needing a couple of surgeries,” Ashley relates. “After all that, I was afraid to leave my house. I had therapists coming to my house to help me. Finally, one said, You should try hypnosis.
“I remembered using it when I was a little girl, and it helped then, so I tried it again, and it changed my life. After that, I decided to go back to school to become a hypnotherapist. It’s worked out very well for me. I even teach at the school now.”
Ashley, 49, also teaches yoga, the “advanced, hard core, aggressive kind.” One day three years ago, she woke up after teaching such a session with intense pain in her right hip. Thinking she had probably strained a tendon, she simply took it easy for a couple weeks.
When two weeks of self-care failed to alleviate her pain, Ashley visited a doctor who recommended she see another doctor. Ashley chose instead to visit Philip E. Clifford, MD, AAHKS, AAOS, of Outpatient Joint Replacement Center of America.

Advanced Technique

Outpatient Joint Replacement Center of America was co-founded by Dr. Clifford and Paulina “Mattie” J. Collier, MPAS, PA-C. Together, they specialize in an outpatient protocol for the surgical replacement of hip and knee joints.
“I went there thinking that I just needed a cortisone shot and I would get the shot and get back to my yoga again,” Ashley recalls. “But that’s not what happened. After taking some x-rays and examining them, Dr. Clifford told me I had hip dysplasia.”
Found most often in children and women, hip dysplasia is a condition in which the failure of the hip socket to completely cover the ball portion of the upper thigh bone results in a partial or complete dislocation of the hip joint.

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

When found in children, the problem can often be corrected through the temporary use of a soft brace. In older children and adults, the issue can lead to cartilage tears and typically needs to be corrected through hip replacement surgery.
Ashley’s dysplasia not only forced her to abandon her yoga instruction, but it also hampered her ability to walk. To get her moving again, Dr. Clifford recommended his outpatient hip replacement surgery.
This unique 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.
“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.”
“And 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 actually encouraged them to do just that.”

Take It to the Extreme

Photo courtesy of Ashley Caputo Ashley’s speedy recovery allowed her to teach a yoga class just two days after her surgery.

Education and communication are also important factors in the protocol.
Dr. Clifford says he typically spends more than an hour preparing patients and educating them on the regimen they need to follow afterward to make it successful.
“Not only that, 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.”
Ashley first went to see Dr. Clifford in the summer of 2020. At the time, she couldn’t sit or stand for more than a couple of hours at a time and was struggling to walk up even a short flight of stairs. That all changed following the surgery.
“Within minutes of waking up in the recovery room, I was able to walk up and down stairs without any pain,” Ashley reveals. “I was in physical therapy the very next day, and after I got home, I went out on my porch and did some modified yoga exercises.”
Ashley started doing yoga exercises while in the recovery room. Eager to test the limits of her new hip, she stood up, raised her right leg behind her back and pulled her foot up to her ear, stunning Dr. Clifford and nurses alike.
“It was really amazing to see her do that to that extreme,” Dr. Clifford remarks. “In her case, though, we had actually tested those extreme positions while performing the surgery to ensure she would be able to reach those positions right away.
“But that’s what’s great about this surgery. It allows you to begin using your hip or knee right away. A lot of people are afraid to do that out of fear, but she didn’t have any fear at all. She jumped right back in there, and because of that, she recovered faster.”
Ashley recovered so quickly that within two days of the surgery she was teaching a yoga class and walking a mile without pain. It’s no wonder she describes the replacement procedure as “incredible” and lauds Dr. Clifford and his staff for their care.
“I could not be happier with the outcome,” she raves. “Dr. Clifford and Mattie took great care of me, and since then I’ve referred several people to them. And I’ll continue doing so because they’re the absolute best. They’re kind, genuine people who really know their stuff.”