Dr. David Fabi, San Diego orthopaedic surgeon has received the Leaders in Total Joint Replacement: Generation Next Award. The honor recognized Fabi as one of the Top 40 Nationwide emerging orthopaedic surgeon leaders.
As one of the leading orthopaedic surgeons in the nation, Dr. Fabi improves the lives and mobility of his patients and is working to dispel the misconception that surgery is the only option available for hip and knee problems. He believes that unnecessary surgery results in poor outcomes and non-surgical solutions should always be considered first.
“Orthopaedic surgery is very technical, innovative, mechanical and progressive,” said Fabi, “The goal of the specialty is to enrich the quality of lives of patients. When quality of life is decreased and conservative measures are not the best choice, then surgery is recommended.”
In the field of joint replacement, controversy has arisen over hip replacements performed from the front (anterior) or the back (posterior). Anterior hip replacements have decreased dislocation rates, quicker recovery and the ability to use x-rays during surgery for more accurate placement that spares muscle trauma. The down side is that there’s a steep learning curve for the procedure, increased fracture risk and increased potential for nerve injuries.
The consensus is that the surgeon must stick to what they are successful at and what works best in their hands and the results. Either approach has excellent results in the appropriate surgeon’s hands. Many surgeons perform both procedures. Many results seem to be equal. A more important factor is whether the surgeon is a high volume joint replacement surgeon. Most high-volume surgeons have favorable outcomes no matter what approach.
Dr. Craig J. Della Valle is one of the top hip surgeons in the nation, associate professor at Rush University Medical Center in Chicago, and concurs with Fabi’s position. “I honestly don’t think it will make a difference in terms of patient based outcomes,” said Della Valle. “I think in expert hands it works, but I am not sure it will make a difference to the patient, which at the end of the day is what is most important.”
That expert opinion is echoed by Dr. Keith R. Berend, internationally known high-volume surgeon at joint Implant Surgeons in OH, co-developer of the Biomet Rapid Recovery Program. “The anterior incision end up being pretty small,” said Berend. “The anterior approach spares muscle and enhances recovery.”
For those who may be considering a joint replacement, the best advice is that patients ask their surgeon about his/her rate of infection and dislocation rate, and overall patient satisfaction. Look for infection rates of 0.5 percent and dislocations of 1 percent or less. Satisfied patients should be able to return to work within two weeks.
Patients should seek clinicians that perform an average of 150 knee replacements and/or 100 hip replacements annually. Surgeons should examine all treatment options, including anti-inflammatory medications, steroid or hyaluronic acid injections, along with physical therapy and the use of braces, canes and walkers.
The three most important things to look for in a professional in an orthopaedic specialty is someone with an established reputation among patients and other physicians, adequate experience and training and a good bedside manner, all of which will quicken a patient’s recovery.
To facilitate a good doctor-patient relationship and improve treatment outcomes, individuals need to seek a clinician with whom they have a common interest. “Look for a surgeon who has a wide array of interests and knowledge with which you can make a connection,” said Fabi. “When a patient and clinician share a connection, that connection will make for a very special experience and help improve outcomes.”
Dr. Fabi can be reached by phone at 619-299-8500 at the San Diego Orthopaedic Associates Medical Group, located at 4060 4th Ave., San Diego, CA.