By Ben Turner
Andrew Chambers, MD is an orthopedic surgeon at Dallas Orthopaedic Joint Institute who specializes in joint replacement surgery. He received extensive training in joint replacement surgery during his fellowship at Harvard Medical School / Massachusetts General Hospital, which was voted as the top hospital in the United States.
Dr. Chambers has implemented the techniques learned at Harvard Medical School into his own practice and offers minimally invasive total hip / knee / shoulder replacement, partial knee replacement, revision surgery for malfunctioning, loose, and infected joint replacements, arthroscopic surgery of the hip, knee, and shoulder, and revision of failed and recalled metal-on-metal total hip replacement implants. Dr. Chambers focuses special attention on surgical techniques for rapid recovery after total joint replacement, which allow his patients a more predictable and earlier return to home and an active lifestyle.
Dr. Chambers is a Texas native and grew up in Houston, Texas. He attended medical school at The University of Texas Medical Branch in Galveston and completed residency at John Peter Smith Hospital in Fort Worth, Texas. He then completed a fellowship in joint replacement surgery at Harvard Medical School. In his free time, Dr. Chambers enjoys traveling and spending time with friends and family. He is an avid sailor and enjoys participating in sailing races on the local lakes in the Dallas/Fort Worth area.
I had the opportunity to visit with Dr. Chambers and ask some common questions that many patients may have about joint replacement.
What drew you into pursuing joint replacement surgery as a career choice?
During my orthopaedic surgery residency, I was drawn to pursue specialized training in joint replacement surgery simply because I enjoyed watching how, for the right patient, undergoing a joint replacement can dramatically improve quality of life and get them back to being functional and participating in the activities that they love. Joint replacement is a unique field in medicine because the majority of my patients don’t come to my office because they are “sick” or have an uncontrolled medical condition that they need to correct. Most patients come to see me because they are suffering from arthritis and want to improve their quality of life, mobility, and independence. While we prefer to control the symptoms of arthritis first with non-operative measures, some patients may require joint replacement surgery. It is personally rewarding for me to see the dramatic improvement in quality of life that can be achieved in the right patient after undergoing joint replacement surgery.
I have heard that joint replacement can be painful, is this true?
While some soft tissue related pain can be experienced after surgery, we have made dramatic improvements in the pain management protocols after undergoing joint replacement. Many years ago, it was not uncommon for patients to stay in the hospital for several weeks after undergoing joint replacement. Whereas now, our pain management regimen has become so successful that many of my patients can go home on the same day as the surgery. Rather than treating pain once it has reached its peak, we have implemented ways to try and prevent pain from developing. We start the prevention of pain in the pre op area before surgery. We continue other measures during the surgery and after surgery. We have found that by attacking pain before it sets in, patients are happier, experience less side effects from medications, start walking and doing physical therapy sooner, and ultimately can recover faster! Many patients state that having their joint replaced was not as bad as they originally thought it was going to be.
I have heard about a robotic assisted hip and knee replacement; can you explain what this is and how it helps?
Yes, I am pleased that we offer Makoplasty robotic arm assisted hip, knee, and partial knee replacement surgery. For many years, robots have revolutionized other professions such as automobile manufacturing and computer chip design, so it is only natural that robots have now been developed to assist with surgical procedures such as joint replacement. The MAKOplasty procedure is changing the way joint replacement surgeries are performed by providing each patient with a personalized surgical experience based on their specific diagnosis and unique anatomy using a CT-based 3D modeling. It offers several advantages over conventional joint replacement procedures. First, it is extremely precise and reproducible. The robotic arm is programmed to know exactly which portion of bone should be removed and which should not. Even though I, as the surgeon, am still in ultimate control of doing the surgery, the robot acts as a guide and is accurate to the millimeter! The robot also makes the surgery safer by helping to prevent inadvertently damaging important structures such as ligaments, nerves, and blood vessels. It does this by creating a “haptic boundary” in which it will not allow the blade to exit the “safe zone” during the surgery. The third, and potentially most important advantage, is that it has the capability of decreasing the amount of soft tissue releases and soft tissue dissection that is normally required with conventional knee replacement. This may result in less post-operative pain and potentially faster recovery.
What can I do to avoid needing a joint replacement?
Patients that are already suffering from arthritis can avoid or delay surgery by implementing lifestyle changes such as daily low impact exercise, weight loss, and muscle/core strengthening. Physical therapist or trainers can assist with these goals. We also may recommend a brace that can help offload the knee in certain types of arthritis. Oral medications such as Tylenol or NSAIDs are commonly prescribed as a modality for controlling arthritic pain. Intra-articular steroid injections such as cortisone or viscosupplementation (Hyaluronic acid) injections may help control pain as well. We will tailor a specific, individualized plan for each patient to help avoid surgery for as long as is reasonable.
When is the right time to have a joint replacement?
I typically have a conversation with my patients who are contemplating surgery and assess their overall pain level and disability that their arthritic joint is causing. The goals of total joint replacement are different for different patients. Some patients choose joint replacement because they want to get back out on the golf course and their knee arthritis is stopping them. Other patients may choose joint replacement as a way to remain independent and maintain the ability to shop, clean, and complete activities of daily living. Some patients are still working and are concerned that their arthritic joint will hinder their ability to continue to work. Some are simply ready to not be in pain anymore. We will have a discussion on the goals of surgery and will decide mutually on when to proceed.
What can I do before my joint replacement to help speed up recovery and healing after my surgery?
Overall, living a healthy lifestyle dramatically helps with post-operative recovery.
Maintaining a healthy weight and correcting any nutritional deficiencies such as vitamin D levels and albumin (protein) levels are encouraged. Smoking and nicotine use must be stopped prior to surgery. Good control of medical conditions such as diabetes, hypertension (high blood pressure), and thyroid disorders all are important. Surprisingly, untreated depression and mood disorders may also adversely affect the outcomes after surgery.
Some patients may benefit from “pre-hab” type of exercises to increase strength, endurance, and flexibility prior to surgery. We can develop an individualized routine in coordination with a physical therapist. Good dentition and treatment of any tooth/mouth infections is important prior to joint replacement.
We work closely with the patient’s primary care provider to make sure that all medical conditions are optimized before proceeding with joint replacement.
Dr. Chambers has office locations throughout the Dallas Metroplex. He performs surgery at Methodist Dallas, Charlton, and Richardson hospitals.
To schedule an appointment with Dr. Chambers, please call 214-947-3248.