Posts By: Stuart Kozinn, MD

Update on the Anterior Hip Replacement procedure

I started doing the anterior hip procedure about 3 years ago after learning it from its inventor Dr. Joel Matta, who practices in Los Angeles. Now, after doing many hundres of anterior hips, I am even more excited about its potential.  I predict it will be the most preferred approach to hip replacement 5 years from now ( it takes a long time for a “new procedure” to prove itself, and have many established surgeons be willing to learn it and change from the way they have already been doing hips.

The biggest update is that wea re now doing larger, more muscular males as well. It is harder in these men, because we do not cut any muscles, therefore things get tighter when bigger muscles are “in the way”. With experience however, even the biggest men can benefit from this technique. My results are nothing short of spectacular when I compare every category of possible complications to the older posterior approach!  If you have hip arthritis, there has never been a better time to get it fixed. Please visit our facebook page deicated to this procedure at www.Facebook.com/AnteriorHipReplacements

Is it realistic to see you for surgery outside the metro Phoenix area?

Is it realistic to see you for surgery outside the metro Phoenix area?

I have been researching Doctor’s credentials and philosophy on complete knee replacement. I suffered trauma to the knee from a car accident years ago. If I have transportation to and from your facility is it realistic to schedule surgery with you if physical therapy can be performed in my immediate area (Tucson)?

Submitted by Debbie C..

Stuart C. Kozinn, MD Responds:

dear debbie :

Of course!  We see many patients from out of state, and out of the country! (I think I am the official USA total joint orthopedist for Hermosillo, Mexico!)  In fact, I would like to develope Scottsdale healthcare as a “Travel medicine” destination for joint replacement, and may get that together soon.   Tucson is easy, because you can go home from the hospital after a few days and then return in 2 weeks to get your sutures out. rehab can be done locally in Tucson.  Call my office and ask for Gerry, she can help you make any travel arrangements that are necessary. i hope to see you soon for a consultation in the office.

Stuart Kozinn

 

Do I really need a hip specialist?

Do I really need a hip specialist?

My regular ortho doctor told me I need a hip replacement for arthritis in my hip. I asked him about his experience, and he only does about ten of these operations a year, but he’s more than capable of performing the operation. I didn’t feel too great about his answer, and I’m very unsure of what to do next.

Submitted by Jim S.

Stuart C. Kozinn, MD Responds:

Some people spend more time researching their car mechanic than they do their surgeon. It has been shown that Total Joint centers, and surgeons who do more than 100 hips or knees a year have better results with less complications. I have done a fellowship in joint replacement at Harvard Medical School, and specialize in joint surgery. I do over 600 total joint surgeries a year, and my results are extraordinarily  good. We partner with Scottsdale Health Care, and I am the Medical Director of the SHC Total Joint Center where you recover on a special VIP floor with private rooms. A team approach is used to get you up and moving as fast as possible. Pre-operative teaching in the form of our free Joint Center class helps get you mentally prepared before surgery and leads to a faster recovery as well. Come on in for an appointment, and I’ll be happy to evaluate your hip and go over your options.

New Technologies to Replace Worn Out Joints

Living with chronic pain is stressful and debilitating. Joint pain, stiffness, and chronic swelling that leads to limited mobility and function affects more than 70 million Americans with arthritis. Along with chronic pain comes depression, anger, and anxiety that affects not only the sufferer but also family members and friends.

Although most people associate arthritis with the elderly, according to the center for Disease Control, three out of every five adults younger than 65 suffer with joint arthritis. Increased participation in sports and very active lifestyles has lead to an increase in people of all ages with hip and knee arthritis. According to the CDC, as the population ages that number will increase, making joint disease one of the most prevalent health conditions in America and a leading cause of disability. Because arthritis is treatable, experts at the CDC advise people not to ignore their pain and stiffness, and to seek medical attention.

While there is no known cure for osteoarthritis, there are effective treatments that will reduce joint pain and increase mobility and function. For a thorough evaluation of your hip or knee joint condition, your doctor will refer you to a specialist – an orthopedic doctor. After diagnosis, your doctor may recommend exercise, weight loss, and anti-inflammatory medications, which all help in alleviating joint pain. Sometimes, however, these treatments don’t effectively reduce the pain; and in those cases, your doctor may recommend surgery.

Today’s surgical treatments for osteoarthritis, such as total joint replacement, include innovative, more minimally invasive procedures, says Stuart Kozinn, MD, Medical Director of the Scottsdale Total Joint Center and a specialist in minimally invasive joint replacement. A graduate of UCLA medical school, with training at Cornell’s Hospital for Special Surgery in New York and Harvard Medical School’s Department of Orthopedic Surgery, Kozinn also recently served as Chief of Surgery at Scottsdale Healthcare-Osborn and is director of its new Center for Joint Replacement.

According to Kozinn, there are several causes of chronic hip and knee pain, but the most common diagnosis leading to joint replacement is osteoarthritis. “As active people age, the smooth cartilage which acts as a shock absorber in joints, may wear out and cause paiful bone rubbing directly against bone. Playing sports, such as jogging and tennis, can accelerate the disease,” says Kozinn. Eventually the arthritic hip or knee will hurt even at rest, and at that point, surgery may be the only viable option.

The knee and hip joints concentrate the body’s weight on a relatively small area, and they are therefore the most commonly affected by osteoarthritis. Orthopedic surgeons can successfully replace arthritic joints with artificial ones that will greatly improve mobility and function.

Recent technological advances in joint replacement surgery include more durable biomaterials that won’t wear out easily over time. Metal on metal bearing surfaces, hard ceramic materials, and highly crosslinked polyethylene liners have  improved the lifespan of modern joint replacements. Titanium and Cobalt-chrome metal alloys have proven to be very durable and compatible with human bone. New knee replacement designs that provide increased bending and rotation may improve the activity levels of recipients.

“Minimally invasive surgical techniques have been developed that allow less disturbance of the surrounding muscle and soft tissues, leading to more rapid recovery times and less pain”, says Kozinn. “Patients have been enthusiastic about the smaller incisions that result in shorter hospital stays and less noticeable scars.”

Patients are encouraged to walk the same day as surgery, and to leave the hospital in two or three days. Kozinn also specializes in partial knee replacement surgery, which may be preferable in earlier cases of knee arthritis. “A motivated patient can be out of the hospital the following day after minimally invasive unicompartmental knee replacement, and back to light work in one week”, according to Kozinn.

New techniques in hip replacement surgery are also available. Minimally invasive incisions allow younger patients who have trouble taking time off from work to recover more rapidly. Many patients refuse to give up their active lifestyles, and most hip replacement patients can return to tennis, golf, and skiing.

The new “Direct Anterior Approach” to total hip replacement is resulting in incredibly rapid recoveries, never before thought possible.  Specialized cementless implants and modified instruments have made these adjustments possible. “My routine patients are walking in the halls weight bearing as tolerated on the day of surgery”, says Kozinn.

Today’s technology has resulted in more rapid recoveries, but as with any surgery, complications can occur. “Your surgeon will discuss these risks with you before any surgery is done.” It is important for the surgeon and the primary care medical physician to work as a team to determine the best treatment plan for the patient. Not all patients are candidates for minimally invasive procedures. “Large, very muscular, or heavy patients, as well as those with complex deformities are better treated with more traditional approaches”, notes Kozinn.

With today’s advances in medical technology, more patients are interested in joint replacement surgery to obtain relief from crippling arthritis. For more information about minimally invasive joint replacement surgery, us at (480) 994-1149, or schedule an appointment.

Difference Between Partial and Total Knee Replacement

Dr. Kozinn explains the difference between a partial knee replacement and total knee replacement, and why a partial knee replacement might be the right choice for some patients.

Mario Gomez – 2 Anterior Hip Replacements

Mario-GomezMario Gomez had both hips replaced by Dr. Stuart Kozinn, after traveling the country in search of the best orthopedic surgeon to perform the procedure. Mario’s recovery was so rapid that he returned to Dr. Kozinn to have his other hip replaced, too! “Thanks for the best hip replacement I could get!”

Dr. Kozinn used the anterior approach for both hips, which had Mario walking 2 hours after his surgery. Mario drove home from the hospital the next day!

Watch the Interview with Mario Gomez

Watch Mario’s Commercial

 

Robert – Total Hip Replacement

My name is Robert, and I recently had a total hip replacement on June 14th. I just want to express my sincere appreciation to the admitting department and to ALL doctors and nurses that attended to me. If you have to have surgery, Scottsdale Healthcare Osborne is the only way to go. It was a very excellent experience and well done.

Dr. Stuart Kozinn was my orthopedic surgeon who did wonders with my hip. No question when I selected Dr. Kozinn for the surgery.  He is a gem. He spent much time with me explaining the procedure. I can’t recall ever meeting a doctor who took so much time to explain everything both before and after the surgery.

To all the nurses and aides both in out patient deptartment and to all those in the pre-op and post-op departments. Everybody was great.

To all the folks in the admitting department and to the entire staff at Scottsdale Healthcare Osborne, a sincere Thank You.Stu OR pic

Tony – Total Knee Replacement

Knee replacement surgery can change a patient’s life. Just ask Tony Danninger. “I can stand and walk forever,” says Danninger, a Phoenix resident who works as a lead security screener at Sky Harbor International Airport. “Before my surgeries, I was collapsing sometimes when I would take a step down, because my knees were in such bad shape. Now life is so much better after I sought out the best total knee replacement surgery I could get.”

Danninger had his total knee replacement surgeries a little more than a year apart. First was his left knee, when he underwent a minimally invasive procedure on his right knee. “The technique preserves more of the quadriceps muscle in the thigh,” says Stuart Kozinn, M.D., a nationally acclaimed orthopedic surgeon on staff at Scottsdale Healthcare who performed Danninger’s surgery. “And we used a rotating platform that allows the new knee to bend and rotate, so it may feel more natural in active patients”. According to Dr. Kozinn, “The rotating platform acts like a shock absorber, hopefully offering a longer-lasting knee joint for younger and more active patients who still want to participate in sports such as golf and tennis”.

Some patients, like Sharon Young of Scottsdale, do well with a minimally invasive partial knee replacement. “Dr. Kozinn said my bone loss was not severe and that I was able to have a partial replacement,” Young, 63, says. She had a total knee replacement a year before her partial replacement. “I’m especially delighted with the partial replacement,” she says.

“Not everyone with knee arthritis is a candidate for a partial knee replacement,” Dr. Kozinn says. “Partial replacement has been referred to as the first arthroplasty in the young, and the last arthroplasty in the old”. In the younger patient is can be a more conservative bridging procedure until a total knee replacement is necessary many years later. In the elderly patient, it can provide excellent pain relief without the increased medical risks and trauma of the larger knee replacement procedure.

Dr. Kozinn says patients who undergo partial knee replacement experience less stress, typically go home one day after surgery and are often able to use a cane immediately, rather than a walker. “These patients have less pain and become more functional much more quickly and usually don’t have to go to formal physical therapy,” Dr. Kozinn says. Formal physical therapy is usually not required after partial knee replacement by Dr. Kozinn.

Another new technology, computer-assisted navigation may help a surgeon in the future properly balance and align the knee. “It’s an emerging technology that is not yet ready for prime time,” Dr. Kozinn says. “But it looks promising in the future as a way to enhance the ability to accurately measure and check the alignment of a patient’s knee.” Much like modern automobiles have computerized check ups- someday we will be able to scan our knees for problems.

“We have used a minimally invasive and quadriceps sparing approach for many years.  When coupled with our rapid recovery program, which includes femoral nerve pain blocks, and immediate full weight bearing, patients are returning to their jobs and athletic activities much sooner.”

Amanda – Total Hip Replacement

There was still snow on the ground on June 10, 2001 in Pagosa Springs, Colorado when Amanda Armijo and her husband mounted their horses for a familiar ride. Amanda’s black and white painted horse, Matisse, stumbled in the deep snow and fell down a slope, pinning her between a tree and his massive 1,500 pound body. She knew she wasn’t paralyzed, but she couldn’t move.

Cell phones were useless in this remote location, so Amanda’s husband went for help. Rescuers took the wrong trail and most were stricken with altitude sickness. Helicopters in the area already were dispatched to a nearby fire, and because of the elevation and rough terrain, would not have been able to air-lift her safely. Being in a national park, motorized vehicles were prohibited, further delaying her rescue.

A local hiker, who happened to be a nurse practitioner, found Amanda and administered first-aid. Her stranger-than-fiction tale finally came to an end nine hours later when she was removed from the park on a one-wheel cart and taken by ambulance to a Durango hospital. It was there she learned that her right hip was both fractured and dislocated.

After being flown to another hospital in Denver, Amanda’s doctors discouraged her from getting a full hip replacement. Instead, they inserted two screws in her hip. She spent the next eight weeks completely immobile and in great pain. Having led an active lifestyle since childhood, she now was reduced to just a spectator. She endured the pain of stiffness and arthritis for five years until the Armijo family moved to Arizona and met Dr. Stuart Kozinn, Chief of Surgery at Scottsdale Healthcare Osborn Medical Center.

“Dr. Kozinn suggested an all titanium hip replacement. He was extremely honest about what he could do for me. He considered my active lifestyle when he altered the device by several millimeters to allow for more mobility. The physical therapy after the surgery was amazingly easy. I was taking the stairs in five days and back to my power yoga class in only four weeks!”

Xray of a Cementless Total Hip Replacement

Xray of a Cementless Total Hip Replacement

Coming from a long line of Olympic swimmers, it didn’t take long for the 45 year-old to dive back in the pool. She currently is coaching her daughter Ivy’s swim team, “Swim Neptune,” and enjoys all of the activities she loved before the accident – including horseback riding.

When asked what advice she would give someone in a similar situation, she said, “You don’t need to live in pain. One short month after your hip replacement surgery, you can have a new life. If you don’t do it for yourself, do it for your family.” She smiled and winked when she said, “Thanks to Dr. Kozinn and the staff at Scottsdale Healthcare, I’m a much nicer person!”

Charles – Total Hip Replacement

By the time Paradise Valley resident Charles Irion hit his early 40s, he had the worn out hips of someone twice his age, yet the ongoing zest for life of someone half his age.

In fact, the adventurer, author and entrepreneur was lacing up his hiking boots at nearly 60 years old to conquer Mount Kilimanjaro―Africa’s highest mountain.

What made this possible? Hip replacement surgery at Scottsdale Healthcare Shea Medical Center’s Total Joint Center.

A former cross-country runner, motorcycle rider, hiker, skydiver, climber and all-around devotee to living life with gusto, Charles experienced severe hip degeneration early in life. Thinking he was far too young for hip replacement, he lived with the pain of his hip bones rubbing against each other due to the deterioration of their cushioning cartilage. For years, he limped and constantly shifted his weight to relieve the discomfort that frequently woke him at night.

At age 51, Charles had had enough. He began interviewing doctors and ultimately chose Scottsdale Healthcare board-certified orthopedic surgeon Stuart Kozinn, MD to replace one of his hips. Pleased with the results, he returned to Dr. Kozinn later to replace the other hip.

“I talked to a lot of my neighbors who are anesthesiologists, and everyone had a profound respect for Dr. Kozinn’s abilities and expertise. When I met with him, he matter-of-factly answered all of my questions and wasn’t pushy,” says Charles.

After living in pain for nearly two decades, Charles had lost a lot of his flexibility―something that physical therapy and rehabilitation through Scottsdale Healthcare’s Total Joint Center helped him regain.

“I’m now free of pain. Hip replacement has been a god-send,” Charles says.

Not surprisingly, he encourages others with hip degeneration not to put off the hip replacement surgery that can return their mobility and restore their enjoyment of life.

“Pain and the stress it causes can impact your quality of life and shorten your lifespan. If you spend years in pain, you don’t get that time back. There are multiple benefits to stepping up and doing something sooner rather than later,” Charles says.

After attempting to climb Mount Everest in 1987 before his hip replacement, Charles will tackle Mount Kilimanjaro in mid-2011. His first major climbing expedition with his new hips, the adventure is Charles’ way of celebrating his upcoming 60th birthday, as well as conducting research for the last book in his series of murder mysteries that take place on the world’s seven highest mountains.

It’s all thanks to Dr. Kozinn and hip replacement surgery at Scottsdale Healthcare.

“I could have gone anywhere. But the quality of care, the staff and the facilities were great at Scottsdale Healthcare. That’s why I went there―not just once, but twice,” Charles says.

Was this helpful to you? If so, give it a +1