Joint Replacement

Whether you have wear-and-tear arthritis or a joint that has been injured in the past, we offer the complete realm of joint replacement surgery with Dr. Justin Strickland and Dr. Tarun Bhargava. This includes standard procedures like total knee and hip replacement, as well as minimally invasive procedures like partial knee replacement and MIS anterior hip replacements. For upper extremity, this includes total shoulder replacement, humeral head resurfacing as well as total shoulder replacement. From expert diagnosis and cutting-edge procedures to customized rehab therapy, Mid-America Orthopedics works hard to be a best practices organization focused on returning your quality of life. We're a single-stop destination for a complete regimen of orthopedic care.

TOTAL KNEE REPLACEMENT

Total knee replacement is more accurately described as total knee resurfacing. Dr. Bhargava will remove the worn cartilage, bone spurs, and a few millimeters of bone from the end of the bones. This is then replaced with metal (titanium and cobalt chrome) with a plastic liner in between and behind the knee cap (polyethylene). The procedure takes about 90 minutes and you will need to stay in the hospital for two or three days.

You can expect to be up walking the day after surgery. You will also work with a physical therapist on range of motion and strengthening exercises for about six weeks, which can be done in the Mid-America Orthopedics offices. Time off of work varies significantly based on work demands and current abilities.

PARTIAL KNEE REPLACEMENT

Partial knee replacement is a resurfacing of only one side or compartment of the knee. Most commonly this is the inside (medial), but can also be the outside (lateral) or the front (patellofemoral). Dr. Bhargava will remove the worn cartilage, bone spurs, and a few millimeters of bone from the end of the bone of the affected area. This is then replaced with metal (titanium and cobalt chrome) with a plastic liner in between and behind the knee cap (polyethylene). The procedure takes 90 minutes and you will need to stay in the hospital for one day. As compared to total knee replacement, the procedure is less invasive and recovery is quicker. However, not everyone is a candidate for this procedure and Dr. Bhargava will determine this based on your history, physical exam, and radiographs.

You can expect to be up walking the day of surgery. You will also work with a physical therapist on range of motion and strengthening exercises for about six weeks. Time off of work varies significantly based on your work demands and your current abilities.

TOTAL SHOULDER REPLACEMENT

A total shoulder replacement completely replaces the ball of the shoulder (humeral head) and the socket (glenoid) of the shoulder. It is performed for arthritis of the shoulder. Patients will have a pre-operative CT scan and with the use of 3-D technology they will have a customized surgical plan. Dr. Strickland removes the diseased humeral head and replaces it with a short metal (cobalt chrome) stem and metal ball.  The glenoid is carefully prepared and replaced with a new plastic (polyethylene) socket component. The procedure takes about 90 minutes and most patients stay in the hospital for one night; however, some total shoulder replacements can be performed as an outpatient depending on medical conditions and insurance. 
 
You can expect to be in a sling and pillow brace for six weeks following surgery. You will also work with a physical therapist on range of motion and strengthening exercises for about 3 months, which can be done in the Mid-America Orthopedics offices. Full use of the shoulder is not expected until 3 months following surgery. 
 

REVERSE TOTAL SHOULDER REPLACEMENT

Reverse total shoulder replacement is performed most typically for patients who suffer from arthritis of the shoulder due to a chronic rotator cuff tear. It can also be performed for irreparable rotator cuff tears and shoulder arthritis with significant bone loss. Patients will have a pre-operative CT scan and with the use of 3-D technology they will have a customized surgical plan. Dr. Strickland removes the diseased ball (humeral head) of the shoulder and replaces it with a short metal (cobalt chrome) stem and metal tray. The socket (glenoid) of the shoulder is carefully prepared and replaced with a metal (cobalt chrome) socket and ball component. A plastic (polyethylene) liner is then impacted into the metal tray on the humerus side. The procedure takes about 75 minutes and most patients stay in the hospital for one night. 
 
You can expect to be in a sling and pillow brace for six weeks following surgery. After 6 weeks in the brace, you will also work with a physical therapist on range of motion and strengthening exercises which can be done in the Mid-America Orthopedics offices. 
 

MIS ANTERIOR TOTAL HIP REPLACEMENT

The MIS anterior approach is a true minimally invasive procedure that utilizes a plane to go between the muscles and nerves, thus allowing for a faster recovery. The MIS anterior approach requires a special hospital table and is therefore not available at all hospitals. In addition, the incision is in the front (anterior) so patients who are significantly overweight may not be a candidate for this procedure (there can be an increased risk of infection).

Total hip replacement involves removing and replacing the deteriorated ball (femoral head) and socket (acetabulum) of the hip. Dr. Bhargava will remove the femoral head and the worn cartilage, bone spurs, and a few millimeters of bone from the end of the socket. This is then replaced with metal (titanium and cobalt chrome) with a plastic liner in between. The procedure takes about 90 minutes and you will need to stay in the hospital for two or three days.

You can expect to be up walking the day after surgery. You will also work with a physical therapist on range of motion and strengthening exercises for about six weeks. Time off of work varies significantly based on your work demands and your current abilities.

ANTERIOR-APPROACH HIP REPLACEMENT

This is an innovative, less invasive alternative to traditional hip replacement surgery. Many conventional hip replacement surgeries are performed with an incision to the lateral (side) or posterior (back) of the hip and thigh. Small tendons (short rotators) are detached to reach the hip joint and then re-attached later in the operation. This procedure typically requires strict precautions after surgery, such as limited hip motion for six to eight weeks. You must also limit flexing of the hip to no more than 60 to 90 degrees, which can make normal activities, like sitting in a chair or getting in a car, very difficult.

Anterior-approach total hip replacement minimizes pain and reduces recovery time. Because the surgeon can reach the hip joint from the front of the hip rather than from the side or back, the hip can be replaced without detaching muscle from the pelvis or femur.

Many surgeons are choosing this hip replacement technique because they believe it offers patients potential advantages that include:

  • Faster recovery time, because key muscles are not detached during the operation.
  • Fewer restrictions during recovery. Most patients have significantly greater mobility and range of motion following surgery.
  • Reduced scarring since the technique requires one relatively small incision.
  • Reduced need for pain medication.
  • Less time spent in rehabilitation.

Following the procedure, the patient is able to immediately bend the hip freely and bear full weight when it feels comfortable. Average recovery time for anterior-approach hip replacement surgery is two to eight weeks versus two to four months with conventional surgery.

MINI-OPEN HIP DEBRIDEMENT

Dr. Bhargava uses a minimally invasive anterior (front side) approach to remove bony prominence from the hip joint. This is indicated for patients with femoroacetabular impingement (hip pain and a bony prominence). Patients must not have significant hip arthritis. This is an outpatient procedure, but will require physical therapy and a period of non-weight bearing (crutches or a walker) assistance.

Risk of these surgeries can include, but is not limited to, infection, blood clots, knee stiffness, and/or nerve or vessel damage. These effects are minimal and Dr. Tarun Bhargava will discuss these with you prior to surgery.