Clinical Experience and Education

The fellowship is organized in block rotations in which the fellows rotate with specific faculty at Memorial Hermann Orthopedic & Spine Hospital (MHOSH) and Memorial Hermann Memorial City (Mem City).  The fellows participate in all phases of patient clinical care including preoperative evaluation, planning, and follow up.

While many programs provide exposure to basic and complex primary and revision hip and knee replacement, the volume of periprosthetic fracture care sets us apart.  With the world’s busiest trauma center located in the world’s largest medical center, the fellows leave our program well versed in the management of these complex cases.  In addition, as a tertiary referral center for a large geographic region, the fellow is exposed to a high volume of diverse revision experience.

The program is well balanced.  The fellows are trained in the direct anterior, the anterior based muscle sparing, and posterior hip approaches. The fellows will also have the opportunity to experience the subvastus and the lateral parapatellar approach to the knee.  Mako robotic-assisted surgery for THA, TKA, UKA, and PFJ are also done by several of our faculty members.  Experience a broad range of implant vendors including Stryker, Smith & Nephew, Depuy, Zimmer Biomet, Total Joint Orthopedics, and Conformis.

Our weekly didactic Adult Reconstruction Conference is attended by all faculty, fellows, and residents on service as well as our research team.  Lectures, case presentations, and journal club articles are presented and research project updates are discussed.  The fellows are expected to present several times throughout the year.

Clinical Hip Experience

The faculty provide a broad exposure to hip approaches including the direct anterior, the anterior based muscle sparing, and the mini-posterior and piriformis sparing approaches.  In addition, the fellow will also have exposure to Mako robotic-assisted THA.

The large referral volume of post-traumatic arthritis with retained acetabular and femoral hardware provides another unique experience with complex conversion THA.

Hip revision techniques include experience with Extended Trochanteric Osteotomy (ETO) for stem extraction and other proximal femur osteotomies for complex dysplastic hips, management of instability and failed metal on metal hip arthroplasty.  Exposure to acetabular reconstruction using augments, allografts, jumbo cups, double cups, cup cage reconstruction, and custom implants.

Clinical Knee Experience

Primary knee arthroplasty experience includes exposure to both conventional and Mako robotic-assisted surgery, measured resection, and gap balancing techniques, cruciate-retaining and substitution, UKA (medial, lateral, and patellofemoral) arthroplasty, and post-traumatic arthritis with retained hardware.

Knee revision experience includes management of large bone defects using metaphyseal fixation (sleeves and cones), extensor mechanism reconstruction, and staged surgery for PJI.

Unique to the program is the experience obtained from managing a large volume of periprosthetic TKA fractures with ORIF, revision, or distal femur replacements using press-fit and cemented techniques.