As a patient, you may hear these terms and not know what they mean. Simply stated, Autograft is tissue of your own used to augment or replace lost or damaged tissue. This can be utilized for bone grafts or ligament reconstruction. Allograft is tissue used from another person. Xenograft is tissue used from another species. In recent years, Allograft tissue has become more popular for ligament reconstruction. The advantage is primarily “donor site morbidity” or problems inherent in borrowing the tissue. This in real fact is negligible and problems can…

The last 10 years has seen the development of Computer Aided Navigation for Total Knee Replacement. This has been advertised as “more accurate” but there is little evidence that this is the case. Knee replacement which is instrumented off of the center of the tibia and the center of the femur is highly accurate and does not rely on pins which are visualized by the computer aided process from across the room. In addition, because the pins are close to the knee itself, any tiny error introduced by bumping a…

The Anterior Approach is not new. It was described in the 1800’s by a German Surgeon! In the last 5 or 10 years, there has been a push towards Anterior Approach Total Hip Replacement.  It is my feeling that this was done primarily for marketing purposes. When the first total hips were implanted, Sir John Charnley realized that to minimize wear of the plastic liner in a total hip, the ideal head diameter would be 28 mm.  This is quite small.  The smaller the head, the more likely dislocation becomes following…

Individual Practice versus Large Group Practice ​As “Health Insurance Companies” have become more powerful and controlling over the years, physicians have banded together often to theoretically lower their overhead costs.  I have enough experience with this to know that Big is not Better.  Large groups have clout, but they typically use answering services and complex phone tree messaging to direct calls.  This makes it difficult for patients to reach any Physician, let alone their own.  They often speak to Nurse Practitioners or Physician Assistants instead of their own Physician.  Only…