I'm Candidate for Joint Replacement. What Do I Need to Know?

The goal of Infirmary Health’s Orthopaedic Institute is to provide comprehensive orthopaedic services to the Gulf Coast Region. Infirmary Health has invested in many the newest technologies, providing our hospitals with some of the most advanced surgical techniques for orthopaedics. These technologies offer improved patient outcomes, increased movement and shortened recovery time. 

Additionally, Infirmary Health’s partnership with Gulf Orthopaedics is bringing orthopaedic practice locations to new areas in Mobile and Baldwin counties. Gulf Orthopedics’ experienced and trusted physicians provide the latest, most cutting-edge surgical and non-surgical treatment methods, specializing in trauma and sports medicine, shoulder replacement, hip replacement, knee replacement and foot-ankle treatment. 

Michael Granberry, MD, board-certified orthopaedic surgeon with Gulf Orthopaedics and the director of Infirmary Health’s Orthopaedic Institute, joins us to discuss joint replacements, how to choose the right provider and facility for your procedure and the growth in orthopaedics for Infirmary Health.

As the FIRST CHOICE for healthcare in the Gulf Coast Region, Infirmary Health is here for you, here for LIFE.
I'm Candidate for Joint Replacement. What Do I Need to Know?
Featuring:
Michael Granberry, M.D.
Dr. Michael Granberry is an area leader in orthopaedic surgery, specializing in the treatment of the hip and knee, with more than 30 years of trusted experience. Dr. Granberry received his medical degree from the University of Texas – Galveston and completed his residency with Baylor College of Medicine. He went on to complete a fellowship in joint replacement with the University of California – San Francisco. Orthopaedics is a family tradition for Dr. Granberry as both his father and his brother have also practiced as orthopaedic surgeons.

Dr. Granberry practices with the team at Gulf Orthopaedics. Together, these experienced and trusted physicians provide the latest, most cutting-edge surgical and non-surgical treatment methods, specializing in trauma, sports medicine, shoulder replacement, hip replacement, knee replacement and foot-ankle treatment.
Transcription:

Joey Wahler (Host): The goal of Infirmary Health's Orthopaedic Institute is to provide comprehensive orthopedic services to the Gulf Coast Region. Infirmary Health is invested in many of the newest technologies, providing hospitals with advanced surgical techniques for orthopedics, which offer improved patient outcomes and recovery times. And Infirmary Health's partnership with Gulf Orthopedics is bringing orthopedic practice locations to new areas in Mobile and Baldwin counties. So we're discussing joint replacements, choosing the right surgeon and facility for your procedure and the growth in orthopedics for Infirmary Health.

This is LIFE Cast, a podcast sponsored by Infirmary Health. Thanks for listening. I'm Joey Wahler. Our guest, Dr. Michael Granberry, a board-certified orthopedic surgeon with Gulf Orthopaedics and Director of Infirmary Health's Orthopaedic Institute. Dr. Granberry, thanks for joining us. So first off, what are the most common types of joint replacement procedures that you do?

Dr Michael Granberry: So there are obviously replacements for many of the joints in the body, the most common being the hip replacement and the knee replacement, followed probably by the shoulder replacement, which has gotten more popular recently. I, myself, concentrate on total knees and total hips.

Joey Wahler (Host): Gotcha. For those that have symptoms, be it pain or what have you, when generally would a patient be a candidate for joint replacement surgery?

Dr Michael Granberry: So generally, joint replacement surgery is done for arthritic problems with the joint where the joint itself has started to wear out either through natural attrition and age or due to some other Problem with the body like rheumatoid arthritis or some of the other inflammatory diseases that have more ranging influence on the body than just the joints. But the vast majority are simple wear and tear type degenerative processes, which develop into pain and stiffness and swelling of the joint over time. We obviously try and treat conservatively to start with. But when conservative treatment doesn't alleviate the symptoms or allow the needed activities, then we consider total joint replacement.

Joey Wahler (Host): And so that degeneration that you mentioned in a joint, is part of that genetic? Do some of us have more miles, so to speak, on those joints than others are born with?

Dr Michael Granberry: Your genetics have a lot to do with your body, how tall you are, what color your hair is and all that kind of stuff. But there's a lot more things that the DNA codes for, that's where genetics comes from. And the composition of your bone, the composition of your joints and the cartilage in your joints particularly are managed a lot by your collagen. So that's one of the basic building blocks that the body uses to build your bones and joints and skin tissues and such. And some people are not as resistant to damage as other people are. And so, yes, it definitely can run in families where they develop arthritis earlier rather than later.

Joey Wahler (Host): So for the procedures that you mentioned you do the most, give us an idea in a nutshell of what's involved in that type of surgery.

Dr Michael Granberry: Most of the surgery I do is for, again, total hips and total knees for people who are having trouble walking or sometimes even sleeping at night, the joint can hurt. And so, the surgery typically is about an hour where we replace the surfaces of the bones, where the cartilage rubs together with the other cartilage, and replace those surfaces with artificial materials and then a rehab program after to retrain your joint and re-establish your gait pattern, hoping to alleviate the pain and get people back to the activities that they want to perform.

Joey Wahler (Host): And what advanced or minimally invasive technologies do Infirmary Health hospitals offer for joint replacement surgery?

Dr Michael Granberry: We offer rapid recovery, rehabilitation programs involving how we do the medications. We do try and minimize incisions, although putting the components in the correct position and rebalancing the ligaments correctly is the most important part of the surgery. And there have been rapid developments recently in computerized assistance in making the cuts and balancing the joints. I myself use two different systems with the knees. One is a small accelerometer-based computerized system to help determine where the cuts are on the top of the shin bone and the bottom of the thigh bone. In addition, the Infirmary has recently got the Velys computerized navigation robot that actually helps assist and hold the saw in the correct position after measuring where the bones are to make these cuts.

Joey Wahler (Host): Well, you lead me beautifully there, doc, because I was going to ask you next about robotic surgery as it applies to what you do. We hear so much about it in almost all walks of medicine these days, and that really helps when it comes to being more precise, doesn't it? Which is something you just touched on as well.

Dr Michael Granberry: Yeah, the precision of the cuts and the balance of the ligaments is the most important part in this new robotic system. Using computers and navigation does help maximize that, particularly for knees and hips, knees that perhaps aren't exactly correct, you know, a little bit out of the ordinary. So they don't really lend themselves to the standard orientation systems that we use.

Joey Wahler (Host): Gotcha. Now after joint replacement, what is, if there is such a thing, a patient's typical recovery time?

Dr Michael Granberry: Typically, nowadays, people either go home that afternoon or the next day after surgery, I would say more than half the patients are still staying overnight. But as we get better and better, going home the same day is going to become kind of the average, if not the standard. So there's therapy for up to six weeks, usually starting at home for a while and then do an outpatient therapy. People are allowed to weight bear on their joints the same day and we actually encourage getting up the same day of surgery and walking around. But we taper off the pain medications and reintegrate them into life. I let people start chipping and putting on the golf course at two weeks. We have to let the skin heal before we do any kind of emerging type activities in the pool or whatever. But I encourage people to get back to their lifestyle and what they want to do with a few protective motion, preventative things here for a while, particularly around hips to keep them from dislocating.

Joey Wahler (Host): And that chipping and putting plateau that you mentioned, that's important to a lot of people now, is it?

Dr Michael Granberry: You know, my standard patient is retired, right? They're typically older and a lot of their self-worth is getting out on the course several times a week with their buddies and getting around. And the worst they do is go out with their foursome and drop off the edge of the green and chip up and putt, then progress. It's really three months before you do a really hard drive, but you can progress through that between chipping and putting, and I tell them, "It's time to get your short game in order."

Joey Wahler (Host): No more excuses. I love it. They're not so much worried about walking as they are about when they can hop in the car and get up and down the course, right?

Dr Michael Granberry: Yes, sir.

Joey Wahler (Host): So a few other things, please. If someone needs joint replacement, what should they consider when choosing their provider and the facility for which that doctor works?

Dr Michael Granberry: There's been several studies over the last 10 years, really demonstrating significantly that going to an experienced joint surgeon, the joint surgeon specifically does more than a hundred cases a year and going to a high-volume joint center like the Infirmary Hospital, really maximizes your chance of getting a good and excellent result, particularly the surgeon of greater than a hundred a year, and what they call a high-volume hospital for doing total joints. One that's got a joint program, perhaps has a dedicated system for managing these postoperative and preoperative patients for this surgery.

Joey Wahler (Host): So experience counts, right?

Dr Michael Granberry: Absolutely. It's been demonstrated several times.

Joey Wahler (Host): And speaking of which, tell us a little bit more then about Infirmary Health's growth in this area of orthopedics in general, and also how Gulf Orthopaedics is growing to serve the Gulf Coast region in general.

Dr Michael Granberry: So last year during 2021, we formed Gulf Orthopaedics and partnered with the Infirmary to provide orthopedic services here. I, myself, almost all my surgery is done at the Infirmary. And last year, I also started being the director of this institution where we are putting in the processes to have everybody on the same page, starting from preoperative all the way through rehabilitation for these total joints, to have the whole program developed. And that's what I'm in the midst of doing currently.

We've also invested in the correct technology in the hospital, in the surgery area for both the navigation systems, special tables and fluoroscopic instruments for doing our total hips, really to keep us up on the forefront of current technology and practice.

Joey Wahler (Host): And so, doctor, in summary, what's your main message here for those that may be considering joint replacement?

Dr Michael Granberry: Again, be sure that you pick a surgeon that does a lot of these cases. Ask your friends, ask your buddies because it's a fairly common procedure nowadays, and you're going to find somebody that you know, that's had a good response with a surgeon and a hospital and institution. We are the biggest hospital in town here, and we do a lot of surgery and it shows in our results.

Joey Wahler (Host): I'm sure it does. Well, folks, we trust you're now more familiar with joint replacement and what Infirmary Health and Gulf Coast Orthopaedics can offer in that area. He can't help you with your golf game per se, but he can help you get back out on the course with a healthier body, right? Dr. Michael Granberry, thanks again so much.

Dr Michael Granberry: Thank you very much.

Joey Wahler (Host): And as the first choice for healthcare in the Gulf Coast Region, Infirmary Health is here for you, here for life. To learn more about their Orthopedic Institute, please visit infirmaryhealth.org . That's infirmaryhealth.org. If you found this podcast helpful, please do share it on your social media. And thanks for listening to LIFE Cast, a podcast sponsored by Infirmary Health.

Hoping your health is good health, I'm Joey Wahler.