The UCSF Total Joint team performs some 800 hip and knee procedures each year. Patients come to us from across North American and around the world.We believe that experience matters, and customized patient care also matters. Thus, our goal is to match the patients problem with the appropriate expertise. Our volume of patients and surgical procedures is high enough that whether it’s the latest diagnostic tool, or new techniques, or technology (new approaches, new materials and implants, computer navigation, advanced MRI imaging, gait analysis and human performance evaluations) that provide excellent results for a particular joint, our surgeons are international experts that have published extensively on their experience and insights (reference CV’s) and have the skill, knowledge, and experience to select the approach that is right for each patient.
While the hip and knee are by far the most commonly replaced joints, our physicians also have in-depth experience with the shoulder, elbow, hand, ankle, and other joints. We apply the latest technology and techniques for conservative approaches to joint reconstruction, such as arthroscopy, partial replacements, cartilage grafts and bone grafts, and minimally invasive approaches. Some of these conservative techniques are appropriate for younger people, and people with specific joint injuries.
Your prescription and plan for treatment should be individualized to your needs. Part of that planning includes a personalized discharge plan designed allow return to home and daily life as quickly as it is medically safe. As recovery continues in the months following the surgery, complication rates are low, outcomes are excellent, and patient satisfaction is high.
There are many non-surgical treatments for various types of arthritis. Particularly, in certain forms of inflammatory arthritis such as rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis there are newer disease modifying drugs that can make substantial improvements in quality of life for patients suffering from these conditions. At the Orthopaedic Institute, we work with the Division of Rheumatology to support a rheumatology clinic that is staffed by experts in the conditions and medications. Prosthetics, orthotics, and various types of shoe modifications, braces, and other supports are part of comprehensive treatment for some conditions.
When medication and physical therapy are no longer controlling your joint pain, you may have a condition that warrants surgical treatment. Our first goal is always joint preservation. In some situations, hip arthroscopy is appropriate to treat a cartilage tear (labral tear). In other situations, removal of impinging bone arthroscopically or through a “mini-open” procedure is considered (hip impingement). Hip arthroscopy is an outpatient procedure that uses a fiber optic light to look inside the hip joint, allowing repair or removal of torn cartilage and removal of impinging bone spurs. Other hip impingement procedures include small incisions to reshape the ball of the hip and the hip socket, restoring more normal movement to the joint and relieving pain.
Certain congenital or developmental abnormalities in young people (Developmental or congenital hip dysplasia) may benefit from an osteotomy to correct the abnormal shape of the hip socket and provide more coverage of the ball of the hip by the socket.
When joint degeneration, stiffness, and pain are more advanced and cartilage is irreversibly lost, then joint replacement may be an effective option for relieving your pain and improving your quality of life. Until recently, joint replacement was reserved for patients age 60-75. Today, more people in their 50s and even younger are having knee and hip replacements, not because their joints are being damaged faster, but because of improvements in implant technology and surgical technique. While the indication for joint replacement remains advanced joint deterioration and pain resistant to medical management, patients are now encouraged to proceed before becoming medically deconditioned. Earlier intervention can result in a more successful and complete recovery.
Advances in anesthetic techniques (nerve blocks and regional anesthesia, less emphasis on narcotics) and rehabilitation make it possible to perform joint replacement procedures with less pain and physiologic stress. Controlling and minimizing pain and nausea, as well as rapidly advancing motion, mobilization, and therapy enhances the success of the surgical procedure and the satisfaction of the patient.
The UCSF Arthritis and Joint Replacement Center provides joint treatment customized to your age, your condition and your lifestyle. Our joint specialists are experienced in treating joint problems resulting from a variety of chronic or traumatic conditions. A patient educator and a patient advocate ensure that patients and their families are fully informed and that patient care is personalized, comprehensive and convenient.