JOHN M. DELGADO, M.D.
Orthopedic Trauma and Joint Replacement Surgery
Fellow of the American Academy of Orthopedic Surgeons
Excellence in Orthopedic Care.
My primary goal as an orthopedic surgeon is to maximize my patient's level of functioning and therefore their quality of life.
My specialties include but not limited to hip, pelvis, acetabulum, knee, and ankle.
Anterior Hip Replacement
Anterior hip replacement or arthroplasty is a surgical procedure in which the hip joint is replaced using the anterior approach. This approach is minimally invasive using a small incision (8cm.) in the front of the upper thigh, does not cut through any muscle, and has multiple benefits.
The anterior approach utilizes a natural plane between two separate muscles rather than splitting through the center or the gluteus muscle as in the posterior approach. Thus, tendons and muscles around the hip are not cut but spared which leads to less pain, quicker recovery, shorter hospital stay, lower dislocation risk, and decreased limp when
compared to other approaches.
During the anterior approach, the patient is placed in a supine position which allows for the use of live fluoroscopic imaging, which ensures accurate prosthetic positioning.
Complex Hip Replacement
A hip replacement is considered complex when the patient presents a past history of trauma to the hip or pelvic region, is born with certain congenital deformities such as hip dysplasia and also hip replacement in the setting of an acute traumatic acetabular injury.
Total and Partial Hip Replacement
A total hip replacement or total hip arthroplasty involves the removal of damaged bone and cartilage in which the head of the femur and the acetabulum, also known as hip socket, are replaced with a prosthetic component.
A partial hip replacement or hip hemiarthroplasty is typically done for elderly people who present a hip fracture. In these types of cases, the broken femoral head is replaced with the prosthetic component to restore ambulation.
Revision Hip Replacement
A revision hip replacement is performed to correct a failure of a previous hip replacement. Patients who need this type of procedure usually present with implant wear, dislocation, infection, periprosthetic fracture or fracture around the implant previously placed.
This type of surgery is more complex than primary hip replacement surgery.
Pelvic and Acetabular Fractures
Pelvic fractures can occur in young individuals as a result of a serious traumatic injury such as a car or motorcycle accident. These fractures can be of stable and unstable nature.
Unstable pelvic fractures can result in substantial deformity, pain, disability, hemorrhage, nerve and blood vessel damage, bowel and bladder damage, and even death. These typically require surgical treatment by a specialist who has trained in pelvic fracture surgery.
On the other hand, stable pelvic fractures can be treated non-operatively. Pelvic fractures can also occur in elderly individuals with osteoporosis as the
result of a low energy accident such as a ground-level fall, while these type of fractures can be painful, they are usually stable and can be treated non-operatively.
Acetabular fractures occur in a region of the pelvis that forms the socket of the hip joint. These can result in damage to the articular cartilage of the hip, which can lead to the development of arthritis, pain, and disability. These often require surgical treatment.
Total, Partial, and Revision Knee Replacement
Partial knee replacement or unicompartmental knee arthroplasty is a surgical procedure that involves only one part of the knee. The bone and cartilage of the affected knee compartment are resurfaced and replaced with a prosthetic component.
The average hospital stay for this procedure is between 0-1 day. This type of procedure can be done as an outpatient but it can vary from person to person.
Total knee replacement or total knee arthroplasty is a surgical procedure that involves the entire knee joint. The bone and cartilage of all three
compartments of the knee are resurfaced and replaced with a prosthetic joint.
The average hospital stay for this procedure is between 2-3 days but it can vary from person to person.
Revision Knee Replacement or Revision Knee Arthroplasty is a surgical procedure intended to correct a failure of a prior knee replacement. This procedure is more complex than the primary knee replacement and aims to remove the original prosthetic components that failed in exchange for new ones.
The average hospital length of stay for this procedure is 2-3 days but it can also vary from person to person.
Upper and Lower Extremity Fractures
These include any fractures of the upper extremity such as shoulder, humerus, radius, ulna, and wrist; as well as those of the lower extremity (femur, tibia, fibula, ankle, and foot).
These types of fractures can occur for a variety of reasons such as injury.
In the upper extremity, depending on the severity of the fracture, the bone that is injured, and the amount of fracture deformity, both operative and non-operative forms of treatment are considered.
In the lower extremity, depending on where the injury occurs, the fractures can be treated operatively and non-operatively. In the femur,
fractures are typically treated operatively with minimally invasive intramedullary rod surgery due to the need to restore ambulation.
Many elderly patients experience fractures at the upper end of the femur which require surgical treatment to prevent loss of ambulation and being bed bound.
Stable fractures of the leg can typically be treated non-surgically with the use of casts and braces.
Complex Articular Fractures
These include fractures of the joint such as glenoid fractures (shoulder), distal humerus and proximal ulna and radius (elbow), distal ulna and radius (wrist), acetabular fractures (hip), femoral head fractures, distal femur and tibia plateau fractures (knee), distal tibia pilon/plafond (ankle), and talus, calcaneus (hind foot).
These fractures occur when there is a break at the end of the bone that involves the articular cartilage. Damage to the articular cartilage can lead to post-traumatic arthritis and severe disability. These injuries require special attention and, typically, surgical treatment is required to restore precise anatomy to the joint to minimize the risk of future arthritis.