Program Overview

Introduction to the Adult Reconstruction Fellowship

The fellowship is organized in block rotations, where fellows rotate with specific faculty at Memorial Hermann | Rockets Orthopedic Hospital (MHROH) and Memorial Hermann Memorial City (Mem City). The fellows participate in all phases of patient clinical care, including preoperative evaluation, planning, and follow-up.

Clinical Experience and Education

The program provides exposure to basic and complex primary and revision hip and knee replacement. The volume of periprosthetic fracture care sets the program apart, with the world's busiest trauma center located in the world's largest medical center. The fellows are trained in various approaches, including:

• Direct anterior
• Anterior-based muscle sparing
• Posterior hip approaches
• Subvastus and lateral parapatellar approach to the knee
• Mako robotic-assisted surgery for THA, TKA, UKA, and PFJ

The program also provides experience with a broad range of implant vendors, including:

• Stryker
• Smith & Nephew
• Depuy
• Zimmer Biomet
• Total Joint Orthopedics
• Conformis

Weekly Didactic Adult Reconstruction Conference

The conference is attended by all faculty, fellows, and residents on service, as well as the research team. The conference includes:

• Lectures
• Case presentations
• Journal club articles
• Research project updates

The fellows are expected to present several times throughout the year.

Clinical Hip Experience

The faculty provides a broad exposure to hip approaches, including:

• Direct anterior
• Anterior-based muscle sparing
• Mini-posterior and piriformis sparing approaches
• Mako robotic-assisted THA

The program also provides experience with complex conversion THA, including:

• Extended Trochanteric Osteotomy (ETO) for stem extraction
• Proximal femur osteotomies for complex dysplastic hips
• Management of instability and failed metal on metal hip arthroplasty
• Acetabular reconstruction using augments, allografts, jumbo cups, double cups, cup cage reconstruction, and custom implants

Clinical Knee Experience

The program provides primary knee arthroplasty experience, including:

• Conventional and Mako robotic-assisted surgery
• Measured resection and gap balancing techniques
• Cruciate-retaining and substitution
• UKA (medial, lateral, and patellofemoral) arthroplasty
• Post-traumatic arthritis with retained hardware

The program also provides knee revision experience, including:

• Management of large bone defects using metaphyseal fixation (sleeves and cones)
• Extensor mechanism reconstruction
• Staged surgery for PJI
• Periprosthetic TKA fractures with ORIF, revision, or distal femur replacements using press-fit and cemented techniques