Joint Replacement Done Right


When you need a new hip or knee, choose a surgeon with demonstrated mastery

Lorraine Tudor, a sprightly octogenarian who lives in Arizona, needed a total left hip replacement, and she could have chosen any number of hospitals in her area to have it done. Instead, she got on the phone, tracked down the surgeon who had replaced her right knee and right hip in Arizona years before and then flew all the way to Pensacola so that Brett R. Smith, M.D., now co-director of Baptist Health Care’s Andrews Institute Total Joint Center, could do her surgery.

Why? Because for Tudor, a retired nurse, being confident that this operation would be done correctly was well worth the extra cost of travel. “You do what works, and Dr. Smith did a beautiful job on me before,” she says. “So it was a foregone conclusion that it had to be him. In eight years of practice he’s never had a patient develop an infection and his expertise commands excellence in the OR and in after-care. I wouldn’t dream of choosing anyone else.

Dr. Smith, who was on a fellowship at the Institute for Bone and Joint Disorders in Phoenix when he did Tudor’s earlier procedure, says it’s not unusual for patients to travel for such surgeries, because getting it done right the first time is critical. “The success rate for first-time total hip and knee replacements far exceeds that of repeat surgeries,” he says.

Another key is choosing a surgeon who does a lot of joint replacements. “Research shows that those who do fewer than 30 a year don’t have as good a track record as those who do more, “says Dr. Smith. He performs hundreds of these procedures a year, and so do his colleagues at the Andrews Institute. And he says that about half of his surgeries involve fixing problems that have developed following previous replacement operations done elsewhere.

That’s something you want to avoid. “With every additional surgery it becomes necessary to remove more bone, which can lead to fractures or loss of function,” says Dr. Smith. “Plus, there is more scar tissue, which can cause stiffness and loss of motion.

Prospects are much brighter with first-time replacements when they’re done properly. “After a successful first hip or knee replacement, the activities patients can return to are unlimited, “Dr. Smith says. “They include walking, swimming, cycling, golf, tennis, aerobic conditioning — almost anything one wishes to do.

I cannot think of anything at all that he could have done better,” says Tudor. “You judge the success of an operation based on function and pain. I had a lot of pain before the surgery and I have no pain now. I go shopping, I travel and I am grateful to say that I’m an active 80-year-old woman. In my mind, I’m 35!


To schedule an appointment to discuss joint-replacement surgery, call 850.916.8700.