South Carolina Hip Preservation Center

Dr. Gross is a leader in the nation in hip resurfacing, as well as specializing in hip resurfacing, minimally invasive hip replacement, MRI guidance for total and partial knee replacement, as well as revision surgery.

The Hip Resurfacing Advantage

It is the method that reconstructs the damaged hip closest to a natural hip. We remove only the surface of the joint (femoral head and acetabulum) and replace these with new durable metal surfaces. This leaves most of the bone of your original hip in place. The normal biomechanical function of the hip remains near normal. We do this with a minimally invasive 4-5 inch posterior approach that allows rapid recovery to full normal muscle function. After the healing process there are no restrictions on activity. A standard total hip replacement can’t compare.

Advantages are summarized:

• Full athletic activity without restrictions
• No hip instability (dislocations)
• Bone preservation
• No stem related thigh pain
• Longer lasting

Why Minimally Invasive Hip Replacement?

When hip replacement is performed through a minimally invasive 3-4inch posterior approach the hospital stay is minimized and the recovery is rapid. Transfusion is almost never required. Pain control is excellent. In certain patients hip resurfacing is not possible and this may be the best option.

Why MRI Guidance Knee Replacement (Total and Partial)?

Knee replacement can be either total (all surfaces) or partial (one compartment only). Alignment of implants is critical to successful function. Guides can be manufactured from preoperative 3D MRI scans to assist the surgeon in accurately placing these implants.

Why Revision Surgery?

Revision surgery is performed when the first joint replacement fails. The causes of joint replacement failure vary, as do the surgical corrections. This is much more complex than primary (first time) surgery. Our published success rate with revision of hip resurfacing is nearly the same as for primary surgery. Others have published failure rates as high as 50%.

South Carolina Joint Replacement Center | Midland Orthopaedics recently merged with Columbia Neurosurgery to create Midlands Orthopaedics and Neurosurgery. Our goal is still the same: to provide cutting-edge treatments to patients with hip and knee pain.

The latest options in hip surgery and knee replacement

• Hip resurfacing
• Total hip replacement
• Revision surgery for hip resurfacing and replacement
• Total knee replacement
• Partial knee replacement
• Revision surgery for total and partial knee replacement

A unique combination of personal attention and advanced surgical techniques

We offer patients a unique combination of personal attention in a private practice setting combined with the most advanced surgical techniques that are not even available in many university centers. As leaders in new technology, we have a research-based practice with the goal of constantly advancing treatments. If you are a person that is interested in conservative treatments that have a long track record, this is not the right place for you. Patients who wish to take advantage of the latest treatments must also be somewhat more risk-tolerant because sometimes there are unforeseen consequences of new technology. We do not train residents or fellows here, so you are certain to have your operation performed by Dr. Gross personally.

Extensive education to keep our patients well informed

We think it is important that our patients are well informed, therefore, we offer extensive education on this website as well as in our office and in the hospital. Our staff prides itself in providing personalized attention that is lacking in many medical encounters today. In order to make the entire experience of joint surgery as pleasant as possible, we have developed a comprehensive blood management technique, a multimodal pain management program, as well as minimally invasive surgical techniques. Using all of these methods in combination allows us to almost completely avoid transfusions, get patients walking immediately after surgery, and control pain well enough to allow most patients to have joint replacement surgery as an outpatient procedure. You will be sent home (local patients) or stay in a hotel for 1-2 nights before traveling home (out-of-area patients). Those who still require hospital admission usually stay only one night.

The postoperative recovery protocol varies depending on several patient-specific factors. The most important is bone density. If the DEXA scan done preoperatively indicates good bone density the “fast” protocol is followed. Patients stay mostly at home with light activities for 3-5 days until narcotics are no longer required. They are then allowed to drive. At that time we also start a slowly progressive walking program with crutches for 1-2 weeks, then a cane for 1-2 weeks. At 1-2 weeks people typically return to desk work (sedentary), by 6 weeks most people walk one mile at a time and can resume work that requires moderate walking. Impact activities (running, jumping), heavy lifting ( >50lbs), extreme bending (deep squats), or fall risk activities (ladders, bikes) are to be avoided until 90% of healing has occurred by 6 months postop. Therefore, heavy physical work and sports can be resumed at 6 months.

Many patients believe that they heal faster or better than the “average” and try to resume activities faster than I recommend. This sometimes leads to a suboptimal result. I strongly recommend limited activity as detailed above for 6 months. After that full unrestricted activity can be resumed with HRA. By 1 year the hip should not result in any limitations except occasionally distance running.

In general, HRA patients are able to resume all desired activities including unlimited sports. However, not all patients are able to satisfactorily resume distance running. Many patients are able to perform triathlons and marathons and even ultramarathons normally, but some do require a modified return.

The success of our model is proven by the fact that nearly 70% of our patients are willing to travel from other states and occasionally even from other countries to be treated here. Within days from their surgery, they are traveling back across the country to their homes. Half of the remaining in-state patients come from locations outside the Columbia metro area. Most famous university centers cannot make this claim. The access to information via the Internet has allowed this to occur. Patients are now empowered to inform themselves independently of their local doctors and they increasingly question the standard treatment options that may not suit their needs and desires. This is why we make extensive information available on this website. But don’t take it from us. Numerous independent reports (that we are unable to screen) can be found online on such sites as Surface Hippy attesting to our patient's satisfaction.

The surgeon you choose drives the quality of the result

The surgeon you choose is the most important factor that determines the chance of success. The type or brand of implant, the hospital used and various other factors are important, but of much less consequence. But these choices are all driven by the surgeon you choose. For example, I have never used the recalled DePuy ASR or Zimmer Durom implants. Insist on seeing written published data for an individual surgeon, not just vague statements of chances of success. At a teaching center, it is also important to ask who will be doing the operation.

If you wish to be evaluated for surgery, this can be accomplished by submitting information to us online and by mail. When we receive this information, Dr. Gross will call you to discuss your case. We can make all pre-op arrangements remotely. You can then travel here, and meet our staff and Dr. Gross a day prior to your surgical procedure. Most patients are able to travel home within a few days.

Our patients come from all over the United States. We are not limited to serving the southeast. Here is a sample of the regions our patients came from since 2005.

Do our competitors post their results online?

The most important factor in achieving a successful result is the surgeon’s skill. You can only assess this from published data. We publish our results on this website and in scientific journals (see all of my publications).

99% 15-year implant survivorship in 5500 cases using the Biomet uncemented resurfacing system (99.3% in men and 98.3% in women)

These are results in all comers, not just selected lowest-risk patients (men with osteoarthritis). This compares favorably with the recent National Joint Registry report from Great Britain where a similar 92% overall 8–10-year survivorship is reported for both the cemented Biomet and BHR hip resurfacing systems. It also compares favorably to benchmark data of all three major joint registries (British, Swedish, and Australian) for THR where the mean patient age is 70 and implant survivorship sits at approximately 95% for 10 years. For younger patients, 10-year benchmark data for THR falls off to a dismal 80% at 10 years for patients under 50 years of age.

Summary

Outpatient surgery?

We have pioneered outpatient joint replacement surgery at Midlands Orthopaedics and Neurosurgery. We began in 2012 and have performed thousands of joint replacements in the last 10 years. We have now perfected this to the point that most of my joint replacements are done as outpatient procedures. Local patients go home several hours after the operation and follow up with me in the office 1 week later. Out-of-area patients go to a hotel instead where I see them the next morning before they begin their drive home. Only patients with certain serious comorbidities or those with uncooperative insurance plans are still done at the hospital.

Most patients who have had one procedure done at the hospital and another as an outpatient, prefer the latter. The outpatient approach is safe, convenient, friendly, less costly, and avoids exposure to hospital infections. One requirement to qualify for outpatient surgery is to bring a capable and responsible caretaker (family or close friend at least 18 years of age) with you.

updated 2/2023

Dedicated to the preservation of the natural function of the hip

Located in Columbia, South Carolina, the South Carolina Hip Preservation Center provides cutting-edge treatments such as minimally invasive resurfacing to patients with hip and knee pain.

We offer the latest options in hip surgery and knee replacement, a unique combination of personal attention and advanced surgical techniques, extensive education to keep our patients well informed and a board certified, orthopaedic surgeon who take advantage of the latest treatments and has published track record as one of the best in the world for hip resurfacing and joint replacements.

Schedule your consultation with Dr. Thomas P. Gross today - (803) 256-4107.