Hampton Roads Orthopaedic and Sports Medicine
In 2006, Dr. Anthony Carter made history when he introduced the muscle-sparing anterior approach hip replacement surgery to Hampton Roads. Dr. Carter, an orthopaedic surgeon with Hampton Roads Orthopaedic and Sports Medicine, learned the procedure – known in layman’s circles as the “jiffy hip” – from Dr. Joel Matta of Santa Monica, California. Dr. Matta introduced the procedure in this country, after learning it from French surgeon Dr. Thierry Judet. Dr. Carter remembers being criticized at the time by surgeons outside his practice: “They were saying that there’d be too high a complication rate, or that there was no proof that it would produce better results, all kinds of things.”
But he stuck with it, he says, “because I saw the benefits of it. My patients were doing remarkably well. I love it when a patient comes back after surgery doing so much better so quickly.” As he performed more of these surgeries, word of his results spread and his patient load grew and grew. That has been gratifying, Dr. Carter says, “but more importantly, many surgeons have adopted the procedure because it’s so much better for their patients. It’s changed the landscape around here.”
He estimates he’s done more than four thousand of these surgeries, and now performs them for all of his hip replacement patients – at a rate of 650 per year.
In December of 2012, he introduced a new option for knee replacement patients: the 3-D robotic arm-driven MAKOplasty. “It helps with positioning primarily because we’re using the robotic arm to assist us,” he says, “and it puts the components in very precisely. With the knee resurfacing for the partial knee replacements, we can take away only what’s diseased, so we can preserve all the ligaments and the knee tends to feel much more natural. Recovery is much akin to what we see with the hips; it’s cutting recovery time in half. It’s been really exciting.”
Dr. Carter credits the comprehensive blood management program he instituted for some of his successful outcomes: “By optimizing patients’ hemoglobin preoperatively we decrease the risk of transfusion.”
Dr. Carter says the next evolution is to ensure these procedures can be safely and routinely done in the outpatient setting. “It’s better for the patients, and cuts costs all the way around,” he says. Of course, it will also necessitate more effective pain management, and that’s just one component of his current research. He’s also involved in various research projects on hip and knee replacements involving the use of ceramic components, as well as a tourniquet-less knee replacement. And there’s the promise of a new knee prosthesis with longer life and better function, and a study out of Massachusetts General about lowering the dislocation rates of hip replacement prostheses.
He’s eager to learn, and then to share these innovations, and travels frequently around the country and the world to teach them to other orthopaedists. His next stop is Bangkok, where he’ll address a group of surgeons there.
Dr. Carter completed his medical training at Boston University, and his internship and residency programs at NYU/Bellevue Medical Center. He was Board certified in orthopaedic surgery in 1994, and after three years treating patients at Langley Air Force Base, joined Hampton Roads Orthopaedic and Sport Medicine.
While he’s excited about innovations in his field, Dr. Carter remains judicious. “There’s always a way to do things better,” he says, “and I always want to stay ahead of the curve – but always with my eyes wide open.”