Frank Gottschalk, M.D.
For people with severe hip or knee damage, most often from years of arthritis, joint replacement may be the best option. Those patients are Frank Gottschalk, M.D.’s specialty. He’s a Professor of Orthopaedic Surgery who has served patients at UT Southwestern Medical Center since 1984. His practice focuses on reconstructive hip and knee surgery, osteotomies (realigning bone), and amputations.
Our hip replacement technique allows for easier recuperation, with most patients back on their feet either the same day or the next day.”
The hip joint is buried deep within muscle and other tissue, and reaching it with a minimum of damage to those tissues has long been a challenge for surgeons. For hip replacement surgery, Dr. Gottschalk uses an innovative technique, a modified anterolateral approach (also called modified Watson-Jones) that is less damaging than most other methods. Because he operates from the front of the leg, his incision doesn’t disturb muscles behind the hip. That means less risk of dislocation. His technique also minimizes damage to hip abductors (muscles that pull the leg outward), which allows for shorter recovery times.
“We don’t cut the muscle, and we try to preserve its nerve supply,” Dr. Gottschalk says.
He also brings a less invasive approach to knee replacement, making a short incision that avoids splitting muscle. Dr. Gottschalk says the majority of his patients requiring this procedure have end-stage osteoarthritis of the knee, are typically over the age of 45, and have not benefited from most forms of non-operative care. If needed, he can perform knee replacement surgery on both knees at the same time.
Dr. Gottschalk uses a hip implant from Switzerland, one with a rough surface that allows the bone literally to grow onto and merge with it. These implants avoid the use of bone cement, and they seldom loosen or need to be replaced. They are effective for patients with arthritis, as well as individuals with some forms of hip fracture.
When it comes to amputation, Dr. Gottschalk emphasizes a crucial step – anchoring muscle to bone. Normally, muscles anchor to bone on both ends, so that when the muscle tightens it pulls on the bone and moves it.
Dr. Gottschalk and his colleagues at UTSW have long taught fellow surgeons and trainees to reattach muscle directly to the remaining bone during amputations. That way the patient can still use the muscle to move the limb after surgery, making their prosthesis much more useful.