Orthopaedic Surgeon or Innovator?
Dr. James Ramser weighs in on total hip health
The hip is a major weight-bearing joint in the body and is responsible for many functional activities such as walking and running, sitting and standing, and climbing stairs. By keeping hips strong and mobile, folks can enjoy life to the utmost.
How can people keep their hips healthy? What is good routine care of hips? Dr. James Ramser, Jr., MD, orthopaedic surgeon, weighs in to offer helpful pointers for folks to bear in mind. We get to know his history, ties to Virginia, and love of all things mechanical, at the same time.
“Unfortunately, there is very little that can be done to prevent hip degeneration,” says Ramser. “Usually the arthritis is more of a hereditary problem. Staying active and keeping strong muscles around the hip joint is probably the best way to manage things. I recommend walking as the best exercise.”
Q: What is something you’d like people to know about hip health that may surprise them?
Dr. Ramser: There is a condition called hip impingement syndrome that can be treated early with arthroscopy and delay the need for hip replacement, so if a person experiences groin pain or catching, they should get an evaluation for this. This brings up a point that most people don’t realize. Hip problems tend to cause pain in the groin. Buttock pain is usually unrelated to the hip, and is more of a back problem.
Q: We understand that you were the first surgeon in the area to begin anterior hip replacement. Can you tell us more about how this development changed surgical outcomes for patients?
Dr. Ramser: I began doing direct anterior total hip replacement in 2010, and to the best of my knowledge, I was one of the first surgeons in Virginia to routinely perform this procedure for essentially all of my primary total hip replacements – regardless of age, sex, or weight. The procedure is more difficult in heavier patients and especially in muscular men. I’ve developed some techniques to overcome this difficulty.
I had previously done the more standard posterior hip replacement for 18 years, and decided to switch to the anterior approach to decrease the risk of dislocation, decrease the need for blood transfusion, and to more reliably restore equal leg lengths. The anterior approach has met this goal beyond my expectations.
The dislocation rate has decreased to less than 0.5% and the need for blood transfusion has decreased more than 10 fold. There is typically much less pain after an anterior approach, and, in my experience, the post-operative return to activity is usually much faster.
Q: You have been in practice for a long time. What do you love most about your trade? What motivates you?
Dr. Ramser: The favorite part of my work is seeing a very happy patient who walks with no pain 4-6 weeks after surgery. This is true, especially, when prior to surgery they could barely walk or sleep due to the pain. It never gets old. I am also very attracted to the mechanical aspect of my work. It’s in my blood. My grandfather was a mechanic in the coal mines in West Virginia and my father was an orthopedic surgeon. Unfortunately, my father died very early in his practice; he would be astounded to see what we can do today.
Q: If you weren’t a surgeon, what trade might you enjoy?
Dr. Ramser: I would either be a mechanical engineer or a clock maker. In fact, if I ever retire in 10-15 years, I might open a clock shop. I used to take clocks in and repair them for patients, but I had to stop because it was becoming a second job.
Q: You live in the community that you serve, grew up nearby, and trained and pursued education in Virginia (at what is now Virginia Commonwealth University Medical School and University of Virginia). What do you love about Virginia, and specifically, about being part of this community?
Dr. Ramser: I love Virginia and wouldn’t want to be anywhere else. I especially love this community because it has maintained its small town character and rural roots. It’s nice to go to a store or a restaurant and catch up with five people that you know.
Sponsored by Blue Ridge Orthopaedic & Spine Center