What is the volume of the HOI joint replacement fellowship?
Orthopaedic Specialty Institute is the highest volume joint replacement center in Orange County. We have a large referral base and are effectively a tertiary care center for very complex cases and specialized care. We are sent revision surgeries from throughout California and even outside of the state. In addition, we have the highest volume. Our surgeons collectively do over 1,600 cases between 3 surgeons. Each fellow is anticipated to complete 600 cases with 15-20% being revision surgeries.

What type of cases will the fellows see?
The breadth of cases that our practice offers includes complex revision, hip and knee revisions. We have many complex acetabular revisions, including pelvic discontinuity surgeries, cup-cage reconstruction, and jumbo cup reconstruction. We do many femoral total hip revisions, including long stem extended trochanteric osteotomy surgeries. Our knee replacement revision surgeries include hinged prosthesis reconstruction of bone loss using sleeves and augments. We also have one of the largest direct anterior practices in the nation. We provide exposure to the posterior approach as well and unicompartmental knee arthroplasty.

What is the outpatient clinic experience?
The fellow will have exposure to a high-volume joint replacement clinic experience, where outpatient management of preoperative and postoperative patients will be quite intensive. We believe that this is a very important part of the training in addition to the operative experience.

What is the educational experience of the faculty?
The faculty at Orthopaedic Specialty Institute is dedicated to teaching and education. Dr Robert Gorab and Dr Steven Barnett were faculty at the University of California, Irvine Medical Center, where they volunteered time to teach the residents joint replacement. They also had a teaching position at the Long Beach Veterans Affairs Hospital. Dr Jay Patel directs the research and education program for the fellowship, having recently been trained at the Hospital for Special Surgery. Dr. Nader Nassif is a fellowship trained arthroplasty and orthopaedic oncology surgeon trained at Hospital for Special Surgery and Memoral Sloan Kettering.

What type of ancillary support is available in the fellowship?
The Orthopaedic Specialty Institute offers a significant support staff to make sure that the fellow spends as much time on educational and clinical duties as possible. This includes a good number of physician assistants and nurse practitioners both in the outpatient and inpatient setting to help with clinical duties and rounding duties. We have multiple registered nurse first assistants in the operating room so that we are not actually dependent on the fellow to do our cases; however, this allows us to spend more time with teaching with the fellow. We have a research associate hired by the Orthopaedic Specialty Institute as well as access to a research associate at the Hoag Orthopedic Institute, who will do much of the chart review and collection of data for the fellow; therefore, the fellow can focus on the structure of the research projects and the presentation of the projects.

What is the research program at OSI?
Our research program at Orthopaedic Specialty Institute is quite extensive. We have a large registry over the last 10 years, and we have access to statisticians. We have over 10 ongoing projects at this time, and we are involved with clinical trials of joint implants. The fellows will have access to all of these projects and will be allowed to choose projects that are interesting to them and their career.

What type of educational conferences are part of the fellowship?
We have created a significant didactic conference schedule that includes a preoperative planning conference, a postoperative review conference, a series of didactic lectures on topics chosen by the faculty and the fellow, a journal club, and a monthly arthroplasty conference, where we invite over 40 faculty from around the area who are subspecialists in joint replacement.