By: 1 February 2022
Surgeon in Focus – Joseph Assini

Joseph Assini is a board-certified, fellowship-trained orthopaedic surgeon specialising in adult hip and knee replacement, complex joint reconstruction and general orthopaedic trauma based in Denver. Dr Assini is committed to innovation to help get patients back to healthy activity, faster and one of his major areas of interest is in Rapid Recovery Total Joint Arthroplasty. Through this, most of Dr Assini’s patients will leave the hospital the same day as their surgery.


OPN: What drove you to choose surgery as a career – and orthopaedic surgery in particular?

JA: I was drawn to surgery because I love the visual and tactile element that comes along with it. That essentially drove me into a procedure-based field like orthopaedics. I knew orthopaedics was for me because it’s so rewarding, almost instantaneously. You get to truly “fix” patients who are struggling with mobility day to day and give them their quality of life back.


OPN: It is clear that the healthcare industry has been greatly impacted by the global pandemic, what has been the greatest impact for you within the orthopaedic industry?

JA: I would say the biggest change that has arisen from pandemic is the number of surgeries moving to outpatient facilities. There are a lot of positives with this – we are able to use better anaesthesia, get patients up and moving quicker. These improvements benefit both the patient and the surgeon. Because of these improved outcomes, I truly believe that this model is here to stay. Previously, many were hesitant about this model, fearing that more negatives would arise such as increased readmissions – but this has not been the case. It forces the industry to develop products that allow for these fast recoveries, such as MicroPort Orthopedics Anterior Path approach. The anterior path is minimally invasive, leading to a quick recovery. Similarly the medial pivot knee design, which Microport pioneered, mimics the function of the knee very closely and this reduces swelling, pain and aids in faster return to function. As products continue to innovate rapidly, this will widen the trend of outpatient surgeries.


OPN: What’s the best part of your job?

JA: I have two favourite aspects of my job. The first is working with patients that have suffered a bad outcome from a previous surgery, such as a hip or knee replacement, and being able to get them back to a healthy, functional and pain-free quality of life. The second is treating patients that are overall in great health, living an active lifestyle and eager to keep moving, but unfortunately are very limited by just their knee or hip. Being able to perform a surgery and have them recovering back to full function, doing everything they love, in a short amount of time is incredibly rewarding.


OPN: … and the worst?

JA: The changing landscape of medicine from an insurance standpoint. Medicine has changed drastically, in that while I used to think strictly as a clinician, recommending what I believe to be best for my patients, we now have to think inside the parameters of what will be paid for – which makes our job exceedingly difficult at times.


OPN: What has been the highlight of your career so far?

JA: It’s hard to name just one. First off, establishing a successful practice here in Denver and being able to help so many people over the past 8 or 9 years has been incredible. For example, I’ve had the opportunity to help a patient that suffered from a severe fracture, and had not been able to walk in years, get back on her feet due to a knee replacement. Personally, working with peers and professionals in the industry to develop novel ways of doing procedures, such as MicroPort Orthopedics AnteriorPATH®, has been both rewarding and humbling.


OPN: You recently spoke at the AAHKS event in November, talking about methods to improve the anterior approach when performing a total hip replacement, can you tell us more about your discussions?

JA: Our panel spoke about MicroPort’s AnteriorPATH®, in which you use a cannula to aid in placing the acetabular component. In doing so, we can move the incision into a transverse (bikini-based) cut. This improves overall healing, decreases the risk of numbness, and leads to better cosmesis since the incision is hidden in the groin. Without the use of a cannula, there is a high complication rate with this approach. Using both the AnteriorPATH®and cannula makes this approach much more accessible to a wider breadth of surgeons. In fact, I think the majority that utilise this approach become more efficient at total hip arthroplasties and also see improved outcomes for their patients.


OPN: Are you currently involved with any scientific research?

JA: I am currently part of a leadership group at HCA Inc. Each year, HCA hospital perform over 50,000 joint replacements worldwide. This is an incredible amount of data. We are utilising this database to answer important clinical questions that cannot be answered adequately with smaller studies. For example, we are currently evaluating ways to reduce the amount of narcotics required in the post op period. I am also participating in three studies evaluating the long term performance of hip and knee implants.


OPN: Are you planning to attend any orthopaedic events in 2022?

JA: I will attend AAHKS and likely one of the ICJR events as either faculty or participant.


OPN: If you weren’t an orthopaedic surgeon what would you be?

JA: Formula 1 driver.


OPN: What would you tell your 21-year-old self?

JA: Don’t rush to get through all the training it takes to become a surgeon.


OPN: Away from the clinic and operating theatre – what do you do to relax?

JA: Driving, golf, mountain biking and skiing. I have two small children so spending time with them and my wife is a major priority for me.


OPN: How do you think the future looks in the field of orthopaedic surgery and what are your predictions for 2022 and the next decade?

JA: Outpatient surgeries will continue to increase – which will cause a shift in the insurance/payer landscape. Technology will continue to evolve and play an even bigger role in the field, specifically technologies such as augmented and virtual realities (AR, VR). Robotics is a huge initial investment and outcomes are not as improved as you would think when you look at them from an overall time and cost standpoint. On the other hand, some of these newer technologies, such as AR and VR, are more accessible and affordable and can greatly improve placement, and are helping to democratise healthcare as they can be used in multiple surgery centres or ORs.


Every patient is different, and individual results vary. There are risks and recovery times associated with surgery. Consult your doctor to determine if hip replacement surgery is right for you. The views, opinions and product experiences discussed in this interview, whether implicit or explicit, are those of the presenting surgeon and do not necessarily reflect the views and opinions of MicroPort Orthopedics Inc.