How I Approach Hip and Knee Replacement
Every surgeon makes choices about how to do a joint replacement. These are mine, and the reasons behind them, explained the way I'd explain them next to you in clinic.
By Dr. Luc Rubinger, MD, MBA, FRCSC · Orthopaedic surgeon, hip & knee replacement · Durham Bone and Joint Specialists, Ajax
Three principles
Disturb as little as possible. Move muscles aside rather than cutting through them.
Restore what's yours. Rebuild the joint to fit you, not a textbook average.
Measure, don't guess. Use X-ray and robotic data to confirm the plan in the operating room.
The techniques I use
The anterior approach for hip replacement
Reaching the hip from the front, between muscles, for a gentler early recovery.
The subvastus approach for knee replacement
Reaching the knee without cutting the quadriceps tendon.
Kinematic alignment
Rebuilding your knee the way it was before arthritis, not forcing it straight.
Robotic assistance (ROSA and MAKO)
What the robot does, what it doesn't, and why precision matters.
How they fit together
None of these techniques is magic on its own. Together, they reflect one philosophy: get in gently, give you back a joint that fits the way you're built, and check the result before you wake up. And when one of them isn't right for your body or your situation, I'll tell you, and we'll choose what is.
For the full picture of each operation, including what to expect before and after surgery, see Hip Replacements and Knee Replacements.
Seeing Dr. Rubinger
I see patients at Durham Bone and Joint Specialists in Ajax, with surgery at Lakeridge Health Ajax Pickering Hospital and Schroeder Ambulatory Centre. In Ontario, you'll need a referral from your family doctor or nurse practitioner. Referral and contact information.
These pages are general information to help you understand your options. They aren't medical advice for your specific situation.