Complex Reconstruction

Our surgeons perform thousands of complex reconstructive surgeries per year including revision of infected or failed hip, knee, shoulder, and elbow replacements. In addition, GDO surgeons perform complex reconstructive surgery for major bone loss. Bone loss can result from infection, osteomyelitis, tumor, surgical complications, joint replacement loosening, or traumatic injury. Surgeons at GDO have the most extensive experience and training in complex skeletal reconstruction in the DFW area and beyond. We strive to preserve limbs and restore our patients to optimal function.


Joint replacements are usually very reliable procedures. Unfortunately, complications can occur in the immediate postoperative period or years later. Frequent joint replacement related complications treated at GDO include fractures around the prosthetic joint, loosening of the prosthesis, dislocation, instability, painful prosthetic joints, swelling around implants, hematomas, seromas, and wound complications related to joint replacement. If these occur the joint may need to be revised. This involves exploring the joint and possibly replacing all, or part of, the joint prosthesis. These procedures can be very difficult. Expertise in revision surgery optimizes patient outcome. Our surgeons perform the largest number (>750/yr) of revision joint replacements in the DFW area and beyond.


Prosthetic joint infection is an uncommon complication of joint replacement procedures. Artificial joints can become infected at the time of the initial joint replacement, or they can become infected later by bacteria in the bloodstream. Treatment can be complicated and may involve a one or two stage surgical approach. GDO surgeons treat the most periprosthetic infections (>400/yr) in the region by a large margin. Patient outcome is optimized with an experienced team.


The direct cause of avascular necrosis, or “bone death”, is a lack of blood supply. Indirectly, a dislocated joint or fracture may interrupt blood flow. Studies also show that osteonecrosis is linked to excessive alcohol intake and the long-term use of high-dose steroidal drugs, as well as certain health conditions and radiation therapy. It can affect all joints and requires medical and surgical treatment. However, this can often be minimally invasive if caught early. Core decompression, the injection of stem cells or bone graft substitute into the dead area, and joint replacement are common surgical procedures performed for avascular necrosis. Because symptoms can be initially mild, some patients do not receive an accurate diagnosis until more advanced care is needed.


Osteomyelitis is infection within a bone. Medication and precise surgical technique will eliminate infection, prevent extensive bone damage, and allow for salvage of the vast majority of limbs. Osteomyelitis can be complicated, and requires a team of doctors that regularly treat bone and joint infections. Greater Dallas Orthopaedics surgeons treat thousands of patients with bone & joint infections and infected joint replacements.


If a fracture does not heal properly, it may be a persistent source of pain. In order to restore the bone, revision surgery may be recommended. This may involve a change of hardware, bone grafting, or microsurgery to place a vascularized fibular graft. Expertise in this complicated type of surgery is required to optimize outcomes. GDO surgeons have performed thousands of corrections of non/malunited fractures and are the regional experts in this type of surgery.


Rehabilitation of the affected joint is an important aspect of recovery from replacement. The proper usage of the new joint following surgery strengthens these muscles and facilitates healing. This is achieved with a specific physical therapy program designed for each patient.