My Services

My practice is limited exclusively to joints, that is hips and knees, especially for active patients. I specialize in first-time replacements, though I also have extensive experience repairing failed replacements. My practice frequently receives referrals from other surgeons for especially troublesome cases. 

I place an emphasis on outpatient surgery or overnight-only procedures. I was an early adopter (2015) of non-narcotic joint replacement, specializing in the use of injectable agents that provide outstanding pain relief.

A typical procedure at my practice involves the surgical modification of a joint, most often a replacement with a prosthetic device. Patients are often surprised to learn that these replacements frequently involve a simple cap or covering of the bone, and do not involve removal of “big” segments of their bone.

Surgeries can take place in as little as three weeks from the initial consultation. 

Total hip replacement is a surgical operation where the hip joint is replaced with a prosthesis, an artificial implant. This surgery has been performed by orthopedic surgeons for over 50 years and continual advancements make this an effective option for those suffering from a damaged hip joint.

The hip joint is one of the largest weight-bearing joints in the body. It is a “ball and socket” construct in which the round head of the femur (thigh-bone) connects with the acetabulum of the pelvis. The ends of the bones are covered with a smooth, soft tissue called cartilage that allows effortless motion through the hip. The joint is surrounded by soft tissue, muscles, and a capsule that provide stability and leg movement.

Causes of hip problems

The most common cause of a damaged hip joint is arthritis. Patients will present with progressive groin pain and stiffness. Movements at the hip become more painful and difficult. This occurs when the cartilage begins to wear away over time, causing the “ball and socket” to rub together leading to joint damage.

Dr. Barba will discuss your history and symptoms and evaluate your hip joint. X-rays of the hip will be ordered to assess for any joint damage and arthritis. Sometimes, MRIs are ordered to look for other causes of your hip symptoms.

For patients with mild complaints such as occasional hip pain, those who are still performing daily activities without much difficulty, and patients who are not ready for surgery, nonsurgical treatment may be discussed. Some patients benefit from anti-inflammatory medication, physical therapy, and activity modification.

Dr. Barba will discuss whether a total hip replacement is an option for you, and will review outcomes, risks, and potential complications of surgery.

The hip replacement process

During total hip replacement surgery, an incision is made around the hip joint along the side or in front of the hip. The damaged ball is removed and the socket (acetabulum) is prepared. A metal stem is then inserted into the hollow thigh bone and a ball is attached to this prosthesis. A metal cup is inserted into the socket. Finally, the new ball and socket are joined and the surrounding tissue is closed around the hip joint. The incision is closed in a plastic surgery fashion. Dressings are water-proof and patients are allowed to shower immediately.

New advances in techniques and pain management protocols have brought substantial benefits to qualifying patients undergoing THR. For example, hip resurfacing is an alternative procedure for some patients that preserves more of the patient’s natural bones.

Direct Anterior Approach Hip Replacement is another alternative to conventional hip replacement that allows the surgeon to approach the hip joint between muscles without detaching them, as is customary in conventional techniques.

Compared to conventional hip replacement, these new surgical techniques along with new pain protocols can result in:

• Shorter or no hospital stay

• Smaller incision

• Faster recovery

• Reduced post-surgical pain

• Reduced risk of dislocation

• And a more rapid return to normal activities

Post-surgery and recovery

After surgery, you will go to the recovery area. Most surgeries are done outpatient. For patients whose surgery is performed in the hospital, most will stay there overnight. Hip surgeries rarely require therapy. For knee replacements, there can be up to 12 weeks of therapy.

Total hip replacement risks and complications include: blood clots, infection, dislocation of the joint, blood vessel or nerve injury, and implant wear and loosening.

After the surgery, activity precautions to protect your new hip will be reviewed to allow proper healing. Total hip replacement surgery is a successful surgery to remove all or most hip pain due to arthritis. It is important to discuss the risks of the surgery and expectations after the procedure with Dr. Barba.

An increasing number of qualifying OrthoIllinois patients are able to return home for a more comfortable recovery the same day after undergoing Outpatient Total Hip Replacement at OrthoIllinois Surgery Center or a local hospital.

For qualified candidates, Total Hip Arthroplasty (THA) performed as an outpatient procedure in either an ambulatory surgery center or a hospital offers appealing benefits. Traditional THA performed as an in-patient procedure at the hospital can require an overnight hospital stay. In contrast, the same THA performed as an outpatient procedure allows the patient to be discharged the same day to recover post-operatively in the comfort of their own home and realize a significant decrease in cost.

Cost savings are maximized when the procedure is performed in an outpatient ambulatory surgery center. These savings are realized not only with the elimination of hospital and rehab facility in-patient expense, but facility charges for operating room and recovery time at an outpatient surgery center are less expensive than a hospital with the added benefit of reduced risk of acquired infection.

Outpatient eligibility

Additional attention and patient education is required in determining a patient’s eligibility as a candidate for THA in an outpatient surgery center. The relative physical health, mental understanding of and commitment to assuming responsibility for physical therapy post-operatively, and the presence of a caregiver at home during the first 48 to 72 hours to assist the patient with daily living activities are initial requirements. In addition, careful insurance coverage review is applied to secure pre-approval from payers. Not all insurance providers will pay for the outpatient procedure.

Potential patient candidates are assigned a “total joint coordinator” who facilitates that the necessary resources are in place to provide the patient with care from pre-operative to post-operative recovery. This care begins with a visit to a physical therapist for a full evaluation, gait training, and instruction of home exercises prior to surgery day. Within a few hours after surgery, the therapist also works to help the patient begin walking before being discharged to home. Once home, the patient will receive a visit from a home health care worker who will provide instruction and reassurance.

A severely damaged knee due to arthritis can be debilitating, making the simplest day to day activities challenging. The knee is a hinge joint formed by the lower-end of the thigh bone (femur), upper part of the shin bone (tibia), and the kneecap (patella). Ligaments, tendons, and muscles help stabilize and move the joint. During arthritis the cushion surfaces wear away and bones begin to rub together, causing pain and limited motion in this weight-bearing joint. A total knee replacement is a surgical procedure where the knee joint is replaced with a prosthesis, or artificial implant. This surgery has been performed by orthopedic surgeons for over 40 years and continues to be an effective option for patients suffering from knee pain due to a damaged knee joint.

Oftentimes, your physician will discuss alternative treatment options for knee arthritis, as this is an invasive surgical procedure that has risks involved. In addition, your disease severity, symptoms, function, and overall health, play a role in determining the appropriate treatment options.  Noninvasive possibilities include: activity modification, medications, and knee injections that can provide symptomatic relief. If the nonsurgical treatments are no longer helpful and your symptoms are inhibiting you from doing day to day activities, you may want to consider a total knee replacement.

The knee replacement process

During a total or partial knee replacement, the surgeon will make a vertical incision approximately 8 inches long in the front of the knee. The damaged bone on the tibia, femur, and patella is removed and shaped to hold the implants. Next, the metal implants are cemented to the bone and the undersurface of the kneecap is replaced with a plastic button. 

A plastic insert is incorporated between the metal surfaces to allow a smooth surface during movement. The soft tissue around the knee and skin incision is closed with a plastic surgery closure. This means that after the procedure there will be no staples or sutures to remove, dressings are water-proof, and the patient can shower immediately. The procedure takes approximately 1 to 2 hours to perform.

Post-surgery and recovery

You will wake up from anesthesia in the recovery area and be transported to a patient room. If the procedure is performed in the hospital, an overnight stay or direct outpatient discharge will occur, depending on the patient need. Blood thinner medication (such as aspirin) is often prescribed to reduce the risk of blood clots after surgery. While recovering, you will learn skills and participate in physical therapy to get you walking safely. Examples of surgery risks include:

• Infection

• Bleeding

• Pneumonia

• Blood clots

• Reaction to anesthesia

• Blood vessel or nerve injury

• Kneecap dislocation

• Implant wear or loosening

Total knee replacement is a surgery the removes all or most knee pain due to arthritis. Some patients may continue to feel kneecap pain when kneeling after surgery. A total knee replacement can last a lifetime. If the implant wears over time, you may need a revision surgery to remove the worn implant and replace it with a new prosthesis. It is important to discuss the risks of the surgery and expectations after the procedure with Dr. Barba.

For qualified candidates, Total Knee Arthroplasty (TKA) performed as an outpatient procedure in either an ambulatory surgery center or a hospital offers appealing benefits. Traditional TKA performed as an inpatient procedure at the hospital can require an overnight stay, and for some, followed by a transfer to a sub-acute rehabilitation center for another one to two weeks. In contrast, the same TKA performed as an outpatient procedure allows the patient to be discharged the same day to recover post-operatively in the comfort of their own home and realize a significant decrease in cost.

Cost savings are maximized when the procedure is performed in an ambulatory surgery center. These savings are realized not only with the elimination of hospital and rehab facility inpatient expense, but facility charges for operating room and recovery time at an outpatient surgery center are less expensive than a hospital with the added benefit of reduced risk of acquired infection.

Additional attention and patient education is required in determining a patient’s eligibility as a candidate for TKA in an outpatient surgery center. The relative physical health, mental understanding of and commitment to assuming responsibility for physical therapy post-operatively, and the presence of a caregiver at home during the first 48 to 72 hours to assist the patient with daily living activities are initial requirements. In addition, careful insurance coverage review is applied to secure pre-approval from payers. Not all insurance providers will pay for the outpatient procedure.

Outpatient eligibility

Potential patient candidates are assigned a “total joint coordinator” who facilitates that the necessary resources are in place to provide the patient with care from pre-operative to post-operative recovery. This care begins with a visit to a physical therapist for a full evaluation, gait training, and instruction of home exercises prior to surgery day.

Within a few hours after surgery, the therapist also works to help the patient begin walking before being discharged to home. Once home, the patient will receive a visit from a home health care worker who will provide education and answer any questions. Therapy then begins either in-home or as an outpatient.