JOINT REPLACEMENT SURGEON IN INDORE WHAT IS JOINT REPLACEMENT? Joint replacement as the name suggests is the replacement of the torn or damaged joint in the body of an individual. The damaged joint in the body is replaced by artificial joint (prosthesis) made of metal, plastic or ceramic. Joint replacement is most commonly done to relive joint pain that can be caused die to various reasons. Some of these reasons are as follows: 1.osteoarthritis 2.rheumatoid arthritis 3.joint injuries The joint replace surgery helps restore the mobility of the patients and give him back the old quality of life where he doesn’t have to struggle with day to day activities due to joint related issues. The joint replacement surgery is mostly performed when the medicines and physiotherapy can’t seem to relieve the pain of the patient. Common Joints Replaced: 1.Knee (most common) 2.Hip 3.Shoulder 4.Elbow 5.Ankle TYPES OF JOINT REPLACEMENT 1. Knee Replacement Total Knee Replacement (TKR): Entire knee joint is replaced — both sides of the joint and the kneecap. Partial Knee Replacement (PKR): Only one part (inner, outer, or kneecap area) of the knee is replaced. Revision Knee Replacement: Done if the first knee implant wears out or fails. 2. Hip Replacement 3. ⁠Total Hip Replacement (THR): Both the ball (femoral head) and socket (acetabulum) are replaced. Partial Hip Replacement (Hemiarthroplasty): Only the ball of the hip joint is replaced. Hip Resurfacing: Bone is preserved by capping the ball instead of replacing it. Revision Hip Replacement: Second surgery if the first implant fails. 3. Shoulder Replacement Total Shoulder Replacement: Both the ball (humeral head) and socket (glenoid) are replaced. Partial Shoulder Replacement (Hemiarthroplasty): Only the ball part is replaced. Reverse Shoulder Replacement: Used in cases of rotator cuff damage or failed previous surgeries — ball and socket positions are reversed. 4. Elbow Replacement Replaces the damaged parts of the elbow joint with metal and plastic components. Mostly done for rheumatoid arthritis or complex fractures. 5. Ankle Replacement Less common than other joint replacements. Used in advanced arthritis or post-injury damage when movement is severely limited. SIGNS THAT ONE IS IN NEED OF JOINT REPLACEMENT: Joint replacement is usually considered when joint damage severely affects your daily life, and other treatments like medicines, physiotherapy, or injections no longer help. Here are the key signs that someone might need a joint replacement (knee, hip, shoulder, etc.): 1. Persistent Joint Pain Constant or severe pain that doesn’t go away, even with rest or medication. Pain that wakes you up at night or limits your ability to sit, stand, or sleep. 2. Stiffness and Limited Movement Difficulty in bending, straightening, or rotating the joint. Trouble doing everyday activities like climbing stairs, walking, or lifting your arm. 3. Swelling and Inflammation Chronic swelling that doesn’t improve with rest, ice, or medicines. Signs of joint inflammation that come and go, or stay constantly. 4. Joint Deformity Visible changes like bowed legs, uneven leg length, or misalignment of the joint. The joint may appear “sunken,” twisted, or bulged. 5. Dependence on Painkillers or Walking Aids Needing pain medicines daily just to function. Using a walker, cane, or crutches regularly due to pain or weakness. 6. X-ray or MRI Shows Severe Damage Imaging shows bone-on-bone contact, joint space narrowing, cartilage loss, or joint collapse. Bone spurs, cysts, or joint erosion. 7. Failed Conservative Treatments No long-term relief from: Physiotherapy Joint injections Weight loss and lifestyle changes 8. Declining Quality of Life You avoid walking, traveling, or socializing because of joint pain. Pain interferes with work, hobbies, or mental health. ADVANTAGES OF JOINT REPLACEMENT SURGERY: 1.Pain Relief Significantly reduces or completely eliminates chronic joint pain. 2.Improved Mobility and Function Restores movement, making walking, climbing stairs, or daily tasks easier. 3.Better Quality of Life Helps you return to normal activities, work, and hobbies with greater independence. 4. Long-Lasting Results Modern implants can last 15–20 years or more, giving years of active, pain-free living. For more details on total hip replacement/ DAA total hip replacement, please visit our dedicated website for hip joint issues created by Dr Vikas jain- www.hipreplacementindia.in https://hipreplacementindia.in/treatment/bikini-hip-replacement/

HIP REPLACEMENT SURGEON IN INDORE WHAT IS HIP REPLACEMENT SURGERY? Hip replacement surgery, also known as hip arthroplasty, is a surgical procedure in which a damaged or worn-out hip joint is removed and replaced with an artificial joint (prosthesis) made of metal, ceramic, or plastic. This is usually done to relieve severe pain, stiffness, and loss of mobility caused by conditions like osteoarthritis, rheumatoid arthritis, fractures, or avascular necrosis. The surgeon replaces the ball-and-socket parts of the hip joint: the head of the femur (thigh bone) and the hip socket (acetabulum). Hip replacement helps restore normal movement, reduce or eliminate pain, and significantly improve quality of life when other treatments like medication, physiotherapy, or lifestyle changes no longer work. MAIN CAUSES OF HIP REPLACEMENT 1. Osteoarthritis The most common reason. Caused by age-related wear and tear of the hip joint cartilage.Leads to pain, stiffness, and reduced mobility. 2. Rheumatoid Arthritis An autoimmune disease that causes chronic inflammation of the joints. It Destroys cartilage and bone, leading to severe joint damage and deformity. 3. Hip Fractures This is Especially common in older adults after falls. If the bone can't be repaired properly, hip replacement is often needed. 4. Avascular Necrosis (AVN) It Occurs when the blood supply to the hip bone is reduced, causing the bone to die and collapse. It Can be due to steroid use, alcohol abuse, trauma, or certain medical conditions. 5. Childhood Hip Diseases (e.g., Developmental Dysplasia, Perthes' disease) Improper hip development can cause long-term joint problems. These conditions may eventually lead to early joint damage and arthritis, requiring replacement in adulthood. TYPES OF HIP REPLACEMENT SURGERY 1. Total Hip Replacement (THR) – Most Common Both the ball (femoral head) and the socket (acetabulum) are replaced with artificial components. 2. Partial Hip Replacement (Hemiarthroplasty) In this surgery Only the femoral head (ball) is replaced and the socket is left as it is. 3. Hip Resurfacing In this surgery The femoral head is not removed, but instead it is reshaped and capped with a metal cover. The socket may still be replaced. 4. Revision Hip Replacement A repeat surgery is done when a previous hip replacement has failed or worn out. This is More complex and may involve replacing only part or maybe all components. It is Needed due to implant loosening, infection, fracture, or wear. WHO NEEDS HIP REPLACEMENT Hip replacement surgery is recommended for people who have severe hip joint damage that causes chronic pain, stiffness, and difficulty in movement, and does not improve with medicines. Who needs it : 1.People with Advanced Osteoarthritis 2.Patients with Rheumatoid Arthritis 3.Individuals with Avascular Necrosis (AVN) 4.People with Hip Fractures (Especially Elderly) 5.Those with Childhood Hip Disorders. Common signs that you may need hip replacement surgery : 1.Constant hip pain, even while resting 2.Stiffness and limited range of motion 3.Limping or difficulty standing/walking 4.No improvement with physiotherapy, medication, or injections. HOW IS HIP REPLACEMENT DONE? Hip replacement surgery is a procedure where a damaged hip joint is replaced with an artificial implant to relieve pain and restore movement. It usually takes 1.5 to 2 hours and is done under spinal or general anesthesia. How is it done? 1.Anesthesia The patient is given spinal anesthesia (numbs the body below the waist) or general anesthesia (makes you sleep during surgery). Sometimes a combination is used. 2. Incision A cut is made over the side, front, or back of the hip, depending on the approach used. Traditional approach: larger incision (20–30 cm) Minimally invasive: smaller incision (8–15 cm) 3. Removing the Damaged Bone The femoral head (ball part of the hip joint) is removed. The damaged cartilage and bone from the socket (acetabulum) are also cleaned out. 4. Inserting the Artificial Implants A metal or ceramic cup is placed into the hip socket. A metal stem is inserted into the thigh bone (femur), and a ball (metal or ceramic) is attached to the top. These parts together form the new artificial hip joint. 5. Fixing the Implants Implants may be cemented into place (common in older adults) or left uncemented, allowing bone to grow onto them Sometimes a combination of both methods is used. 6. Closing the Incision Muscles and tissues are repaired, and the skin is stitched or stapled. For more details on total hip replacement/ DAA total hip replacement, please visit our dedicated website for hip joint issues created by Dr Vikas jain- www.hipreplacementindia.in https://hipreplacementindia.in/treatment/bikini-hip-replacement/

Best Knee replacement Surgeon in Indore WHAT IS ARTHRITIS? Knee replacement surgery is mostly performed in the cases of arthritis. It is a general term for various conditions which can cause pain, swelling and stiffness in the joints. It can affect one or multiple joints in the body sometimes leading to complete damage of cartilage which leads to making the movement severely painful. Symptoms of Arthritis: 1. Joint pain 2. Swelling and warmth 3. Stiffness (especially in the morning) 4. Redness 5. Limited movement 6. Cracking or grinding sounds. WHAT IS KNEE REPLACEMENT? Knee replacement, also known as knee arthroplasty, is a surgical procedure where a damaged or worn-out knee joint is replaced with an artificial joint (implant). This artificial joint can be made of metal, plastic, or ceramic. It is usually done to relieve severe knee pain and improve movement when other treatments like medicines or physiotherapy doesn’t seem to work or provide relief. TYPES OF KNEE REPLACEMENT There are 4 main types of knee replacement surgeries, each chosen on the basis of how damage the knee is and the patient's age, activity level, and overall health. 1. TOTAL KNEE REPLACEMENT SURGERY (TKR) As the name suggests total knee replacement surgery is the type of surgery which replaces the complete knee of the patient. In this surgery entire knee is replaced including both sides if the knee ( femur and tibia) and sometimes even the knee cap ( patella). This surgery is generally suitable for the people going through severe arthritis as it provides long term relief and generally the recovery of 2-3 months. Most people above 60 with arthritis are advised with Total knee replacement surgery. 2. PARTIAL KNEE REPLACEMENT SURGERY (PKR) As the name is self explanatory, partial knee replacement unlike total knee replacement replaces only one part of the knee. It can either be any of the two sides of the knee or the frontal part. It is recovered fast as compared to total knee surgery and is less invasive. It is usually done in early stages of arthritis. 3. BILATERAL KNEE REPLACEMENT In bilateral knee surgery both knees are replaced on the same day or in the single surgery. It is suitable if both knees are severely affected and you are medically unfit and in alarming need if both knee replacements. The recovery is intense as compared to the prior two surgeries as both the knees are replaced. REVISION KNEE REPLACEMENT A repeat surgery done when an old knee implant wears out, loosens, or gets infected. It is more complex than the first surgery. It is Usually needed after 15–20 years of the first replacement (or earlier if complications arise). SIGNS THAT YOU NEED KNEE REPLACEMENT: Knee replacement surgery is generally required when the non surgical treatment can’t seem to relieve the pain any longer. 1. Severe knee pain. 2. ⁠Advanced Arthritis 3. ⁠Joint Stiffness and limited range of motion 4. ⁠Swelling and inflammation doesn’t just go away 5. ⁠Failed non surgical treatments 6. ⁠Poor quality of life like difficulty in performing day to day activities like walking. 7. ⁠Deformity or structural instability. Knee visibly looks crooked. 8. ⁠post traumatic Arthritis. For more details on total knee replacement/ robotic total knee replacement, please visit our dedicated website for knee issues created by Dr Vikas jain- www.tkasurgery.com https://tkasurgery.com/robotic-total-knee-replacement-surgery/

There are four different muscles that stabilize the ball and socket that make up the shoulder joint. These muscles are responsible for arm movement and shoulder stability. Through repeated heavy lifting, incorrect posture the tendons which attach muscles to bone may injure and tear. The muscles forming the part of the rotator cuff are Supraspinatus, Infraspinatus, Teres minor as well as Subscapularis, although the most common tear is of the tendon of Supraspinatus muscle. Torn Rotator Cuff Signs and symptoms include: • Pain and weakness with overhead movements • Pain with putting on and taking off clothes • Pain with reaching behind the back when showering • Pain with lying on the painful shoulder • Difficulty performing physical activity or even job duties It’s not uncommon for people with a rotator cuff tear to feel the following: • Increased pain in the shoulder with lifting or during overhead activities. • Inability to fully lift arm due to weakness of the shoulder muscles. • Pain in the shoulder at night, keeping them from sleeping • Pinching, catching, or popping sounds in the shoulder with movement • Restricted range of motion, especially with reaching behind the back or overhead Though most often rotator cuff tears are of traumatic origin, degenerative tears with increasing age are equally common and should be considered for repair too in symptomatic patients. Rotator cuff tendon tears are ultimately confirmed through Magnetic Resonance Imaging (MRI). A rotator cuff repair is a surgery to restore the muscle tendon attachment to the humeral head (the ball of the ball and socket shoulder joint). It is most often done today through an arthroscopic technique – small incisions around the shoulder. PRE-OPERATIVE STEPS Every effort is made to assess the patient prior to surgery in order to ensure safety of the patient for the elective procedure. 1. After admission, routine blood work-up will be done prior to surgery. Depending on the age of the patient and other premorbid conditions, other investigations such as Echocardiography may be performed in elderly patients. 2. All the investigations prior to surgery are performed in order to ensure that the surgical procedure can be safely tolerated by the patient, since shoulder arthroscopy is an elective procedure. If any risk is involved, the patient/ attendants will be informed so. 3. Blood transfusion though rarely required, may be done depending on the reports. 4. X-rays and MRI will be done ideally in order to guide the surgical plan and the prognosis. 5. Surgical consent will be explained to the patient detailing the procedure as well as the risks involved, if any. INTRA OPERATIVE STEPS 1. After anesthesia induction and patient positioning your surgeon will make two small incisions in the front and one small incision each in the back and the side of the shoulder joint. 2. The surgery is performed using a small fiberoptic camera (an arthroscope) and other small instruments inserted through the incisions. 3. The fatty tissue which is leading to symptoms of bursitis is removed along with a burr thinning of undersurface of the acromion bone is performed which is known to cause rotator cuff tears. 4. The remaining portion of the torn rotator cuff muscle tendon is mobilized after clear visualization through the arthroscope. 5. After mobilization, suture anchors are inserted into the underlying humerus bone. 6. The tendons are fixed to suture anchors with the help of a device known as Firstpass. 7. Once sufficient hold is obtained in the tendons, knots are applied in order to fix the tendon into the original insertion site on the bone. 8. Once the rotator cuff tendons are firmly in place, the incisions are then closed with small bandages and the surgery is complete. POST OPERATIVE STEPS After surgery, patients will take home a sling used to protect the arm and the newly repaired tendons. Patients need to wear the sling for the first 6 weeks even during sleep. Patients may take the sling off when bathing or performing physical therapy exercises. DON’Ts for the first 6 weeks: • Don’t lift your surgical arm overhead without help • Don’t reach behind your back • Don’t pick up any heavy objects with the surgical arm • Don’t push or pull any objects with the surgical arm • Don’t perform any chores or physical labor requiring the use of your surgical arm Pain Management after Shoulder Surgery Most patients with rotator cuff repair will have some level physical discomfort which is normal. The pain could be sharp when first attempting to move the arm. Most surgeons will prescribe medications which should be taken to reduce pain but the patient should continue with the rehabilitation program. Ice is helpful to reduce inflammation and improve pain in the initial recovery process. Place an ice pack or cold compress over the shoulder for up to 20 minutes several times a day especially when recovering the first few weeks. Some pain and inflammation are normal for routine healing. However, some things may be concerning and require further attention. Watch out for: • Active drainage or pus from the wound after 3 weeks, the incision sites should be closed by this point. • Swelling and stiffness in the hand/wrist/elbow – this may mean that you have some limited lymphatic drainage; try elevating the arm on some pillows when you sit and performing some hand/finger exercises • Severe unresolved pain in the shoulder joint after 6 weeks Rehabilitation after Rotator cuff repair Rotator Cuff Exercises for Weeks 1 – 6 Physical Therapy will be vital to facilitate recovery and provide the best guidance. For the first 6 weeks, patients need to refrain from any aggressive movement or weight lifting. Initial Physical Therapy sessions are very important for preventing injury and for gradual restoration of movement. In the first several sessions, the therapist will perform the arm movements for the patient (passive motion) so as not to strain any of the repaired muscles and tendons Pendulums • Brace against a supportive surface (like a kitchen counter or dining table) • Allow the surgical arm to hang down with just the weight of the arm • Move your body back by bending your knees until the arm begins to swing around passively • Go clockwise, then counterclockwise • Perform 2 sets of 20 repetitions Table Slides • Rest your hand and forearm on a towel placed in front of your dining table • Lean forward with your body and allow your arm to move forward until you feel a gentle stretch and hold at the end for 5 to 10 seconds • Keep your shoulders relaxed, do not shrug your shoulders • Perform 3 sets 10 reps Shoulder Flexion passive range of motion • Lie on your back • Using the strength of your non-surgical arm, bring your surgical arm overhead, hold at the end for 5 to 10 seconds • Keep your shoulders relaxed, do not shrug your shoulders • Perform 3 sets 10 reps Shoulder External Rotation passive range of motion • Lie on your back, with your surgical arm’s elbow by your side • Hold a lightweight stick with both hands • Using the strength of your non-surgical arm, rotate your surgical arm outwards into a gentle stretch • Hold at the end for 5 to 10 seconds • Keep your shoulders relaxed, and keep your elbow by your side • Perform 3 sets 10 reps Your physical therapist may also direct you to work on improving your wrist/elbow and grip strength. Rehab 6 to 12 weeks post-op Most patients will discontinue wearing the sling after week 4 to 6. This will also be the time in which patients will begin moving the arm, first with some help (therapists call this “active assisted” range of motion), then progressing independence with movement (“active”). Shoulder Exercise for Weeks 6 to 8 Active Assistive Exercises (Flexion, Abduction, External Rotation) The goal is to gradually get your surgical shoulder to move with support from your other arm. • With both hands, hold onto a stick • Using the help of the good arm, push your surgical hand: • Straight up and forward (flexion) • Up to the side (abduction) • With your elbow by your side, rotate the arm (external rotation) • When first starting, use your good arm to push most of the weight, then gradually do more with the surgical arm granted there is no pain • Perform 3 sets 10 reps holding for 5 seconds. Flexion with stick Abduction with Stick External Rotation with Stick Isometrics • With your elbow by your side, press a towel with your fist into the wall in each of these directions gradually until muscle activation is felt in the shoulder • Perform 3 sets 10 reps holding for 5 seconds Shoulder Exercises Week 8 to 12 Resisted Shoulder External and Internal Rotation External Rotation Shoulder Internal Rotation • Stand with your elbow to your side and hold onto a resistance band • External Rotation: take the resistance band and rotate the arm outwards • Internal Rotation: take the resistance band and rotate the arm towards your center • Gradually progress resistance, discontinue or decrease resistance if you feel shoulder irritation • Perform 3 sets 10 to 15 reps Other typical exercises performed during weeks 8-12 • Bicep curls • Triceps extension • Wrist flexor/extensor curls • Resisted shoulder extension • Resisted cable row pulls • Wall slides • Resisted internal/external rotation at 90 degrees of shoulder abduction Shoulder Rehab 12 weeks post-op About 3 months or 12 weeks after surgery, patients should be able to raise their arm on their own and be able to lift lightweight objects up to 5 pounds. Exercises past the 12 weeks should be gradually progressed with consideration of how the shoulder feels. Patients should still have routine follow-ups with a physical therapist to determine the intensity of the exercise. The strengthening program going forward should focus on movements for returning to job duties and previous active hobbies. Even if shoulder pain has mostly subsided, the tendons still need time to heal. Returning to Work After Rotator Cuff Repair Most rotator cuff repair patients will expect to be rested for several weeks. People who have a desk job may return to work sooner whereas a manual labor professional may be out for up to 3-6 months. Depending on the progression your surgeon may decide the appropriate time to return to work.

OVERVIEW Fractures (Broken Bones) of the thigh, knee and leg, are common from both minor and major accidents. These are incapacitating in the short term as they commonly require the use of crutches, casts and modifications of activities as well as time off work and driving restrictions. DESCRIPTION Lower limb fractures occur from either direct trauma or indirectly from forces applied to the limb (eg twisting injuries). The type of fracture depends on the size and direction of the injury to the limb. Condition Low energy injuries (such as falls from a standing height), usually result in less complex fracture patterns and less soft tissue injury. Typical symptoms of a fracture include: • Pain • Swelling • Deformity • Difficulty weight bearing/walking Lower energy injuries can be missed and may be passed off as ‘sprains’ or ‘strains’. If you have had an injury that is not responding to treatment, it is advisable to see your doctor and obtain X-Rays to rule out an occult fracture. Higher energy injuries (such as motorcycle and car crashes) typically fracture bones in multiple places, into smaller pieces, and commonly disrupt the soft tissues resulting in large amounts of bruising and swelling. These can be challenging to treat and frequently require surgery to restore the bones to their anatomical position to make healing quicker and your function better in the long term. TREATMENT The treatment of lower limb fractures requires careful tailoring to the individual patients demand and the type of fracture sustained. Non-operative treatment of lower limb fractures may involve: • Crutches • Braces • Plaster Casts • Orthotic Shoes • Activity Restriction • Physiotherapy Dr. Jain always encourages non-operative treatment whenever possible ,however many fractures do much better with surgical intervention as surgery can speed up recovery and improve the short and long term outcome. As there many different types of lower limb fractures, there are a large range of surgical options that can be used, these can include: • Plates + screws • Wires • Rods/Nails • External Fixators Sometimes a combination of these is used, and Dr. Jain will discuss the surgical plan with you pre-operatively. He uses the latest technology in minimally invasive percutaneous orthopedic trauma implants, to give you the best outcome possible with the least amount of scarring and soft tissue injury. After surgery, Dr. Jain will discuss your operation as well as plan your rehabilitation in line with your goals and expectations. He uses a highly qualified team of physiotherapists and rehabilitation specialists to get you back to your activities as quickly as possible. Dr. Jain has extensive experience treating fractures, he has completed Training at Cascais Hospital in Lisbon (Portugal, Europe) with world recognized leaders in Orthopedic Trauma Surgery, and has worked as an Orthopedic Joint Replacement & Trauma Consultant at Tata Hospitals. He routinely attends conferences and visits trauma centers worldwide to refine his skills and stay on top of the most recent advances in trauma surgery. He is also actively involved in various trauma research projects and regularly teaches junior doctors.

OVERVIEW Fractures (Broken Bones) of the Shoulder, Elbow and Wrist are common from both minor and major accidents. These are incapacitating in the short term as they commonly require the use of a cast or brace and restrict the use of the affected limb. DESCRIPTION Upper limb fractures occur from either direct trauma or indirectly from forces applied to the limb (eg twisting injuries). The type of fracture depends on the size and direction of the injury to the limb. Low energy injuries (such as falls from a standing height), usually result in less complex fracture patterns and less soft tissue injury. Typical symptoms of a fracture include: • Pain • Swelling • Deformity • Difficulty lifting things Lower energy injuries can be missed and may be passed off as ‘sprains’ or ‘strains’. If you have had an injury that is not responding to treatment, it is advisable to see your doctor and obtain X-Rays to rule out a fracture. Higher energy injuries (such as motorcycle and car crashes) typically fracture bones in multiple places, into smaller pieces, and commonly disrupt the soft tissues resulting in large amounts of bruising and swelling. These can be challenging to treat and frequently require surgery to restore the bones to their anatomical position to make healing quicker and your function better in the long term. TREATMENT The treatment of lower limb fractures requires careful tailoring to the individual patients demands and the type of fracture sustained. Non-operative treatment of upper limb fractures may involve: • Braces or Slings • Plaster Casts • Activity Restriction • Physiotherapy Dr. Jain always encourages non-operative treatment whenever possible, however, many fractures do much better with surgical intervention as surgery can speed up recovery and improve the short and long term outcome. As there many different types of upper limb fractures, there are a large range of surgical options that can be used, these can include: • Plates + screws • Wires • Rods/Nails • External Fixators Sometimes a combination of these is used, and Dr. Jain will discuss the surgical plan with you pre-operatively. He uses the latest technology in orthopedic trauma implants to give you the best outcome possible. After surgery, Dr. Jain will discuss your operation as well as plan your rehab in line with your goals and expectations. He uses a highly qualified team of physiotherapists and rehabilitation specialists to get you back to your activities as quickly as possible. Dr. Jain has extensive experience treating fractures, he has completed Training at Cascais Hospital in Lisbon (Portugal, Europe) with world recognized leaders in Orthopedic Trauma Surgery, and has worked as an Orthopedic Joint Replacement & Trauma Consultant at Tata Hospitals. He routinely attends conferences and visits trauma centers worldwide to refine his skills and stay on top of the most recent advances in trauma surgery.