Dr. Derek Jenkins, an orthopedic surgeon with University Orthopedics and affiliated with The Miriam and Rhode Island hospitals, has becomes one of the youngest recipients of the Arthritis Foundation’s Dr. Hal Horwitz Lifetime Achievement Award at the age of 44. Jenkins answered PBN’s questions about the award and his career.
PBN: What does it mean to be earning the Arthritis Foundation’s 2024 “Dr. Hal Horwitz Lifetime Achievement Award for Physician Excellence”?
JENKINS: It’s a great honor and I feel tremendous gratitude to the Arthritis Foundation and to the nominating committee, especially considering I am one of the youngest recipients of the award. Looking back on my training, I have always felt as though I am standing on the shoulders of the giants who came before and paved the way. I have had the opportunity to learn the surgical treatment of arthritis from true masters of joint replacement surgery in New York, Boston and at the Mayo Clinic. Having that strong foundation in the basics of technique, pathology and the understanding of anatomy has been an advantage in my ability to inspire and implement change here in Rhode Island. These are life-changing operations, and I am grateful to have been and continue to be involved in the transformation of these surgeries and the impact they have on our patients’ quality of life.
PBN: Looking back on your career, what has been your proudest accomplishment so far?
JENKINS: Innovation and implementing change is not always easy. When I began at The Miriam Hospital, our academic practice with University Orthopedics represented the minority of surgeons. That’s not the case anymore, but at the time, there were challenges to being the new guy and looking differently at things. People can be set in their ways, not for ill intent, rather because they are used to doing things a certain way. Much of the advanced instrumentation and equipment I trained on did not exist at The Miriam when I joined. I’m grateful for the influence of my chairman at the time, Dr. Michael Ehrlich, who supported bringing the Hana orthopedic surgery table to the hospital. Since then, The Miriam has procured multiple Hana tables and the direct anterior approach to hip replacement on the Hana table is the most commonly used technique at the hospital. It’s important to believe in yourself and what you’re doing, and I’m proud that I remained faithful to my training and practice and didn’t deviate to do what was more common at the time.
PBN: What methods have you used to solve unique joint replacements?
JENKINS: Being a part of the teaching staff at Brown and with university-affiliated hospitals is exceptionally rewarding because the medical students and surgeons-in-training ask great questions to better understand your thought process. One of the things I teach is that an important part of this job is understanding how arthritis affects each individual patient. Our patients not only come from many diverse backgrounds, but they also have their own personalities and outlook on life. All of this changes how you approach each patient and discuss treatment with them. Also, every arthritic joint is unique and therefore I treat each one differently. I had the opportunity to learn acetabular osteotomy surgery to treat congenital dysplasia in the young adult hip at the Mayo Clinic and I bring that skillset to all of my hip replacement surgeries. It’s not just a resurfacing – if you do the procedure correctly, you can re-engineer the hip so it is more powerful, less likely to dislocate, and optimizes the natural mechanics of that specific patient. The patient comes first and we can’t ever forget that.
PBN: What trends have you noticed in joint replacement procedures? Where do you see the field headed?
JENKINS: Technology has advanced significantly during my career and I always am open to change and to incorporating new technologies – as long as the evidence supports that. Right now, because of advances in 3-D printing, there are some 3-D printed titanium knee implants showing promise in biological fixation. When I was in engineering school, my mentor held the patent on one of the first porous coatings used to fix implants to bone, eliminating the need to use acrylic cement in hip replacements. This transition occurred in the 90s but it hadn’t been until recently that we were able to engineer designs in the knee that work similarly. If we can get bone to grow into the implant it would be a major advancement in knee replacement surgery and I want to be a part of making that happen. There’s a huge focus on studying new technologies and it’s a very exciting time. I feel I have the responsibility to help advance the practice of arthroplasty and move the ball downfield so the next generation of surgeons that we’re training can take it from there. It’s a process in which we are all invested.
PBN: You were the first surgeon at The Miriam Hospital to use the direct anterior approach for a hip replacement on a specialized surgical table using real time X-ray guidance. Can you describe the procedure and how it’s different from the traditional technique?
JENKINS: The direct anterior approach to hip replacement isn’t a new idea but it’s really been perfected with the use of a specialized table and instruments. My grandfather was a cabinetmaker and I learned at a young age how to use a block plane and fit dovetail joints together. That level of precision craftsmanship, attention to detail, and building something both functional and beautiful still appeals to me in the work I do. Again, with a foundational understanding of the anatomy, I’m able to carefully dissect through surrounding tissue and muscle and sneak these implants into the hip. Because it’s such a small incision, utilizing real-time radiographic guidance allows for more precision in placement and quality control. It can be easy to do something perfectly once, but doing it consistently, over and over again under changing circumstances – that’s the daily challenge. My goal is always to produce the best outcome for each individual patient, and you do that by falling in love with the process and by making exceptional repetitive performance a habit.
Katie Castellani is a PBN staff writer. You can reach her at Castellani@pbn.com.
