Derek R. Jenkins, MD

Care Philosophy

Advantages of Surgery with University Orthopedics and Dr. Jenkins: An emphasis on a higher level of care and attention to detail.

• Patient-focused: Specialized care of the Hip and Knee
• Education and training: Ivy league educated and specialty trained in Orthopaedic Surgery in New York City with a Fellowship in Hip and Knee replacement at the prestigious Mayo Clinic in Rochester, Minnesota.
• Experience: Thousands of hip and knee patients successfully treated using surgical and non-invasive techniques. Hundreds of successful hip and knee replacement surgeries performed, alleviating pain and restoring function. Dr. Jenkins does complex re-do (revision) surgeries referred in from other hospitals and has the expertise and knowledge to do the job right the first time and prevent additional surgery
• Quality: Dr. Jenkins has one of the lowest surgical complication, revision and infection rates in the state, lower than national averages.
• Technology: Applies engineering principles to Orthopaedic Surgery, using computer assisted technology, intra-operative image guidance for optimum component placement, and surgical planning to custom fit replacements to each individual patient’s unique anatomy facilitating quality control, consistency, and precision in each surgery
• Less Invasive: Direct Anterior Approach for hip replacement surgery on a specialized operative table with a smaller incision, lower risk of hip dislocation, and quicker recovery
• Teacher and mentor: An active part of the teaching faculty as an Assistant Professor at the Brown University School of Medicine, Dr. Jenkins emphasizes the conscientious incorporation of advanced surgical technology and state-of-the-art new techniques leading to quicker recovery and less pain
• Performs partial and total joint resurfacings: These reconstructions selectively target only the part of the knee or hip affected by arthritis, while sparing the healthy bone and ligaments
• Custom Approach: Every joint replacement patient treated as a unique individual with custom fit implants and surgical plan based on their unique anatomy. Dr. Jenkins is not limited to one implant or manufacturer and is able to provide the right replacement for you.
• Patient-specific surgical plan: Each surgery is carefully planned, leading to restoration of healthy alignment and a goal for the highest level of physical function possible
• Less Medications: Dr. Jenkins avoids the use of strong blood thinning medication postoperatively and instead uses aspirin and early patient motion to prevent blood clots for most patients after surgery, decreasing risk of bleeding while maintaining low rate of blood clots.
• Less scarring: Most patients skin is closed using plastic surgery techniques with dissolving suture.
• Reducing risk factors: Prioritizes and focuses on the best long-term outcomes of his joint replacement surgery through reduction of modifiable risk factors whenever possible by helping patients lose weight, quit nicotine products, and control diabetes blood sugar before surgery
• All surgeries are done with care by hand of an experienced, fellowship-trained total joint surgeon  
• Quicker Recovery: Dr. Jenkins practice is particularly dedicated to patients who are active younger professionals who are looking for a quicker recovery and better outcome compared to traditional surgery, to enable patients to return to work sooner and with less pain.

Teamwork, goals and the benefits of the Miriam Hospital.

• Dr. Jenkins operates at the Miriam Hospital, Ranked #1 in Rhode Island by US News & World Report, Becker’s Hospital Review, and the only Total Joint Center of Excellence in the State. The Total Joint Center has earned The Joint Commission’s Gold Seal of Approval for its total knee and total hip replacement programs and is a Blue Cross Blue Shield Blue Distinction Center for knee and hip replacement, and has been awarded Magnet Recognition for Excellence in Nursing Services five times.
• Dr. Jenkins is dedicated to an organized, team approach to patient success including an accelerated Physical Therapy and home care program integrated within the Miriam Hospital Total Joint Center and the University Orthopedics System conveniently located close to home right here in Rhode Island.

Dr. Jenkins Presentation on Same Day Total Joint Surgery

If you are interested in outpatient (same day) total hip or knee surgery (without overnight hospital stay) at the east bay surgery center with Dr. Jenkins, please call 401 453 9032 extension 0 during business hours or leave a message and we will schedule an office visit and consultation.   

Publications

Recent Publications and Presentations

• “Minimum Five-Year Outcomes with Porous Tantalum Acetabular Cup and Augment Construct in Complex Revision Total Hip Arthroplasty.” Jenkins D, Odland A, Sierra R, Hanssen A, Lewallen D. J Bone Joint Surg Am. 2017 May 17
• American Academy of Orthopedic Surgeons (AAOS) and Orthopaedic Research Society (ORS) Annual Meeting, San Diego, CA, 2017, National, “Consistent corrosion progression preceding gross taper failure in THR of a single design.” Martin A, Jenkins D, Zhang R, Dalldorf C, Van Citters D. Poster.
• “Modifiable Risk Factors in Total Joint Arthroplasty: A Pilot Study.” DeFroda SF, Rubin LE, Jenkins DR. Rhode Island Medical Journal. 2016 May 2;99(5):28-31.
• Video Chapter 23: Mini-Open Direct Anterior Approach: Anterior Limited Exposure Direct Anterior Approach for Treatment of Femoroacetabular Impingement in “The Direct Anterior Approach to Hip Reconstruction” Jenkins D and Rubin L. Bal B, Rubin L, Keggi K Eds. Slack 2016.
• 47th Annual Eastern Orthopaedic Association Meeting, New Orleans LA, 2016, Regional. “Modifiable Risk Factors in Total Joint Arthroplasty” DeFroda S, Warwick J, Jenkins D.
• 29th Annual Congress of the International Society for Technology in Arthroplasty, Boston MA, 2016, International, “Functional Improvement and Pain Relief After Total Joint Arthroplasty.” Ramirez J, Goodman A, Shah K, Jenkins D.
• 29th Annual Congress of the International Society for Technology in Arthroplasty, Boston MA, 2016, International, “Modifiable Risk Factors in Total Joint Arthroplasty: A Pilot Study.” DeFroda, S, Jenkins D.
• 2015 Annual Brown Orthopedics Symposium: Current Topics in Active Adult Hip and Knee Orthopedics for the Primary Care Provider, Warren Alpert Medical School of Brown University, Providence RI, 2015, Regional, “Physical Examination of the Hip and Knee,” “Arthroplasty of the Knee: Partial vs. Total Knee Replacement.” Course Director.
• “Porous Tantalum Acetabular Augments in Complex Revision THA: Results at 5-12 years post surgery. “Jenkins D, Odland A, Sierra R, Hanssen A, Lewallen D.  Presented at 2014 American Academy of Orthopaedic Surgeons (AAOS) Meeting, and 2014 Mid-America Orthopaedic Association (MAOA) meeting.
• Chapters 59 A & B: Options for Acetabular Revision and Surgical Techniques: Metal Augments in “Techniques in Revision Hip and Knee Arthroplasty, by Giles R Scuderi MD”.  Jenkins DR, Sierra, RJ, Lewallen DG.  Elsevier 2014
• "A Randomized, Controlled, Prospective Study Evaluating the Effect of Patellar Eversion on Functional Outcomes in Primary Total Knee Arthroplasty." Jenkins DR, Rodriguez JA; Ranawat AS, Alexiades MM, Deshmukh, AJ; Fukunaga T, Greiz M, Rathod P, McHugh, M.  Journal of Bone and Joint Surgery, May 21, 2014.
• Presented at Lenox Hill Hospital Department of Orthopaedic Surgery Annual Research Symposium, New York, NY, Eastern Orthopaedic Association Annual Meeting, European Federation of National Associations of Orthopaedics and Traumatology (EFORT) Annual Meeting in Berlin, Germany, American Orthopaedic Association (AOA) Annual Meeting, Annual Congress of the International Society for Technology in Arthroplasty (ISTA) in Sydney, Australia, Podium presentation at the 2013 American Academy of Orthopaedic Surgeons (AAOS) Meeting in Chicago.
• Role of corrosion in taper failure and head disassociation in total hip arthroplasty of a single design. Martin AJ, Jenkins DR, Van Citters DW. J Orthop Res. 2018 Nov;36(11):2996-3003. doi: 10.1002/jor.24107. Epub 2018 Jul 26.

Community Involvement and Volunteer Service

Proud sponsor of the 2023 pinewood derby

Arthritis Foundation Walk to Cure Arthritis

Arthritis Foundation Walk to Cure Arthritis 2016 Medical Honoree, Providence RI, Planning committee member. Record breaking results this year with over $106K raised to support Arthritis Research, advanced technologies, and cutting-edge joint pain treatments, which is more than ever before and in the top 25 in the country. Over 300 participants registered for the walk along Blackstone Boulevard in Providence. 6-15-16

East Greenwich Soccer Club Assistant Coach

Dr. Jenkins volunteers as assistant coach for the University Orthopedics sponsored East Greenwich Soccer Association Little Kickers soccer team.

News

Hip and Knee Replacement Patients are Getting Younger

As joint replacement surgery has evolved, so have the patients. Namely, the average age of those having hip or knee replacement surgery is decreasing. For hips, the average age is now 65 and knees is 66. 

According to a study from the American Academy of Orthopedic surgeons, not only is the average age of joint replacement patients younger, but there is also a projected increase in the number of surgeries that will be performed before the end of the decade.

What was once thought of as a last resort for older patients has now transitioned to a way for active individuals with arthritis to continue their healthy lifestyle well into the future.

Non-surgical options for hip and knee arthritis

It is best practice to offer patients nonoperative treatments first. That includes activity modification, gait aides, nonsteroidal medications, and injections, among others. It is only when these treatments fail that I offer joint replacement surgery as an option. The goal of that surgery is to relieve pain and improve joint function for our patients. 

New joint replacement technologies and techniques to benefit younger patients

Everyone’s bones are a little bit different. There are several new approaches to performing joint replacement surgery, with a focus on less invasive procedures. I work to customize each surgery to the individual patient. 

• Direct anterior approach for hip replacement. My approach to hip replacement has been molded through special fellowship training in both young adult hip surgery and the direct anterior approach (DAA). I’ve been performing hip replacements through this approach for over 10 years now, with experience performing thousands of surgeries. The DAA and other minimally invasive approaches may be of particular benefit in the younger active patient. These procedures allow surgeons to work through natural soft tissue planes without cutting muscles or tendons. This helps to prevent damage to the well-functioning anatomy of patients. The DAA is a more technically complex surgery and can take longer in the operating room, but results in a quicker recovery and less risk of hip dislocation. While other approaches to minimally invasive surgery can have excellent results, I have found the DAA works best. 
• Image-guided surgery. Some hip surgeons, including myself, use a technology known as “fluoroscopic image guidance” during surgery. This image guidance offers the surgeon greater quality control to align the implant, so it fits more precisely to a patient’s unique anatomy. Precision in placing implants allows me to forgo any hip precautions, so my hip patients do not have to worry about not crossing their legs or elevated toilet seats to prevent hip dislocation.
• Cementless technology for hip and knee replacements. The implants we use are complex biomedical engineering devices. Bone cement, or a type of grout, was originally used to keep implants in place during joint replacement surgery. Unfortunately, that bond can break down over time. Years ago, “cementless technology” was developed for hip replacements and has now become the standard of care. Development of uncemented total knee replacements took more time to perfect, but new technologies such as 3-D printing of titanium and the development of porous tantalum have revolutionized uncemented knee replacement designs. The potential benefit of cementless fixation is a longer-lasting, more durable bond between implants and our patient’s bone. We have seen excellent results with certain uncemented designs, and my partners and I are now using some of these implants in appropriate patients, most commonly younger patients where long-term fixation will be of greatest benefit.  

Do younger joint replacement patients have shorter hospital stays? 

It’s important to note that most of our patients still spend the night in the hospital and leave the next day. Younger, healthy patients can have shorter hospital stays after hip or knee replacements. In fact, in some instances, younger healthy patients with good home support can even leave from the recovery room and go home on the day of surgery. 

My partners and I were the first in Rhode Island to offer outpatient total joint surgery, without the need for an overnight hospital stay. This accelerated surgical recovery program has increased in popularity, especially through the COVID-19 pandemic. I believe there is a healing value for patients recovering in their own home. They can sleep in their own bed, eat their own meals, and heal in the comfort of their normal environment, with their loved ones to support them. There is also value in the resources available in the hospital for our patients with medical conditions that may need treatment during their early recovery. 

Is it possible to replace only part of a hip or knee?

Everyone develops arthritis differently and I treat each patient as an individual. In some patients, more often in my younger patients, only one part of their knee becomes worn out. For these patients, targeted surgery to replace only the worn-out part can be very helpful. In general, however, it is much more common for patients to have a total knee replacement. Often there is arthritis in more than one part of the knee. Replacing only part of the knee will not treat all the arthritic areas in these patients. Partial hip replacements are also useful, but usually for patients who come to the hospital with a hip fracture. We have found partial hip replacements are not very beneficial in younger patients. 

Are hip and knee joint replacements major surgeries?

Yes. It is important to understand that although joint replacement surgeries are some of the safest surgical procedures, no surgery has a 100 percent success rate and there are risks to any surgery, though complications are rare.

Some patients are also at higher risk for complication due to their unique situation and medical conditions. We do our absolute best to work with those few patients who have complications to bring them to a successful outcome.

While the surgery is not without risk, many patients with severe hip and knee arthritis can experience significant benefits from joint replacement. My best advice is for patients to sit down with their surgeon before considering hip or knee replacement, ask questions, and have a conversation about what the risks and benefits are. Then you can make an informed decision about whether now is the right time for you to pursue surgery. 

How has joint replacement surgery changed?

Change is a constant in orthopedic surgery. It keeps the job interesting! I put a lot of thought into using new techniques and technologies in the treatments I offer. Before changing something that has worked well in my hands, or offering patients something new, it is critical to study and evaluate these new techniques and technologies to understand risk and potential benefit to patients.

I do, however, believe it is our responsibility to evaluate and offer new treatments and try new things because it is in the best interest of patients to practice at the state of the art. If we get stuck doing the same thing over and over again, we will never improve, we will never move medicine forward. 

What is the failure rate of joint replacements?

With the bearing surfaces and replacements currently available, as a rule of thumb, there is about a one percent all-cause failure rate per year after joint replacement surgeries. That would mean that for a 60-year-old there is an 80 percent chance they will still have a well-functioning joint replacement when they reach age 80. Those are good odds in the patient’s favor. 

For younger patients, the failure rate I discussed does not perfectly apply. Any mechanical device will wear out over time and service. Younger patients are more likely to live a higher-impact lifestyle, putting more stress on their implants. This may lead to a shorter effective lifetime before revision surgery is necessary.

This is really an arena where newer technology and techniques have great potential in improving the longevity and durability of the replacement surgeries we perform for these younger individuals. This is also where my background in engineering has given me a unique approach to understanding and evaluating the intricacies of new technologies and their application to updating the mechanical and biologic aspects of these complex engineered devices. 

How do you approach using these new technologies and changing the way you do surgery? 

As an engineer, I am attracted to new technologies, but as a surgeon I am cautious of unproven treatments. This has really helped provide a balance to my practice. I continue to adapt and update the techniques and technology in my surgical operations, but only after careful consideration of the effect on patients as human beings.

The field of orthopedics and adult reconstruction of the hip and knee is really the perfect combination of engineering and medicine. For me, the ability to use technology to find and perform a surgical solution to fix an anatomic problem, and then to share in a patient’s transformation from pain and disability to function and ability is what inspires and drives me every day. 

Rhode Island Hospital Breakthroughs - Spring 2017

The Intersection of Medicine, Art and Engineering

Click here to download PDF.

Dr. Jenkins weights in on arthritis, weight and your joints in the Lifespan blog.

Most patients who come to my office for arthritis have what is known as osteoarthritis. This is the wear-and-tear type of arthritis thought to be the result of years of impact on your hip or knee joints. This causes the cartilage, the smooth gliding cushion on the joint surface, to wear out. You can think of it like years of driving your car. If you wear through your rubber tires and are driving on the metal rims of your wheels, you are in for a bumpy ride.

The weight factor

When it comes to arthritis, I believe weight is an issue. Having a background in engineering before medical school, I like to think about hip and knee joints as mechanical devices. These devices can only withstand a certain amount of pressure through a number of cycles over a period of time. In other words, if a patient is heavier, or does a lot of heavy labor involving those joints, those individuals may be more at risk of wearing that joint out over the course of a lifetime. Likewise, with joint replacements, those devices would wear out faster in heavier patients.

Will losing weight help people with arthritis?

It is very likely that losing weight will help people who have arthritis. Less weight means less pressure on the joint. For an arthritic joint that already has a damaged surface, losing weight can significantly relieve pain.

When I meet a new patient, I recommend nonoperative treatments before surgery and that includes weight loss.  We have some great resources here at The Miriam Hospital.  I have had overweight patients with severe arthritis who were specifically referred to me by their primary care provider for a joint replacement. After losing a significant amount of weight from The Miriam program, they felt their pain that brought them into my office was no longer severe enough for them to want the surgery.  That’s a big win for the patient: their pain improves without ever having surgery.

The benefit of weight loss is not just limited to their joint.  People usually experience an amazing transformation after weight loss.  Other medical conditions such as diabetes improve or are cured, their mood improves, and overall, they just feel better.

Weight and joint replacement surgery

While we do not want to keep anyone from a surgery that could help them, some patients are at a much higher risk for complications than others. I believe we as conscientious physicians should work as partners with patients and their other doctors to decrease as much risk as possible before joint replacement surgery.  This is an area of active study for us here and we have already published on our experience in the Rhode Island Medical Journal.

There is a lot that we can do together. We can help heavier patients lose weight, nicotine users quit their habits, patients with many cavities or dental infections see dentists before surgery, and diabetic patients better control their blood sugar. Many studies have shown that heavier patients, nicotine users, patients with dental infections, and diabetic patients with high blood sugar are at higher risk for infection and don’t heal as well after joint replacement surgery.  

This conversation is difficult to have with patients in the office, but I believe it is an important one. It can take some time and a real team effort to meet these goals, but I believe it can improve surgical outcomes and help patients heal better.

How to improve your arthritis

Osteoarthritis is a progressive disease. Unfortunately, there is not a magic pill or cure yet, although we are excited for promising studies of new, less invasive therapies that are currently being researched in our lab.

We do have many effective, nonoperative treatments that are already available to our patients in the office that can provide years of arthritis pain relief. They include:

• weight loss
• using gait aids, such as a cane
• anti-inflammatory medications
• hip and knee joint injections

When nonoperative treatments have failed, joint replacement surgery, performed by an expert surgeon, is a very effective and safe surgical treatment. It also has some of the best long-term results of any surgical procedure.

In our practice, we are proud that our results and expertise in joint replacement surgery rival those of any hospital or surgery center anywhere in the world.

Preparing for joint replacement surgery

Everyone is unique, and we treat each patient as such in our practice. If you are suffering from hip or knee pain, it is always best to talk with an orthopedic surgeon. There are lots of treatments we can offer to help you feel better.

That said, there are some rules of thumb that will likely help a patient see more success in hip or knee surgery. Some general goals for a patient seeking joint replacement surgery would be to:

• have a body mass index below 40
• be nicotine, tobacco, vape, and smoke-free
• have a hemoglobin A1C below 8 for patients with diabetes
• see a dentist within the year before surgery to fix cavities and treat oral infections

Maintaining your health

The most important advice I can give arthritis patients is to live an active, healthy lifestyle. By this, I mean follow a healthy diet, exercise, and seek routine medical checkups. This will not only help prevent health and arthritis problems, but more importantly, it will also help make you feel better and live longer.

Health maintenance is key. Often in our society, we look for the quick and easy fix and that is not always best. The reality is a little bit of prevention each day, with physical hygiene and watching what we eat, is best for our long-term health.  Living an active healthy lifestyle will likely take you the farthest in the long run.

2015 Annual Brown Orthopedics Symposium

Current Topics in Active Adult Hip and Knee Orthopedics for the Primary Care Provider

Click here to download PDF.