Dr. Brandon Gough, MD
BRANDON GOUGH, M.D.
- American Board of Orthopaedic Surgery
- American Medical Association
- American College of Physicians
- Medical degree, Creighton University School of Medicine
- Orthopedic residency, University of Kansas School of Medicine
- Fellowship, Arizona Institute of Bone and Joint Disorders
Brandon Gough, MD, is a respected, board-certified orthopedic surgeon who specializes in hip and knee replacement surgery in Phoenix, Arizona. By specializing in highly innovative robotic, micro-invasive and muscle-sparing surgical techniques, Dr. Gough is able to help people who are in chronic pain get back to a better quality of life.
Dr. Gough’s focus on avoiding soft tissue disruption means the possibility of a more comfortable recovery period, an outpatient procedure and a quicker return to daily activities. His dedication to personalized treatment through state-of-the-art technology has made him a natural addition to the surgical staff at Phoenix Spine and Joint.
After graduating from Creighton University School of Medicine in Omaha, Nebraska, and completing a residency through the University of Kansas School of Medicine where he was awarded Resident Teacher of the Year, Dr. Gough furthered his surgical skills through the Lower Extremity Adult Reconstruction fellowship at the Arizona Institute of Bone and Joint Disorders.
Dr. Gough also believes in giving back to the community, where he has volunteered his time to help organizations that include the Magis Clinic and Habitat for Humanity.
What can patient’s do to improve their outcome from minimally invasive hip replacement surgery using the direct superior approach as well as Stryker Mako robotic assisted minimally invasive knee replacement surgery? The better you are doing before surgery the better you will do after surgery. You want to go into surgery in the best shape you can be. Continue that exercise regimen after the procedure.
What is the best diet going into joint replacement surgery? Take vitamin D and calcium since most of us are deficient. Bone healing should be the best is can be after surgery. Both hip and knee replacement depend on a patient’s bone growing into the coated portions of the implants. There are studies that suggest a benefit to a low carb diet, but the effect is not terribly strong; still, diets high in protein make sense. Diabetics with high serum glucose levels have a much higher risk of infection; we don’t know for sure that this matters for people without diabetes, but its wise to take on as little risk as possible.
What is the best pain management strategy after joint replacement surgery for patients who are concerned about opioid addiction? Opioid addiction is a real concern. In recent years our communities have suffered tremendous loss of life due to this terrible scourge. Patients undergoing joint replacement are no different than those having other types of surgery in which narcotics have traditionally been used. People have joint replacement should search for narcotic free surgery and narcotic free recovery. Reducing and eliminating opioids starts in the operating room; the anesthetists can use a spinal blocks that last for days to help reduce pain during surgery as well as right afterward. During surgery the surgeon can inject numbing medicine into the fascia and other tissue to reduce pain right after the procedure. In the weeks after surgery Tylenol is a great help and should be taken for 2 weeks after joint replacement surgery. Many surgeons have had good luck with medical marijuana as well.
Have minimally invasive approaches using robotic assistance for joint replacement helped reduce pain following joint replacement surgery? Minimally invasive approaches and robotic assistance have greatly reduced the pain after joint replacement surgery. Right after surgery the pain is much less because the operation is carefully planned. The Stryker Mako robot creates a model of the joint being replace from a Computer tomography scan; the actual joint is registered during surgery so the computer knows where you joint is in space. That means less of your joint needs to be exposed by the surgeon during surgery; that means less pain for you after surgery. The robot also helps the surgeon pick the perfectly sized implant for each patient based on their individual model. If you know someone who had worse pain after surgery for six to twelve months, they probably had surgery without the robot, and they received the wrong sized implant.
How has robotic assistance chance joint replacement surgery? Robotic assistance provides the surgeon with a wealth of information that is used to make the perfect implant selection. The robot also helps make more accurate cuts. These two advantages have really changed the game and made the robot an essential tool for knee replacement surgery in particular.
Are there any permanent restrictions after joint replacement surgery? Dr. Gough believes in restricting activity to lower impact after joint replacement. For most people that means no long distance running. Implants do have a shelf life, and you don’t want to wear them out. The goal is to have one surgery and not have to repeat it. The implants we insert today should be good for thirty years. If you run on the implant that could be reduced to fifteen. If you’re in your fifties today, that means you’ll outlive your implant. We actually want it to be the other way around.