Dr. Adam M. Almaguer is a fellowship trained orthopedic surgeon with special training in joint reconstruction and hip preservation. He treats a variety of patients with musculoskeletal issues resulting from developmental hip dysplasia, arthritis, injury, and overuse.
Dr. Almaguer is a native of Florida and completed his undergraduate education at Florida State University. He earned his medical degree from the University of Central Florida and completed his residency in Orthopedic Surgery at the University of Alabama at Birmingham. Following residency, he completed an Adult Reconstruction and Hip Preservation fellowship at Orthopedic Centers of Colorado.
Under the guidance of Dr. Presley Swann, he obtained extensive training in the treatment of hip dysplasia performing periacetabular osteotomies. This allows him to care for the young adult population in preventing the early onset of hip arthritis associated with hip dysplasia.
Dr. Almaguer’s expertise also includes performing total hip and knee replacements in the outpatient surgical setting. He performs hip replacements through a variety of approaches tailored to each patient’s needs. This includes the minimally invasive, muscle sparing direct anterior approach and bikini incision. He performs total and partial knee replacements using kinematic alignment. This advanced technique involves the use of robotics or patient specific 3-D printed models and guides allowing for a customized joint replacement that is specific to each patient’s unique anatomy.
Outside of orthopedics, Dr. Almaguer enjoys spending time outdoors with his wife, Lexi, and their two children, Luke and Brooklyn. Some of their favorite activities include freediving, spearfishing, hiking, biking, and snowboarding. He and his family are avid Nole fans.
Hip Preservation
Hip dysplasia occurs when the femoral head (ball) is improperly seated in the acetabulum (hip socket). Over time this misalignment causes pain, labrum damage, and cartilage wear. While most cases of hip dysplasia are caught during infancy, mild or “shallow” cases of dysplasia often are not diagnosed until young adulthood.
The field of orthopedics has come a long way in the treatment of hip dysplasia. An entire subspecialty has been created to help treat these patients and restore their function. Prior to the development of this field, the primary treatment method was a hip replacement. Parts of the joint were removed and replaced with a prosthesis. The problem with this route is that young adults, often very active, ware down the prosthesis over time and a repeat hip replacement is often required. The field of hip preservation has overcome these limitations and aims to preserve the patients natural hip joint.
Periacetabular Osteotomy (PAO)
Periacetabular osteotomy (PAO) is a surgical procedure that reorients the patients pelvis into the correct position. Cuts are made to the bone to reposition the acetabulum into the correct position. Screws are then placed to maintain this position. This correction reduces pain and wear and tear of the hip joint which prolongs the need for a hip replacement.
Historically, the procedure releases all the muscles around the hip which results in a more invasive procedure and a longer recovery. Dr. Adam Almaguer has completed extensive training in hip preservation and has adopted innovative surgical techniques to decrease surgical time, blood loss, and reduce the number of post-op days in the hospital.
Knee Replacement
Total Knee Replacement, also called a total knee arthroplasty, is a surgical procedure in which the damaged or worn out surfaces of the knee joint are removed and replaced with an implant. Arthritis, injury, or other diseases can damage the protective layer of cartilage and cause extreme pain and difficulty performing even basic daily activities. Surgery may be recommended if all non-surgical treatment options fail.
Your doctor may advise a total knee replacement if you have:
- Severe pain that limits your activities of daily living (walking, climbing stairs, getting up from a chair)
- Moderate to severe pain that occurs during rest or awakens you at night
- Failure to obtain relief from medications, injections, therapy, and other conservative methods
- A bow-legged or knock-kneed deformity
Your doctor will also look at medical history, physical exam, and X-ray to determine if a knee replacement surgery is right for you.
Kinematic Alignment for Knee Replacement
Total knee replacements are implanted using either Mechanical Axis (MA) or Kinematic alignment (KA). Historically, most knee replacements were done using the mechanical approach. Using this method, every patient has their knee cut at the same angle which effectively makes every patients knee perfectly straight. We know that not every patient has perfectly straight knees. Many patients are varus (bow-legged), and some are valgus (knock-kneed). The ligaments, soft tissues, and patella are used to functioning in these preexisting angles. We now know that cutting every patients knees perfectly straight can cause some to be left with continued pain and swelling after replacement.
After decades of research, we have started to transition over to Kinematically aligned knee replacements. The knee replacement is inserted in the exact position that matches the position of the native knee before the patient developed arthritis. A CT scan is done prior to surgery and measurements are taken down to the millimeter to ensure the most accurate reconstruction possible. This alignment makes for a more custom and comfortable knee replacement.
Dr. Almaguer uses this patient specific approach so that each patient gets a truly customizable knee replacement that matches their individual anatomy.
