You’ve probably heard the horror stories about metal-on-metal hip implants. The lawsuits, the recalls, the "heavy metal" toxicity—it was enough to make anyone terrified of anything other than a standard total hip replacement. But if you talk to James W. Pritchett MD, a Seattle-based orthopedic surgeon who’s been in the game for over 45 years, he’ll tell you a completely different story.
Honestly, the medical world almost threw the baby out with the bathwater when it comes to hip resurfacing.
Dr. Pritchett is kinda the guy who refused to let the technique die. While most surgeons moved toward the standard "big stem in the femur" approach, he focused on perfecting a version of resurfacing that actually works for people who don't want to spend the rest of their lives "taking it easy." He’s a native of Seattle, a University of Washington School of Medicine grad, and basically a legend in the Pacific Northwest for doing things a bit differently.
Why James W. Pritchett MD Thinks Your Hip Deserves Better
So, what's the big deal? Most people think a hip replacement is their only option. You've got bone-on-bone pain, you get a titanium rod shoved down your femur, and you're done.
But James W. Pritchett MD has spent decades arguing that for younger, active patients, this is overkill. Or rather, it's under-engineered. He specializes in hip resurfacing—specifically using highly cross-linked polyethylene instead of the problematic metal-on-metal designs that gave the procedure a bad name in the early 2000s.
Think of it like a dental crown versus a full tooth extraction.
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Resurfacing keeps your natural bone. It preserves the femoral head. Why does that matter? Because your body knows how to balance itself better when its original geometry is still there.
The "Secret" of Polyethylene
Pritchett isn't just a surgeon; he’s a researcher who’s published over 130 papers. He pioneered the use of a specific type of plastic—that highly cross-linked polyethylene I mentioned—to act as the bearing surface.
In a study he published reviewing over 2,100 of his own procedures, the survivorship was roughly 97.5% at nearly a decade of follow-up. That’s massive. He found that patients weren't just "pain-free"—they were actually active. We're talking about people returning to competitive cycling, skiing, and even adventure sports.
The "Odd Duck" with the Steady Hands
If you look at patient reviews, you’ll see a pattern. Some people say he’s "an odd duck." Others mention a "terrible bedside manner" or say he can be "dismissive of feelings." One patient on Healthgrades even mentioned he didn't seem to care about their anxiety.
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But then, you see the other side.
Patients who had seven surgeries with him and wouldn't go anywhere else. Athletes who were told they’d never run again, only to find themselves back on the track thanks to his specific techniques. He’s the surgeon’s surgeon. In fact, he’s famously presented on why other surgeons actually prefer hip resurfacing over total replacement when it’s their own hips on the line.
He’s not there to hold your hand through a therapy session; he’s there to rebuild a joint that most people thought was a lost cause.
Beyond the Hip
While he’s the "hip resurfacing guy," he also does a ton of work with shoulders and knees. He’s pioneered:
- Bicruciate-retaining knee replacements: Keeping both your ACL and PCL during a knee replacement. Most surgeons cut them out. Pritchett thinks they’re vital for that "natural" feel when you’re walking.
- Metal-free alternatives: For people with metal allergies, he offers ceramic coatings.
- Robotic-assisted surgery: He performed the first robotically assisted hip replacement in the Northwest.
What Really Happens in the Operating Room
Let’s get real about the "Direct Superior Approach." This is one of the techniques Pritchett uses. The goal? Minimal muscle damage.
By going in through the top/back without cutting the key muscles that stabilize the hip, he gets people out of the hospital faster. Sometimes the same day.
However, there’s a catch. One patient reported waking up with a 12-inch incision when they expected a small one. This highlights a reality of complex orthopedic surgery: sometimes, the "plan" meets the reality of the patient's anatomy, and a surgeon has to prioritize a successful joint over a tiny scar.
Common Misconceptions About Dr. Pritchett’s Methods
1. "Resurfacing is dangerous because of metal ions."
Nope. Not when you use polyethylene or ceramic. Pritchett moved away from metal-on-metal long ago to avoid those issues.
2. "You can't do sports after a hip replacement."
Pritchett’s whole philosophy is "adventure sports." He designs the reconstruction to handle high-impact loads that would make a standard "stem" implant loosen over time.
3. "He's only in Seattle."
While his main base is the Swedish Orthopedic Institute in Seattle and his office in Kirkland, he’s also seen patients in Redmond and has a global reputation that brings people in from all over the world.
Is He the Right Surgeon for You?
Honestly, it depends on what you want.
If you want a doctor who is going to spend an hour talking about your feelings and comforting you, you might find him a bit cold. But if you’re a 45-year-old who refuses to give up tennis, or a 60-year-old hiker who wants a hip that feels like a "real" hip and not a mechanical part, he’s likely on your shortlist.
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Actionable Next Steps
If you’re considering seeing James W. Pritchett MD, do these three things first:
- Check your imaging: Get a recent MRI or X-ray. He’s a data-driven guy; he needs to see the bone stock you have left to determine if you’re a candidate for resurfacing versus a total replacement.
- Read his research: Go to PubMed or his own site and look up his papers on "Highly Cross-Linked Polyethylene." Understanding the science will make your consultation much more productive.
- Be direct: When you meet him, skip the small talk. Ask about his specific failure rates for your age group and his experience with "stems" versus "resurfacing" for your specific activity level.
He’s currently affiliated with Swedish Medical Center and Proliance Eastside Surgery Center. Whether you like his personality or not, his stats on joint longevity are hard to ignore.