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Terry A. Clyburn M.D. - Joint Replacement Associates
Terry A. Clyburn M.D

Terry A. Clyburn M.D
Orthopaedic Surgeon

Terry Alan Clyburn, M.D., was born at the original Memorial Hospital in downtown Houston in 1952. His father was a design engineer at Hughes Tool Company, designing drilling equipment and rock bits. His mother was a bank teller at the Harrisburg Bank near the Turning Basin of the Ship Channel. His grandfather was a home builder. He worked for his father and his grandfather doing plumbing and carpentry. His father, who spent his days designing mechanical equipment, spent his evenings and weekends working on mechanical equipment. He taught Dr. Clyburn the basics of auto repair, and Dr. Clyburn also helped his father build an airplane.

Dr. Clyburn went to Stephen F. Austin High School in central Houston and then went to the University of Houston where he graduated with a Magna Cum Laude in Science. During his years at the University of Houston, he worked at St. Luke's Texas Heart Institute as a phlebotomist (blood drawer). He also worked at Kelsey Seybold Clinic in the Microbiology Lab. When Dr. Clyburn sustained a knee injury while playing football, he was treated by a local orthopaedist, Dr. Thomas Cain, who invited him to spend some time with him. Dr. Clyburn spent several days with Dr. Cain when he was treating the Houston Oilers, serving as the Chief of Staff at the Shrine Crippled Children's Hospital, and also doing research in the area of cartilage transplantation. Dr. Clyburn became convinced that orthopaedic surgery would combine the skills learned from his grandfather and father as a young man with his interests in science and entering into a field in direct patient care.

Named a Top Doc in Texas by
Texas Monthly three years in
a row 2006-2009

Dr. Clyburn went to medical school at The University of Texas Medical Branch in Galveston. While there, Dr. Clyburn had the opportunity to rotate at the Baylor College of Medicine where he met Dr. Paul Harrington. Dr. Harrington is the developer of the Harrington Spinal Instrumentation System which was originally developed to treat spinal curvature in children that resulted from polio. This system became widely used for all forms of scoliosis, spinal trauma, and other disorders. Dr. Clyburn then entered his internship at The University of Texas Health Science Center at Houston. He began this work in 1979 when interns and the residents still flew with the Life Flight Program. Dr. Clyburn made over 100 flights, bringing in both medical and surgical patients. Interns and residents no longer fly with Life Flight because of risk of legal action against the hospital should they be injured.) Dr. Clyburn then entered his residency at The University of Texas Health Science Center at Houston in the area of Orthopaedics, doing extensive trauma training with the Hermann Hospital, musculoskeletal oncology and reconstruction at the M.D. Anderson Tumor Institute, and treating children at the Shrine Crippled Children's Hospital. During this training, Dr Clyburn completed two research projects and published one report in the Journal of Bone and Joint Surgery. One paper was entitled "Atlanto-axial Instability in Children" and the other "Correction of Bow-Legged Deformity in Dwarfing Conditions". The case report was the first and still only report of "Bilateral Transverse Process Fractures".

In 1984, Dr. John Murray, the Chairman of the Division of Orthopaedics at M.D. Anderson Hospital, invited Dr. Clyburn to work with him treating musculoskeletal tumors and doing extensive reconstructive surgery, a part of this treatment. Dr. Clyburn stayed with Dr. Murray from 1984 to 1987, gaining extensive experience in these extremely difficult reconstructive cases. These included total humeral replacement, including replacement of the shoulder and the elbow, and extensive resection of the distal femur and proximal tibia with custom replacements.

Dr. Clyburn achieved Board certification in 1986. At that time, it was required that the individual be in practice for two years before taking the examinations to become Board certified. A written examination, which is quite extensive, must first be passed, followed by an oral examination in four areas of expertise. Prior to1986, once the Boards had been passed, the Board certification was permanent. However, subsequent to 1986, Board certification required renewal every ten years. Dr. Clyburn repeated the Board examination process in 1996 and passed the examination on the first attempt; he then repeated the examination in 2006, again passing the examination on the first attempt.

Post Core DecompressionIn 1997, Dr. Clyburn felt that he had achieved a level of expertise in performing major adult reconstructive procedures and entered into private practice performing total knee, total hip, total shoulder and other adult reconstructive procedures although he also has specific expertise in other areas of Orthopaedics. As a chief resident at The University of Texas Health Science Center at Houston in 1983 -1984, he began working with the Gulf States Hemophilia Service as an orthopaedic consultant. Hemophilia, which is commonly called free bleeding, affects primarily young men, and results in recurrent bleeding into the joints which can cause very severe forms of arthritis. These problems, like tumor reconstruction, present some of the most challenging cases in Orthopaedics. Most experienced orthopaedists will not operate on hemophiliacs. Also, as a chief resident, Dr. Clyburn began working with the Renal Transplant Service. Drs. Barry Kahan and Charles Van Buren started one of the first renal transplant services in this country. The patients who have undergone renal transplantation often require large doses of Prednisone to prevent rejection of their transplanted kidney. Unfortunately, this medication may lead to a condition known as osteonecrosis or avascular necrosis of the femoral head. This is a condition in which the head or bone of the femur about the hip dies, collapses, and leads to a significant form of arthritis. This condition can also affect the knees and the shoulder. In the early stages of osteonecrosis, the hip, although containing dead areas of bone, will retain its natural shape. In this stage, an approach called "save the hip" is used to attempt to prevent further collapse and the development of arthritis. One of the techniques used to prevent collapse is a surgical procedure called a core decompression. In this technique, a small incision is made over the side of the thigh, and a drill is used to drill through the bone into the area of dead bone. This reduces the pressure within the bone which is quite painful. The decreased pressure also allows new blood vessels to grow into the dead area of bone and to allow healing. This technique is quite successful, and Dr. Clyburn has performed over 500 of these with approximately a 70 percent success rate.

Fibula GraftAnother procedure is called a vascularized fibula graft. In this procedure, a team including a plastic surgeon that specializes in microsurgery by the name of Dr. Melissinos works with Dr. Clyburn. In this procedure, a fairly large drill hole is placed into the area of dead bone of the femoral head, allowing for passage of the fibula, or small bone of the lower leg, to fit into this hole. Dr. Melissinos obtains this piece of bone from the midsection of the lower leg along with its artery and vein that supply it. Once the bone is passed into the femoral head and neck region, it is fixed with a small pin and then the blood vessels are attached to an artery and vein in the immediate area of the hip. This allows for active blood flow into this bone graft and improves the chances of healing of the bone graft. The general literature reports the success rate of this procedure somewhere between 80 and 95 percent. Drs. Clyburn and Melissinos have been extremely selective in which cases they will perform this procedure, but to date, have had 100 percent success with it. This procedure, however, is much more involved than the simple core decompression. The core decompression is done as an outpatient and requires crutches for about six weeks. The vascularized fibula transplant is a long surgical procedure, requiring five to seven days in the hospital and up to several months on crutches postoperatively.

While working with the hemophilia group, Dr. Clyburn became familiar with a technique which was being practiced in Denver and Los Angeles called radiosynovectomy. This involves injecting a low dose of a radioactive material into the joint. The radioactive material dries up the synovial lining of the joint, which in hemophilia is thickened and very prone to bleeding. This reduces the bleeding tendency of the joint significantly and in many cases, avoids major surgical procedures.

Clyburn FixatorAdditionally, Dr. Clyburn has been an innovator through his career. In 1984, he worked with the Zimmer Corporation having a new idea for a unique form of treatment of fractures of the radius bone at the wrist. Prior to this, severe fractures were treated either by casting or by a device called an external fixator which attached pins above and below the fracture, immobilizing the fracture. The result of this type of treatment often resulted in permanent stiffness of the wrist. The Clyburn Dynamic External Fixator was introduced in 1984 and not only provided for maintenance of the reduction of the fracture, but also allowed early movement of the wrist. Advancement in internal fixation techniques with very small screws and plates in the late 1990s ultimately proved to be a superior form of treatment to the Clyburn Dynamic External Fixator, and sales of the fixator ceased.

Hip ViseIn 1995, a new device was developed to hold patients in the proper position for total hip replacement. It is very important while doing a total hip replacement to maintain the patient's pelvis or hip bone in the proper position. This device is called the Hip Vice and is used in centers throughout the world. See the Innovative Orthopaedics website for more details.

In 1991, Dr. Brian Parsley, who also is a native Houstonian, joined Dr. Clyburn in practice after having done joint training in Arlington, Virginia, with one of the developers of the uncemented hip technique. At that time, they moved their practice from the Hermann Professional Building to the St. Joseph's Professional Building. They began what they called a Joint Camp, and they believed that this was the first joint camp in the Houston area. This program was patterned after similar programs in southern Florida which emphasized preoperative preparation, excellent surgical planning, precise execution, and focused postoperative care based on a clinical pathway. Clinical pathways were based on what were called critical pathways used in construction, for each step is pre-planned on a timeline. The use of these principles remarkably improved patient recovery, satisfaction, and reduced hospital stays from well over a week to just over three days.

They continued this program until 1997, when simultaneously, Dr. Parsley was invited to join the full-time staff at Baylor College of Medicine on their Total Joint Service and Dr. Clyburn was invited to become the Director of Total Joint Services at The University of Texas Health Science Center at Houston. In this position, Dr. Clyburn has taught residents how to perform total joint arthroplasty and has been involved in many areas of research.

At that time, Dr. Clyburn also became the Medical Director of Research. In this position, Dr. Clyburn taught residents how perform total joint arthroplasty and he has been involved in many areas of research.

The most noticable development while Dr. Clyburn was at the Universiy of Texas Health Science Center in the Department of Orthopaedic Surgery was the development of antibiotic microspheres. These small beads are capable of releasing antibiotics at a very predictable rate.

Article Article: Fall Prevention in the Elderly

Article Article: Antibiotic Microspheres: Preliminary Testing for Potential Treatment of Osteomyelitis

Article Article: Effective Treatment of Osteomyelitis with Biodegradable Microspheres in a Rabbit Model

Article Article: Pseudotumor in Metal-on-Polyethylene Total Hip Arthroplasty

Article Article: Reconstructive Review

They have been shown to be effective in the treatment of osteomyelitis (bone infection). They also have been applied to implants and have protected these implants from infection. Antibiotic microspheres are not yet FDA approved, but the patent is pending, and continued resarch is ongong which will elead to FDA approval.

Dr. Clyburn feels confident that this technology will eliminate, or at least markedly reduce the risk of infection seen whenever any artificial material is implanted in the human body.

Dr. Clyburn's Curriculum Vitae Dr. Clyburn's Curriculum Vitae

 

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