"A lot of that skill set carries over," says Bramlett. "Much of it involves hand/eye coordination, an understanding of how things fit together, and developing certain efficiencies while working in a particular space. So all of that is part of the process."
That unusual technical background has helped lead Bramlett to becoming principal creator of a new approach for joint surgery called the Alabama Minimally-Invasive Surgical Technique. The MIS results in most surgeries requiring about 30 minutes, with below-normal infection rates and patients typically returning home in two days or less. Bramlett performs approximately 1,000 cases a year.
He gives credit to his experienced team at Brookwood Medical Center for making such a workload possible. "My number-one assistant, Bill Parker, has been with me 25 years and is like having another set of arms," says Bramlett.
"A large part of the technique is doing things in a very standardized manner," he says, "so that you're not re-inventing the process each time you go in. It's a matter of patient preparation, how the staff organizes the room, the patient, the instruments, and so on. It's all aimed at standardization, so that you don't have a random result. We organize around the outcome, and the procedure is all about outcome."
When Bramlett is not in the surgical suite, he has a wide range of interests to help him unwind. One of his favorite pastimes is playing polo.
"I trained horses when I was younger," he says. "They're fantastic animals, so it's always been a fun thing for me. It's not just a question of you learning the horse, it's also a process of the horse learning you.
"I played baseball and other sports through high school and college, and had a baseball scholarship at Birmingham-Southern, but polo is probably the most enjoyable sport I've been involved in. A big part of the experience is the other players' level of engagement. They're just a hardy, healthy, happy group of people who love the sport for the sport itself; there's not big money involved. And we always learn from each other.
"I've been playing for nearly 20 years, but every time I play a match it's still a demanding challenge. And a good match can have the energy expenditure of running a 10K race."
Other side interests include music--he learned the guitar and other stringed instruments as a child--and he's also a self-taught painter. "I developed an interest in modern art," Bramlett says, "and my work is mostly in an impressionist style." Some of his paintings decorate the clinic's offices. "I've also sold quite a few pieces," he says, "but I certainly don't do it for the money, just the satisfaction. It's a good experience to capture a memorable image."
Aviation is another pastime on his list. "I became friends with a lot of pilots, some of them crop-dusters years ago," he says. "The main thing that attracted me to flying was that it's intellectually interesting--so many certifications, requirements, technical aspects. And as a result, flying is a very safe, very positive environment."
Bramlett and his wife Laurie have six children, ranging in age from 15 to 27. "Most of the kids are spread out geographically, so flying is a fun and safe way to get to them," he says.
As for the future of his profession, Bramlett says its focus in coming years will be less on technology and more on enhancing patient recovery.
"Manufacturers continue to produce very sophisticated, high-tech knee and hip devices," he says, "but what's important is educating patients as to what's involved in reconstruction and sports medicine surgery and helping them recover more effectively after they return home.
"That's become sort of the missing link--how to recover safely in the care of their family after they go home from the hospital, especially since hospitals are trying to cut down on length of stays and the extended families who help provide the post-op care are much smaller than they used to be.
"I think preventive care will also be a big part of the picture. Knee replacements, for instance, are doubling every decade. One projection says that by 2020 there'll be 1.4 million cases, and by 2030 some 3.3 million cases. Currently, the infrastructure to manage those procedures and recoveries just doesn't exist.
"So I think how to educate people and manage that case load will be a major issue of the future."