Here are some answers to common questions about the procedure.

When do you potentially need a shoulder replacement?

• When your shoulder consistently gives you pain
• When movement has become too restrictive
• When it no longer responds to such treatments as physical therapy and medications, including pain-relieving injections

What are the causes of these shoulder conditions?

• Osteoarthritis
• Rheumatoid Arthritis
• Posttraumatic Arthritis
• Rotator Cuff Tear Arthropathy
• Avascular Necrosis
• Severe Injury

Who is a likely candidate for the surgery?

• General good health
• Appropriate weight (BMI <40)
• Non-smoker
• Arthritis that has failed to respond to conservative treatment

How common is shoulder surgery?

Shoulder joint replacement has become increasingly common, and is now as effective as knee and hip replacement surgery to help patients get back to their normal activities without pain. According to the Journal of Shoulder and Elbow Surgery, 175,000 to 350,000 procedures per year may be performed by 2025. Orthopedic Performance Institute surgeons, Dr. Matthew Dwyer and Dr. Christopher Phelps, routinely perform shoulder replacement surgery.

How is it done?

Total shoulder replacement surgery, also known as shoulder arthroplasty, involves removing the damaged portions of the shoulder joint and replacing them with artificial components, collectively referred to as a prosthesis.

The surgeon begins by making an incision over the shoulder to access the joint. The damaged or arthritic cartilage and bone from the head of the humerus (the upper arm bone) and sometimes the socket of the scapula (the glenoid) are carefully removed. These surfaces are then reshaped to fit the prosthetic components.

The artificial joint is made from metal and plastic materials designed to mimic the natural anatomy and function of the shoulder. Cement or a press-fit technique may be used to secure the prosthesis, depending on bone quality and the specific implant design.

Replacement Options

There are different types of shoulder replacement procedures, depending on the extent of joint damage and the patient’s needs:

• Partial Shoulder Replacement (Hemiarthroplasty)
  In this procedure, only the head of the humerus (the “ball” of the joint) is replaced with a metal implant. The socket (glenoid) is left intact. This option is often chosen when the glenoid is healthy or when the damage is primarily limited to the humeral head, such as in some fractures.
• Total Shoulder Replacement (Anatomic Total Shoulder Arthroplasty)
  Both the ball (humeral head) and the socket (glenoid) are replaced. The humeral component is typically metal, while the glenoid component is made of medical-grade plastic (polyethylene). This is the most common type of shoulder replacement and is generally recommended for patients with osteoarthritis, rheumatoid arthritis, or severe joint damage.
• Reverse Shoulder Replacement (Reverse Total Shoulder Arthroplasty)
  In cases where the rotator cuff is severely damaged or nonfunctional, a reverse shoulder replacement may be used. This procedure reverses the normal ball-and-socket configuration: a metal ball is attached to the scapula, and a plastic socket is placed on the top of the humerus. This design relies on the deltoid muscle rather than the rotator cuff to lift the arm, making it ideal for patients with rotator cuff arthropathy.

Your orthopedic surgeon will determine which course of action to take.

What evaluation processes are involved?

The Orthopedic Performance Institute’s Dr. Matthew Dwyer and Dr. Christopher Phelps will evaluate you in four key areas.

1. Medical history. You’ll be asked about your overall health, pain and ability to perform everyday activities.
2. Physical examination. This will assess your shoulder motion ad strength.
3. X-rays. These will allow the doctors to evaluate the damage and what needs to be replaced.
4. CT scans and MRIs. These procedures may be warranted to allow a closer examination of the bone and soft tissue.

How long is the surgery?

The procedure is typically performed under general anesthesia and may take about 1.5 to 3 hours, depending on the complexity. Afterwards, you will either be released home or be admitted to the hospital for further observation.

What is the recovery timetable?

Recovery from shoulder surgery is a gradual process that typically spans about a year. In the first 1–2 weeks, patients begin gentle home physical therapy focused on passive range of motion, while keeping the shoulder dry until the surgical dressing is removed during the two-week follow-up. Sling immobilization is crucial during the first six weeks. From weeks 2–6, outpatient physical therapy continues to focus on passive motion, still with sling use. Between weeks 6–10, patients can discontinue the sling and begin active range of motion exercises, avoiding any lifting. From weeks 10–14, therapy progresses to include strengthening exercises. By 3–6 months, most patients follow a home regimen to further improve motion and build strength. Full recovery is typically achieved around one year post-surgery.

Contact Us Today

Don’t let shoulder pain keep you from the activities you love. Contact the Orthopedic Performance Institute in San Antonio at (210) 545-7171 for a complete evaluation with Dr. Christopher Phelps or Dr. Matthew Dwyer.

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Orthopedic surgery can be applied in situations where non-surgical treatments have failed to provide relief from pain or address the underlying condition.

While every patient’s situation is unique, there are some common reasons that orthopedic surgery may be called for:

Severe Trauma or Injury

In cases of severe trauma or injury to the musculoskeletal system, orthopedic surgery may be necessary. These conditions include:

• Fractures that cannot be effectively treated with casting or immobilization alone
• Dislocations
• Severe ligament or tendon tears
• Complex joint injurie

Surgery is performed to realign bones, repair damaged tissues and restore stability and function.

Chronic Pain and Degenerative Conditions

Chronic pain that is caused by degenerative conditions like osteoarthritis, rheumatoid arthritis or spinal disc herniation may require orthopedic surgery after the gauntlet of non-surgical options have been exhausted.

Joint replacement surgeries such as hip or knee replacements can provide significant pain relief and improve mobility for individuals with severe joint damage.

Sports Injuries

Athletes who sustain sports injuries such as torn ligaments (ACL, MCL), meniscus tears or cartilage damage can benefit from orthopedic surgery. Depending on the severity and location of the injury, arthroscopic procedures or reconstructive surgeries may be utilized.

These surgeries intend to restore function, stability and range of motion, allowing athletes to get back in the game.

Congenital or Developmental Abnormalities

Orthopedic surgery may be in order for individuals who suffer from congenital or developmental abnormalities of the musculoskeletal system. These conditions can include scoliosis, hip dysplasia, or limb length discrepancies. Orthopedic surgery can:

• Correct deformities
• Improve function
• Prevent long-term complications

Such surgeries are typically performed on children or adolescents to optimize healthy growth and development.

Infection or Tumor

Orthopedic surgery may be necessary to treat infections or tumors that affect the musculoskeletal system.

Surgeries such as debridement (removal of infected tissues), bone grafting or tumor excision are ways to eliminate infections or remove cancerous or benign tumors. These procedures are essential for:

• Preventing the continuing spread of infection
• Preserving limb function
• Avoiding further potential malignancies

Considerations for Undergoing Surgery

The decision to undergo orthopedic surgery is made on a case-by-case basis, taking into consideration such factors such as the patient’s overall health, lifestyle, and goals.

Orthopedic surgeons, Dr. Matthew Dwyer and Dr. Christopher Phelps, at the Orthopedic Performance Institute will work closely with you to assess your condition, explore more conservative treatment options, and determine whether surgery is the most appropriate course of action.

Contact the Orthopedic Performance Institute in San Antonio or Boerne at (210) 545-7171 for more information or to schedule an examination.

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Who gets plantar fasciitis?

For obvious reasons, runners and athletes are subject to the condition, but people who are carrying too much weight can also suffer. It also afflicts older adults. And if you have a job that keeps you on your feet all day, plantar fasciitis can occur. Anything that puts too much continuous pressure on the ligament can cause it.

How can you prevent a flare-up?

Mix up your routine. If your exercise routine involves lots of running and jumping, try adding some low-impact exercises to give your plantar fascia a break.

Give it a rest. If you’re starting to feel that old familiar heel pain, don’t try to push through the pain. Your feet will thank you.

Give it a stretch. That tendon get can too tight, so you need to limber it up. You’ve seen runners do this before a big race. First, sit down with your legs extended straight out in front of you. Grab your toes and pull them toward you to give the tendon a stretch, but not too hard. Next, stand facing a wall and position your foot flat on the ground behind you. Hold for about 30 seconds per foot.

Wear the correct shoes. Don’t wear shoes that are too tight — or too loose. The shoes that fit right will support your heel and prevent flare-ups. We can also recommend some inserts to provide additional support.

Try over-the-counter anti-inflammatories. It will reduce swelling and the accompanying pain.

In summary…

The best way to treat plantar fasciitis is to not get it at all. If you’re still feeling those symptoms after trying these treatments, don’t wait. Contact the Orthopedic Performance Institute in San Antonio to have your condition examined by an expert!

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What does calcium do for our bones?

Our bodies are comprised of many different minerals, such as iron and magnesium, but the most abundant mineral in the body is calcium.

Our bones are partly made of calcium salts (mixtures of calcium with other minerals), especially calcium phosphate. Calcium phosphate hardens and strengthens bone.

Since our bodies cannot make calcium, we need to get it from foods and drinks to build strong bones and teeth and to keep them healthy. Healthy bones are less likely to break if we have a traumatic injury.

What happens to our bones without enough calcium?

Calcium does more than build strong bone. It also helps our muscles, heart, and nerves work properly.

If we do not get enough calcium in our diets, our bodies take the calcium we need from our bones. Over time, this process makes bones weaker and raises the risk of osteoporosis. Osteoporosis is a disease that renders our bones weak and brittle, and people with osteoporosis have a higher risk of fractures.

How much calcium do we need?

The amount of calcium each person needs depends on their age and sex. Here’s how much calcium people need every day to keep their bones strong and healthy.

Source: National Institutes of Health Office of Dietary Supplements

Which foods have calcium?

The best food sources of calcium are milk and other dairy products, like cheese and yogurt. Other food sources of calcium include:

• Fish (such as salmon and tuna)
• Leafy green vegetables (such as kale and turnip greens)
• Tofu (set with calcium)
• Small fish with bones (including sardines and canned salmon)

Some foods and drinks are fortified with calcium. A food is fortified when the manufacturer adds vitamins or minerals that the food does not naturally have. Examples of foods fortified with calcium are certain brands of juice, soymilk, oatmeal and breakfast cereal.

Some supplements contain calcium. Talk to your health care provider, such as the professionals at the Orthopedic Performance Institute, if you are considering whether or not to take a calcium supplement.

What does vitamin D do for our bones?

Vitamin D promotes bone health in these ways:

• Helps absorb the calcium we get from food.
• Along with calcium, helps protects older adults from osteoporosis.
• Promotes healthy functioning of our muscles and immune system. We need strong muscles to maintain our balance and reduce the risk of falling and breaking bones.

What happens to our bones without enough vitamin D?

When children do not get enough vitamin D, they can develop rickets. With this condition, the bones become soft, weak, deformed and painful.

In adults, too little vitamin D over time can cause:

• Osteomalacia, a painful condition that makes bones and muscles weak and more likely to bend and break.
• Osteoporosis.

How much vitamin D do we need?

Source: National Institutes of Health Office of Dietary Supplements

In the United States, most people do not consume enough vitamin D to meet recommended intakes. Some vitamin D can be made in the body with sun exposure but many people have low vitamin D status.

Which foods have vitamin D?

Not many foods have vitamin D. Some kinds of fish can provide some of the vitamin D we need each day. Examples are:

• Trout
• Salmon
• Tuna
• Mackerel

Most of the vitamin D that Americans get from food comes from fortified foods. Most milk and some yogurts in the United States are fortified with vitamin D, but most other dairy products do not have added vitamin D.

Other foods that may be fortified (check the label to be sure) include:

• Ready-to-eat breakfast cereals
• Orange juice

Some supplements contain vitamin D. Again, consult your health care provider if you are considering taking a vitamin D supplement.

If you’re concerned about your bone strength, a bone density test can help alleviate your worries. Contact the Orthopedic Performance Institute in San Antonio at (210) 545-7171 for more information.

Medical information provided by the National Institutes of Health.

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Sports medicine focuses on the prevention, diagnosis and treatment of musculoskeletal conditions involving the bones, muscles, tendons, ligaments, and joints. You don’t have to be a marathon runner to suffer from such injuries. Stress from repetitive use or even an injury caused by a fall can be treated by a sports medicine professional.

There are two basic categories of injuries treated in sports medicine care. The first involves acute injury and the second involves damage caused by wear and tear and disorders such as arthritis that tend to develop gradually.

Sports medicine professionals can help patients with these symptoms:

• Joint and muscle pain
• Bone fractures
• Foot pain
• Ankle injury
• Overuse injury
• Joint dislocation
• Muscle fatigue
• Sudden, non-emergency injuries

Getting Back Into the Game

The Orthopedic Performance Institute’s Dr. Alexandra Matthews specializes in non-surgical treatment of these injuries, which helps to get patients “back into play” quickly and with less trauma. This is accomplished by utilizing techniques such as platelet-rich plasma (PRP) injections, in which the patient’s own blood is utilized to speed up the healing process. There are also nerve block injections that can block the pain for up to 90 days.

Diagnostic ultrasound is another way the doctor can identify the injury and begin treatment quickly. The Orthopedic Performance Institute utilizes the most modern techniques.

If it is determined that a patient’s condition requires surgery, Dr. Matthews can refer them to an orthopedic surgeon whose knowledge and experience is appropriate to treat the condition.

Avoiding Injury

She also counsels patients on injury avoidance. This is accomplished by instructing them how to train correctly and wear the appropriate gear and footwear. Good nutrition plays an important part, too, as it’s vital to keep bones and muscles strong. Patients aged six years and up are welcome.

Don’t keep living with unnecessary pain. Contact the Orthopedic Performance Institute in San Antonio or Boerne at (210) 545-7171 for an appointment today.

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Dr. Christopher Phelps is now scheduling outpatient procedures in the Bulverde/Spring Branch area at the Singing Hills-Legent Orthopedic & Spine Center. The center is located at 524 Singing Oaks, Spring Branch, 78070.

PROCEDURES

Outpatient procedures performed include arthroscopy and total shoulder, knee, and hip replacements. Patients are evaluated to ensure they’re eligible for an outpatient joint replacement procedure.

INSURANCE

We accept most health insurance plans and will work with you every step of the way to confirm benefits and file claims.

TO SCHEDULE

Call (210) 545-7171 to schedule with a member of our friendly staff.

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Rotator Cuff Tears

A rotator cuff tear occurs when the tendons that attach the muscles of the rotator cuff to the upper arm bone tear partially or completely. This condition is often caused by repetitive motions or sudden injuries. Treatment options for rotator cuff tears depend on the severity of the tear. Non-surgical treatments may include rest, physical therapy, and anti-inflammatory medications. However, in more severe cases, surgery may be required to repair the torn tendons.

Frozen Shoulder (Adhesive Capsulitis)

Frozen shoulder, also known as adhesive capsulitis, is characterized by pain and stiffness in the shoulder joint, limiting its range of motion. The condition typically develops over time and goes through three stages: freezing, frozen, and thawing. Treatment for frozen shoulder usually involves physical therapy, stretching exercises, and sometimes corticosteroid injections to reduce inflammation and improve mobility.

Shoulder Impingement Syndrome

Shoulder impingement occurs when the rotator cuff tendons become pinched between the bones of the shoulder. This often happens during overhead activities and can cause pain and weakness in the affected arm. Treatment for shoulder impingement may include rest, activity modification, physical therapy to strengthen the rotator cuff muscles, and anti-inflammatory medications. In some cases, a corticosteroid injection may be administered to reduce inflammation.

Bursitis

Bursitis is the inflammation of the bursa, small fluid-filled sacs that cushion and reduce friction between bones and soft tissues in the shoulder. Overuse or direct trauma can lead to bursitis. Treatment for shoulder bursitis includes rest, ice application, and anti-inflammatory medications. Physical therapy may also be recommended to strengthen the surrounding muscles and prevent further irritation.

Shoulder Osteoarthritis

Shoulder osteoarthritis is a degenerative joint disease that occurs when the cartilage that covers the bones in the shoulder joint wears down over time. As a result, movement becomes painful and limited. Treatment for shoulder osteoarthritis often involves a combination of pain management with medications, physical therapy to improve joint function and strength, and lifestyle modifications. In severe cases, surgery such as shoulder joint replacement may be considered.

Conclusion

Taking care of your shoulders is crucial to maintaining an active and pain-free lifestyle. If you experience persistent shoulder pain or limited mobility, it’s essential to consult an orthopedist, like Dr. Matthew Dwyer, Dr. Alexandra Matthews and Dr. Christopher Phelps, for an accurate diagnosis and appropriate treatment plan. Early intervention and proper management can significantly improve the outcome for various shoulder conditions. Remember, it’s always better to address shoulder issues promptly to prevent further complications and to get back to enjoying life to the fullest!

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Do you suffer from osteoarthritis pain in your knee? The Orthopedic Performance Institute has a treatment for you. We’re one of the few practices in the San Antonio area that offer iovera°. It’s safe, FDA-approved and performed right here in our office.

Do you have a knee replacement surgery scheduled? iovera° can also be used prior to your surgery to help relieve pain and make recovery easier. Patients who received iovera° as part of their recovery plan reported:

• Greater range of motion
• Less difficulty straightening their bent knee
• Less difficulty bending their straight knee

Additionally, studies have shown that iovera° can help reduce opioid use after knee replacement surgery. 68% less opioids were needed during the hospital stay and 45% less opioid medication was needed 12 weeks after surgery. Patients continued to have reduced stiffness at 30 days and improved ability to complete routine tasks at 90 days.

How does it work?

iovera° uses extreme cold to stop nerves from sending pain signals to your brain. Relief is felt immediately and can last up to 90 days.

The iovera° system is a handheld device that lets Dr. Matthews, our sports medicine specialist, apply just the right amount of extreme cold only to the nerves that needs to be targeted — the ones causing you pain. This process delivers immediate pain relief in the time it takes for a routine doctor’s visit, and it doesn’t hurt. iovera° does not contain medicine. It’s also safe and does not damage or destroy any surrounding tissue.

What does the procedure involve?

A numbing agent (topical or injected) is applied to minimize discomfort during treatment. iovera° treatment is not painful. Then, a small probe (called a “Smart Tip”) is inserted into the skin. Under the skin, a precise cold zone forms, which temporarily freezes the targeted nerve. Dr. Matthews will repeat this process until the targeted nerve is blocked. The entire treatment takes about 15 to 30 minutes.

How should I prepare?

It’s easy to prepare for the iovera° treatment. Wear loose-fitting, comfortable clothing that allows for easy access to the knee area (shorts are a good option).

Dr. Matthews will go over your medical history with you, including:

• Any daily medicines you take (e.g., blood thinners, pain medicine)
• Health history and health conditions you have now and/or have had in the past
• Any previous surgery, treatment, or trauma
• Any previous medical diagnosis regarding the treatment area
• If you have a history of keloid (a raised scar after an injury has healed) formation
• If you have a history of reactions to local anesthetics
• If you have a history of sensitivity to pain or cold
• Any open or infected wounds in the treatment area
• If you regularly use anticoagulants such as fish oil, Coumadin, aspirin, or NSAIDS [nonsteroidal anti-inflammatory drugs, such as ibuprofen]

On the day of the procedure, we will assess your pain, clean and mark the treatment area, and numb it prior to the procedure. Wear loose-fitting, comfortable clothing that allows for easy access to the knee area (shorts are a good option).

Are you seeking relief from knee pain and stiffness? Contact the Orthopedic Performance Institute in San Antonio for a consultation with Dr. Matthews about iovera°.

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Shoulder replacement surgery is most frequently used for severe degenerative joint disease (osteoarthritis) of the ball-and-socket joint. When the smooth surfaces (cartilage) become rough, they rub against each other instead of gliding as normal joints do. This causes discomfort, stiffness and swelling. Shoulder replacement can help to alleviate this pain.

There are other reasons a complete shoulder replacement may be called for, including fractures from an automobile accident or sports injury, as well as bone deformation from inflammatory arthritis

Who needs shoulder replacement surgery?

When patients have developed long-lasting pain that limits their daily activities, shoulder replacement may be the only solution. Shoulder stiffness interferes with sleep as well as the use of their arm. A shoulder replacement is performed to alleviate this pain. It also helps to restore the range of motion of the shoulder joint, which also improves shoulder function and quality of life

In most cases, arthritis and inflammation compromise the cartilage or the surrounding bone tissues. This can, in turn, cause a deformation of the bone tissues, including the ball and socket of the joint and possibly the nearby AC joint. If there is osteoarthritis present in the AC joint, a distal clavicle resection might be able to alleviate symptoms. Otherwise, for a significant problem in the ball and socket of the shoulder joint, a total shoulder replacement may be called for.

Also known as complete shoulder arthroplasty, the procedure involves removing a portion of the shoulder joint. It is then replaced by artificial implants that will restore the full range of rotation to the joint as well as significantly reducing discomfort.

What the average age range for shoulder replacement?

When the shoulder replacement is part of the treatment plan for osteoarthritis or a similar age-related degradation of the joint, the average age is between 60 to 80 years old. However, some individuals who suffered shoulder trauma from sports injuries or an automobile accident may need a shoulder replacement as early as their 40s.

Are there other treatment options?

A complete shoulder arthroplasty procedure is usually viewed as an end-stage treatment to deal with severe damage, deformity or chronic, severe joint pain. The doctors at the Orthopedic Performance Institute will only recommend it when all other avenues of treatment such as rehabilitative exercises, shoulder arthroscopy, and cortisone shots have failed to prove effective.

How is it performed?

The ball — or humeral head — of the joint is replaced with a metal ball. Titanium is one of the primary choices, as it is capable of a process known as osseointegration, when the metal fuses with living bone tissue. The end result is a stable matrix, capable of supporting the surrounding muscle

The glenoid cavity of the shoulder socket is carefully replaced with a smooth cup-like structure made from a durable type of surgical grade plastic. Metal-to-plastic creates a more fluid motion than metal on metal.

In some cases, it might only be the humeral ball of the socket that needs to be replaced. This procedure is known as Hemi Replacement or partial shoulder replacement. It’s most common in cases of trauma to the upper arm from a severe sports injury or automobile accident.

Preparing For Shoulder Replacement Surgery

The staff at the Orthopedic Performance Institute will describe your sedation options. The most common options are a local anesthesia, with interscalene block, where you may be semi-conscious or general anesthesia, where you will be fully sedated. Other preparation measures, such as abstaining from food or drink for 12 hours before the procedure, will also be described.

How long does it take to recover?

While your general health, age, and activity level are all factors, most patients will physically recover from a shoulder replacement procedure in about eight to 10 weeks. However, it may take several months up to a year before you are fully able to return to strenuous activity.

The average post-surgery stay in the hospital is a day or two, depending on recovery and need for pain management. X-rays will be taken to monitor the integrity and position of the shoulder implant. Rehabilitation specialists will also test your range of motion, and you will begin some basic physical therapy.

Are there any limitations after surgery?

Your shoulder will be immobilized in a special sling for the first week or two of the early rehabilitation phase. This allows the ligaments, tendons, and other connective tissues to heal properly. However, you will be able to remove the sling for showering and rehabilitation exercises. Your physical therapist will help you determine when you can begin relying on the sling less and less.

At six weeks, you should have almost full range of motion restored and be capable of light activities. At eight to 10 weeks you should have full active use of the shoulder and natural range of mobility. At that point, your therapist will recommend the exercises you can perform on your own to carefully restore the natural strength and range of motion.

Most patients are pain-free at around six months, though some might notice minor discomfort during this time. Patients with other physical limitations may take up to a full year to become pain-free and able to return to somewhat strenuous exercises.

What is the average success rate? 

95% of patients are pain-free and enjoy the full range of motion within nine months to a year after surgery. Once full osseointegration is achieved, and the rehabilitation phase is complete, the replacement joint should have a lifespan of 15 to 20 years.

Stop living in chronic pain. Contact the Orthopedic Performance Institute in San Antonio to see what treatment options are available to you.

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When do I need a hip replacement?

When traditional, non-surgical treatment options have failed to manage the pain from an arthritic hip, joint replacement (arthroplasty) can be a valuable tool. The surgeons and staff at Orthopedic Performance Institute are dedicated to combating the effects of osteoarthritis and are determined to guide patients back to an active, enjoyable lifestyle.

We combine patient preparation with advanced surgical techniques, innovative pain management tools, and enhanced rehabilitation strategies to revitalize the lives of patients every day. The foundation of our program is extensive patient education coupled with comprehensive support to ensure success from the beginning. Prepare to excel!

What does a hip replacement involve?

In a total hip replacement (also called total hip arthroplasty), the damaged bone and cartilage is removed and replaced with prosthetic components.

• The damaged femoral head is removed and replaced with a metal stem that is placed into the hollow center of the femur. The femoral stem may be either cemented or “press fit” into the bone.
• A metal or ceramic ball is placed on the upper part of the stem. This ball replaces the
  damaged femoral head that was removed.
• The damaged cartilage surface of the socket (acetabulum) is removed and replaced with a metal socket. Screws or cement are sometimes used to hold the socket in place.
• A plastic spacer is inserted between the new ball and the socket to allow for a smooth gliding surface.

A successful recovery is accomplished through extensive patient education and preparation combined with minimally invasive surgical techniques, advanced pain management therapies and rehabilitative support. Surgery itself takes about 1.5 hours; patients should plan to be up and walking with the therapist in the hospital on the day of surgery.

How is pain managed during surgery?

General anesthesia, given by IV, is administered by the anesthesiologist for surgery. Oral medications and additional injectable medications may be given as needed for pain or relaxation.

When should I expect to go home?

Patients should plan on a 1-2 night hospital stay after hip replacement surgery. We then allow the patient to fully recover at home with the assistance of in-home physical therapy and nursing

services as needed. Most patients are discharged with oral pain medication. These medications, when taken as directed, typically provide excellent pain relief at home. A physical therapist will walk with you prior to discharge from the hospital to ensure you are stable and comfortable.

Who is a good candidate for outpatient joint replacement surgery?

The success of total joint replacement surgery is dependent on several factors. One of the most imperative factors is preparation and education of the patient. Our team is dedicated to ensuring our patients achieve their goals of returning to an active, pain free lifestyle but your
understanding, participation and commitment are imperative to the success of your procedure. These guidelines are the basis of our patient selection strategy for joint replacement surgery. Speak with one of our experienced providers to determine if you are a good candidate for joint replacement surgery.

What are the risks associated with joint replacement surgery?

Our surgeons perform hundreds of successful joint replacement surgeries each year and our staff is dedicated to the safety of each of our patients. However, there are potential complications associated with any surgery. Below are some of the risks associated with joint replacement surgery and the precautions we take to minimize these concerns.

Infection. Prior to surgery, your pre-operative testing will help identify active infections and potential sources of infection. These will be treated appropriately. Surgery will not take place if there is any potential active infection present (ex. skin wounds, respiratory infections, bladder infections). During surgery, our team follows meticulous sterile technique. Patients are treated with IV antibiotics and the surgical site is thoroughly cleansed. Post-operatively, we provide detailed instructions regarding wound care and recommend avoiding dental procedures for six  months, including routine cleanings due to the increased risk of joint infection.

Blood Clots. Notify our staff prior to your surgery if you have a history of blood clots. After surgery, you will take Aspirin two times daily. We encourage early walking and regular activity. Compression stockings and foot/ankle pumps can also be helpful in decreasing clotting risk and improving lower leg swelling. We offer Sequential Compression Devices (SCD) for purchase ($225). This simple, battery powered device gently squeezes the lower leg to encourage blood flow and decrease the risk of clotting.  Our knowledgeable staff will educate and fit you with this device prior to surgery.

Additional risks associated with every surgery do exist and include numbness, pain, blood vessel or nerve injury, and complications associated with general anesthesia. Expect to have a localized area of numbness near the incision that will remain indefinitely. This is a change in sensation due to the nature of the incision and does not lead to pain or a loss of function.

What can I do to prepare for surgery?

Your health. Our team is always available to provide patients with step by step guidance through the process of joint replacement surgery and recovery, but a successful outcome is dependent on patient preparation and participation.

• Assemble a packet of your medical and personal information, including copies of insurance, health directives, etc. This information can be brought with you to the hospital as well.
• Avoid alcohol use at least 48 hours before surgery.
• Avoid/quit tobacco use as soon as possible.
• If you are in need of any dental work, such as an extraction or periodontal treatment, schedule it well in advance of your surgery. Due to the risk of infection, no dental work is allowed, including routine cleanings, for six months after surgery.

If you’d like to be evaluated as a candidate for hip replacement surgery, contact the Orthopedic Performance Institute.

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