Joint replacement becoming more popular for hip and knee joint pain sufferers

Joint replacement becoming more popular for hip and knee joint pain sufferers

Joint replacement becoming more popular for hip and knee joint pain sufferers
Save
When to consider a hip or knee joint replacement was the topic of a recent CHI Mercy Health Talking Health program on News Radio 1240 KQEN.
Orthopedic surgeon Dr. Cary Sanders, from Centennial Orthopedics and Podiatry, and Candice Fredricks, a registered nurse and orthopedic coordinator who helped develop the orthopedic service line at Mercy’s New Strides program, were interviewed by host Kathleen Nickel about knee and hip replacements.
The following is an edited version of the program.
Kathleen: What is an orthopedic surgeon?
Dr. Sanders: It’s a bone and joint surgeon that specializes in musculoskeletal care and there are subspecialists in orthopedic surgery that specialize in spine, knee and hip replacements, sports medicine, hand surgery and pediatrics.
We cover everything from the base of the skull to the feet. In our practice, we have a podiatrist that covers all of our complex foot and ankle reconstruction and trauma. That’s Dr. Bishop. The emphasis of my practice is knee and hip replacements.
Kathleen: Candice, lets talk about the New Strides Program and the process you go through when you’re considering joint replacement.
Candice: The patient goes in and it’s decided whether the patient needs hip or knee replacement. Once surgery is scheduled, they sign up for a pre-op class, when they do pre-op lab work and go to the pre-op clinic and get all their screening done.
Then, my class is on Tuesdays and Thursday from 12 to 1:30 p.m. and the first part of it is about physical therapy. They are shown what to expect while they’re in the hospital for their therapy evaluation, their exercises and precautions, after care at home, outpatient therapy, and the equipment that they will need.
In the second half of that class is the nursing part of it which is taught by me, it is everything they can expect while they’re inpatient from the time they check in until they go home, and I also track these patients afterwards so if they return to the ER or are readmitted, or have any issues with therapy, then the surgeons are aware.
The medications we use are discussed so they know. We have standard orders for every patient, doesn’t matter what surgery you have, or what surgeon you have, we follow evidence-based practice, so it reduces error and shows what works best.
They usually have surgery within a week or two.
In the last quarter about 80 percent of our patients have gone home in less than 24 hours.
Kathleen: When does someone become a prime candidate for joint replacement surgery?
Dr. Sanders: Patients come in with all different ages and activity levels, and the reality is that typically what happens is that people sort of decondition slowly. They have pain that limits them. They stop doing certain things in life and that keeps occurring until their activities are very few and they say OK I can’t deal with this any more, I’ve got to get something done.
How do we know when it’s time to have surgery? Essentially, the answer comes down to two questions that a patient should ask themselves.
Number one, how much does it hurt? Patients that have knee or hip pain that cause them a considerable amount of pain, and it’s pretty regular.
The second question is what is that pain keeping me from doing?
Inside of those two questions is really the value of a knee or hip replacement. It can relieve pain, sometimes a lot, but we frequently fall short of 100 percent pain relief.
Kathleen: Talk about arthritis, what is it?
Dr. Sanders: Arthritis just means joint inflammation, and there are a variety of causes of joint pain. The most common is osteoarthritis, which just means bone arthritis,
The top layer kind of gives out and over time, the other layers just kind of give up and eventually what is left is exposed bone with no cushion and as that happens, joints tend to deform and make lots of bone spurs.
Kathleen: Is arthritis usually the reason that someone would end up needing a knee ,hip or shoulder replacement?
Dr. Sanders: Correct, but in the case of hips, there is a subset of fractures that can result in replacement, either partial or full replacement, depending on age. But other than that, it’s basically for arthritis pain.
Kathleen: Candice, you have people up on their feet after surgery pretty quickly?
Candice: Yes, both knee and hip surgery. Once a patient leaves the recovery room, they go to our orthopedic wing. It’s very important to get these people up, and reduces the risk of complications like pneumonia, blood clots, constipation, skin breakdown, and it doesn’t do anybody justice to stay in bed.
Typically, we’ll get them into their room and we’ll have them up to the recliner about an hour later.
Then therapy comes in and does an evaluation and people are walking up and down the hall the same day, typically.
Kathleen: How does pain management work while patients are in the hospital and when they go home?
Dr. Sanders: Swelling and pain prevent people from getting up and going. If they don’t get up, they’re going to get stiff and they’re going to have a poor outcome. So focus on pain management is critical.
The New Strides program has been really helpful for us, because, what we’re doing is using good old-fashioned science to change the way we practice medicine, and also to adopt certain philosophies to the whole hospital system, for everyone including the therapists, nursing staff, and my office staff. Everyone is working together.
We’re always looking for new opportunities, but it’s exciting and fun to be a part of that and see your practice improve and see patients happy and then spreading the good word that this went well. Don’t believe the hype that you have to leave town.
And this is really the heart of most total joint programs that are done well in a big town or little town. This is what it takes to do well and to be able to compete on a national level.
Kathleen: What would you say to someone who is contemplating surgery?
Dr. Sanders: You don’t have to be a perfect, ideal patient to be a candidate for knee or hip replacement. Remember the decision behind knee or hip replacement is how much does it hurt and what is it keeping me from doing, and what do I want to do that I can’t do because of it.
And it’s a very successful operation. As with any surgery there are definitely risks and downsides, but overall it’s a very successful and permanent way to address what typically is an impossible thing to overcome after a certain point.
To hear the entire podcast for the March 19 Talking Health program, go to www.541radio.com .
React to this story:

Images Powered by Shutterstock