Ten Things to Know About Orthopedic Surgeries

Brett Clayton, PA-C, MHS, a physician assistant with the Phelps Health Orthopedics team, answers 10 frequently asked questions about orthopedic surgeries.

What kinds of orthopedic surgeries are performed at Phelps Health?

We do everything from hand surgery to hip and knee, and down to foot and ankle surgery. Our Orthopedics team can perform most orthopedic surgeries here, with the exception of back and spine surgeries.

Am I a good candidate for orthopedic or joint surgery?

Orthopedic surgery in general – barring major injuries, car accidents and fractures, etc. – is most often elective. This means its focus is on quality of life and improving what we call activities of daily living or ADLs. For example, people may struggle with simple tasks like gardening, reaching things in cabinets or walking upstairs, and quality of life diminishes in the process. Orthopedic surgery is all about improving quality of life, improving function and helping patients be as comfortable as they can be. The goal, then, with orthopedic surgery, is to get patients back to the activities they would normally do, but are unable to do, because of an injury or chronic problem.

How do orthopedic providers and patients decide whether surgery or another treatment method is the best option?

Usually in orthopedics, we try a step-wise treatment plan, with a goal of starting as conservatively as possible, before proceeding with surgery. Sometimes when patients come to the office, they've had a fair amount of conservative treatment, and the only choice is surgery. Other times, they come to the office, and they haven't had any treatment, so we try conservative measures first. But eventually, people get to a point where they have to decide, can I live with this, or do I need to fix it? When they reach that point, we recommend fixing them. We can't promise to make people feel like they're 16 or 18 again, but the goal is to get them back to their normal activities, with either no pain or significantly less pain, so they can resume their ADLs without medication.

What can I expect before and after surgery?

An orthopedic provider will meet with you in the office to explain how the process will go, what your recovery time will be and what to expect both before and after surgery. For other, more invasive surgeries, like joint replacement surgeries, we offer Phelps Health Orthopedic Joint Camp classes. In Joint Camp, you will get a comprehensive education detailing what to expect each step of the way for your joint replacement surgery, recovery and rehabilitation, beyond what could reasonably be covered in an office visit.

How long will I have to stay in the hospital?

With a shorter surgery, patients could be going home within an hour or two of arriving, but with a longer surgery, you may be in the hospital for a day or two. It’s our goal to get patients out of the hospital as quickly as possible, as everyone seems to do better when they're in their own home and more comfortable. However, we do keep patients in the hospital when it's for their safety. They may need extra help from the hospital therapists or extra nursing care to get them to a position where they can safely go back home.

Can I contact my orthopedic surgeon using MyChart?

Our Orthopedics team strongly suggests patients use the MyChart app. With MyChart, patients can message us questions, and we can respond much faster than we might be able to through phone calls, as our phones are busy. Patients can even send us pictures of something they're concerned about, so that we can look and tell them how their incision is healing. Bottom line: MyChart is a convenient and user-friendly app.

Will I have scarring after a joint replacement surgery?

We recognize that scarring is a concern. With this in mind, our team uses sutures and string that are as least invasive as possible. We use stitches that don't show through the skin, so we don't have to remove staples or stitches later. Ultimately, patients are happier. They can get back to showering and feeling normal sooner, without having something on the outside of their skin reminding them that they just went through a big surgery. So, the scars are there, but our surgeons are much better at minimizing the overall appearance of scars now than we were a number of years ago. Our team achieves good outcomes with small-looking incisions and thin lines, resulting in an improved cosmetic appearance.

Will I need physical therapy after my orthopedic surgery?

There are specific recovery protocols that our Orthopedics team follows for joint replacement surgeries. Some patients require more therapy than others, and some may not require any therapy – it's definitely patient-dependent. It is also dependent on the surgeon and the provider who performs the procedure, so it's tailored to the patient for what they need. Generally speaking, after a joint replacement, you can expect at least 6 weeks of therapy (in some cases, less), but it also depends on the type of joint, whether it's a shoulder, knee or a hip. Therapy is a mainstay of recovery because it leads to a faster recovery, better pain control and a quicker return to normal activity.

How long does a total knee or total hip replacement typically last?

It depends on a number of factors, including the size and weight of the patient. An artificial joint’s lifespan also depends on which particular joint it is, so a shoulder, for example, might not last as long as a knee or hip. Generally speaking, the goal would be to get 20 years out of an artificial joint.

Does Phelps Health offer conservative treatment alternatives to orthopedic surgery?

Phelps Health has a wonderful Physical Therapy Department. They work closely with our Orthopedics team. We also have excellent treatment options with injections and medications, and even home therapy options if patients have a difficult time getting to a therapist. Several options exist to empower our patients to feel better. If that doesn’t happen, surgery may be necessary.