SERVICES
JOINT REPLACEMENT / ARTHRITIS TREATMENT OPTIONS
Joint and Arthritis Solutions
at Twin Cities Community Hospital
As a valued member of our community, Twin Cities Community Hospital, wants to introduce you to Joint and Arthritis Solutions, an integrated program for arthritis and joint replacement. Our program was created to offer options for people who suffer from chronic arthritis and joint pain…. pain that can slow you down and prevent you from participating in activities you enjoy. Twin Cities offers a spectrum of solutions including minimally invasive joint replacement surgery and alternative bearing implants. And, you have a choice of specialists for your care. All of our solutions start with education to help you understand and participate in your treatment.
At Twin Cities Joint and Arthritis Solutions, you can expect to find:
Team Approach
Continuum of Care – diagnosis, evaluation, education, therapy, intervention and rehabilitation
Dedication to Excellence
Patient education
To learn more about Joint and Arthritis Solutions, and options for regaining your mobility and lifestyle, call us at 1-800-343-7099. A member of the Joint and Arthritis Solutions team will return your call shortly.
Specialist Participating in Joint and Arthritis Solutions
Mark Kowall, MD
Dr. Kowall received his M.D. from Northwestern University Medical School, and completed his Orthopedic Surgery Residency at Northwestern University. He completed a Knee and Shoulder Fellowship at The Orthopedic Specialty Hospital. Dr. Kowall is Board Certified in Orthopedic Surgery, and has been in practice with Dr. Mark Mooney for over 13 years.
Mark Mooney, MD
Dr. Mooney received his M.D. from Stanford University School of Medicine, and completed his Orthopedic Surgery Residency at Stanford University. He completed a Knee and Shoulder Fellowship at The Orthopedic Specialty Hospital. Dr. Mooney is Board Certified in Orthopedic Surgery and has been in practice with Dr. Mark Kowall for over 13 years.
William F. Sima, MD
Dr. Sima received his M.D. from the University of Southern California School of Medicine, and completed his Residency at Los Angeles County – USC Medical Center and his Fellowship in Orthopedics at Harbor UCLA Medical Center and Long Beach Memorial Hospital. Dr. Sima is Board Certified in Orthopedic Surgery and has practiced orthopedic surgery for over 16 years.
Birrell Smith, MD
Dr. Smith received his M.D. from the UCLA School of Medicine, and completed his Residency at the University of Missouri Hospital Affiliates. Dr. Smith is Board Certified in Orthopedic Surgery and has practice orthopedic surgery for over 21 years.
FAQs
KNEE REPLACEMENT FREQUENTLY ASKED QUESTIONS
At Twin Cities Community Hospital, we believe you should have answers to your questions. We have prepared brief answers to commonly asked questions about Knee Replacement surgery; however, all patients considering knee replacement surgery should attend one of the Joint and Arthritis Solutions community lectures, where these and other questions can be asked in a one-on-one setting with one of our orthopedic surgeons.
What is the recovery process?
In general, your orthopedist will encourage you to use your “new” joint shortly after your operation. After total knee replacement, you will often stand and begin walking the day of surgery. Initially, you will walk with a walker or cane.
How long will I be in the hospital?
Depending on the type of surgical procedure, the average stay is around 1-4 days. Patients eligible for a “minimally invasive” procedure, may be in the hospital for only one day. Before you go home, you will need to meet several goals including being able to get in and out of bed by yourself, bend your knee approximately 90 degrees, or show good progress in bending your knee, extend (straighten) your knee fully, walk with a walker on a level surface and climb up and down 2 or 3 stairs and be able to perform the prescribed home exercises
How long will I have pain?
Most patients will have spinal anesthesia, which will minimize pain for the first 12 to 24 hours. After that time, pain can be regulated with oral or I.V. medications. The pain will disappear in stages beginning about two to three weeks after surgery. After about three months, the pain and twinges should disappear. Proper pain management is important in your early recovery. Remember that it is easier to continually minimize pain than to control it after you are in pain. If your orthopedist prescribed I.V. pain control after the first 12 to 24 hours, you will be transitioned to oral pain within a day or two.
How long does physical therapy last?
Your orthopedic surgeon or the joint replacement staff will discuss an exercise program following your surgery. The physical therapy program will vary based on the needs of each patient. Usually a physical therapist will visit you the day of your surgery and begin teaching you how to use your new knee. You may be fitted with a continuous passive motion (CPM) machine that will slowly and smoothly straighten and bend your knee. Even as you lie in bed, you can "pedal" your feet and "pump" your ankles on a regular basis to promote blood flow in your legs.
Why does my knee click?
The noise is normal and is nothing to worry about. About 70% of patients with knee replacement have some kind of noise when their knee bends.
How will my knee replacement affect the arthritis in my other joints?
It should not affect any other arthritic joints. Your other knee might feel better now that the new knee can share the stress of walking.
What does my knee look like?
The replacement parts are made of a combination of metals placed on the thigh and shinbones, and if needed, a “plastic button” for the underside of the kneecap.
When can I increase my activities?
That varies from patient to patient, but in general patients can drive in two to three weeks, slow dance in six to eight weeks and play golf in ten to twelve weeks after surgery. More strenuous sports, such as tennis or running, may be discouraged.
How much bend should I expect in my new knee?
In total, patients should expect greater than 90 degrees of “flexion” to accommodate stair climbing or riding a bicycle. Some patients may obtain near normal flexion.
When will I be able to sleep all night and will anything help?
Most patients return to their normal sleep cycle in four to twelve weeks after surgery. Sleeping with a pillow between the knees, with the surgical knee on top, may help. If a medication for sleep is needed, just ask.
How long will my knee feel hot?
Patients can expect to feel warmth for six to twelve months after surgery. The heat is the body’s indicator that healing is occurring.
Is total joint replacement permanent?
Most older persons can expect their total joint replacement to last a decade or more. Younger joint replacement patients may need a second total joint replacement. Materials and surgical techniques are improving through the efforts of orthopedists working with engineers and other scientists.
FAQs
HIP REPLACEMENT FREQUENTLY ASKED QUESTIONS
At Twin Cities Community Hospital, we believe you should have answers to your questions. We have prepared brief answers to commonly asked questions about Hip Replacement surgery; however, all patients considering hip replacement surgery should attend one of the Joint and Arthritis Solutions community lectures, where these and other questions can be asked in a one-on-one setting with one of our orthopedic surgeons.
Recovery Process
In general, your orthopedist will encourage you to use your “new” joint shortly after your operation. You may often stand and begin walking the day of surgery. You may walk with a walker or a cane for the first four to six weeks after your total hip replacement.
Complications
You should speak with your orthopedist about possible complications of hip replacement surgery. To minimize the risk of the hip coming out of the joint, your surgeon and the joint replacement team will discuss how to safely exercise and move.
Will I experience pain?
Most patients will have spinal anesthesia, which will minimize pain for the first 12 to 24 hours. After that time, pain can be regulated with oral or I.V. medications. The pain will disappear in stages beginning about two to three weeks after surgery. After about three months, the pain and twinges should disappear. Proper pain management is important in your early recovery. Remember that it is easier to continually minimize pain than to control it after you are in pain. If your orthopedist prescribed I.V. pain control after the first 12 to 24 hours, you will be transitioned to oral pain within a day or two.
Should I exercise?
Exercise is an important part of the recovery process. Your orthopedic surgeon and the joint replacement team will discuss an exercise program for after your surgery. Exercise programs will vary for the needs of each patient. After your surgery, you may be permitted to play golf, walk and dance. However, more strenuous sports, such as tennis or running, may be discouraged.
When will I be able to put on my socks and shoes without help or a device?
Your therapist will show you how to put on your shoes and socks and wash your feet, by crossing your operated-on leg over the other knee. When you are able to perform this maneuver, you can do it yourself. Until then, it is best to have help or use an assistive device.
How long do I have to observe the special precautions?
Some must be followed for the rest of your life such as avoiding turning your knee or leg inward while sitting, leaning forward over your lap when you are seated, raising you knee above a 90º angle or picking things up off the floor stiff-legged. Other precautions can be dropped after about 12 weeks, as long as you are conservative in your movements, including tub bathing, sleeping on your side (continue to keep a pillow between your knees) and use of an elevated toilet seat.
Will I be able to kneel or squat to garden, for example?
Yes, kneel on the knee of your new hip. Have a stool close by to help you get up.
Will I need more physical therapy?
Occasionally, patients need additional physical therapy. If you have had both hips replaced, you will need physical therapy to help with balance and additional muscle strengthening.
What sports may I engage in?
Non-impact sports such as golf, cycling, and swimming are recommended, and walking is good for your hip joint and excellent exercise. Ballroom dancing is good exercise, too, and if you enjoy dancing, you will be pleased to find yourself dancing. A friendly game of tennis doubles may be possible, but you should avoid singles games.
How long will it take me to feel "back to normal?"
You will notice that your recovery will come in roughly 3 stages: 3 months after surgery, you will feel better; 6 months afterward, you will feel even better. You may even feel like your “old self” within a year. As the months go by, your stamina will return, the precautions you are taking will become second nature, and you will be able to see how far you have come in your new life.
WHAT INFORMATION IS NEEDED WHEN I REGISTER FOR SURGERY
Twin Cities Community Hospital works closely with the physicians performing joint replacement surgery. The information you should be prepared to bring, includes:
Ø Your date of birth
Ø Your Social Security number
Ø Your phone number
Ø Your diagnosis
Ø Information from your physician letting us know whether you will be an inpatient or outpatient and whether you will have any “special procedures”
Ø Your appointment date, time, location (if already scheduled)
Ø Your physician name and telephone number
Ø Your insurance plan
Ø Your insurance policy and group number
Ø You must also bring a complete listing of all the medications you take (including prescription medications, over the counter medicines and herbals and supplements. You will need to provide the dose, time of day you take the medication and the mechanism by which you take the medication (orally, injection, patch, other). We recommend that you carefully list all medications and the additional information required about your medications, and present that list when you register.
Ø Information about any allergies that you may have
Medications List
As you are admitted to Twin Cities Community Hospital, our staff will make a record of the medications you take. This information is important to our staff and physicians who coordinate your care at the Hospital.
Your Name:
Your Birthdate:
Medication Name and Strength
What is the Dose?
How do you take the medication (routine)?
Reason for taking the medication?
When was the last time you took the medication before coming to Twin Cities (date & time)?
Who is the prescribing Physician for each medication?
What Information is Needed when I am Admitted or Pre-Admitted?
Our goal is to ensure that your registration goes smoothly and with minimal delays. The information below will help us do just that. Please have this information available at the time of your registration or pre-registration. Thank you.
1. Patient Name
2. Date of birth
3. Social Security number
4. Address and phone number
5. Insurance card (we will need to copy the front and back)
6. Drivers license to verify identity (we will copy this ID)
7. Employer, date of injury and your employer’s worker’s compensation insurance carrier if you are receiving care related to a work injury
8. If you are covered by Medicare, we will need both the patient’s and spouse’s (if applicable) retirement date
9. Please understand that we will calculate and collect applicable co-payments and deductibles at the time of your registration
10. A copy of your Advanced Directive will be accepted at this time
We will need to obtain a full listing of all the medications that you take, as you are admitted. To help you in this process, please print the “Medications List” shown in Patient and Visitor Services and provide the information as you are pre-admitted or admitted to the Hospital.. Even if you are unable to print the form, take time to list and provide all the information required on the form.
If you have any questions, you may call any of the following personnel:
Pre-Admitting (805) 434-47-63 or (805) 434-4765
Admitting Supervisor (805) 434-4537
Admitting Director (805) 434-4796
Director Patient Financial Services (805) 434-4536