Joint replacement at the Center for Orthopaedic Excellence at Syosset Hospital
The joint replacement program at the Center for Orthopaedic Excellence at Syosset Hospital is a comprehensive diagnostic and surgical treatment program for people with arthritis, degenerative and congenital problems or trauma associated with the hip and knee. The team is committed to providing patients with the highest-quality, scientifically-advanced joint replacement surgery and rehabilitation to return them to their maximum level of function and mobility.
Watch the video below to learn more about the program:
Total Joint Replacement at Syosset Hospital
Learn about total joint replacement at the Center for Orthopaedic Excellence at Syosset Hospital, where expert surgeons perform hip and knee replacements to patients whose conditions do not improve with non-invasive treatments. A core team, including surgeons, support staff, physical therapists and rehabilitation specialists, are dedicated to joint replacement and work with patients before, during and after surgery to restore their function.
Why choose us?
The Center for Orthopaedic Excellence and its dedicated team of healthcare professionals focus on each patient as an individual. The team believes that continuity of care yields the best results. The doctors interface with each person during every part of the experience and follow the patient through pre-operative education and pre-surgical testing as well as the surgical experience, rehabilitation and a return to a healthy and active life. This continuity of care not only enhances clinical outcomes, but also provides patients with an added level of comfort and reassurance because they are being cared for by the same team throughout their entire treatment.
The center offers a carefully designed continuum of care provided by a team of surgeons, physicians, nurses, physician assistants, rehabilitation specialists and healthcare professionals who have been chosen specifically for their training, skill and compassion.
The team is led by Eugene S. Krauss, MD, FAAOS, FACS, who has developed surgical systems, techniques and standards to optimize patient outcomes and experiences.
International leadership & recognition
More than 500 surgeons from all over the world have observed the center's experts perform joint replacements, and have returned to their native countries with new surgical skills. Conversely, the team has traveled extensively overseas to provide guest lectures, clinical and education programs.
The team also brings their expertise abroad through philanthropic programs, regularly performing hip and knee replacements in Ghana and other areas of the world with medically underserved populations.
When someone suffers from arthritis related to degenerative, congenital, inflammatory, or traumatic causes, it may be hard for them to perform even simple tasks such as walking or climbing stairs. They may even feel pain when sitting or lying down. A painful joint can often prevent patients from enjoying daily activities such as walking, shopping, traveling and recreational sports, leading to a sedentary life. If medications, changing everyday activities and the use of walking aids are not helpful, joint replacement surgery may be an option.
Joint replacement implants are metal and plastic coverings for raw, arthritic bone ends. They replace cartilage that has worn away over the years. Total joint replacement surgery can help relieve pain and get patients back to enjoying normal everyday activities. Replacement implants are made from materials such as titanium or other metal alloys, ceramics, plastics or other newer substances. The goal is to eliminate bone-on-bone friction to create a new, smoothly functioning joint that will last for years.
In a total hip replacement, the surgeon removes the arthritic ball of the thighbone (femur) and the damaged, inflamed cartilage in the hip socket. The ball is replaced by a metal or ceramic ball attached to a stem, placed into the thighbone. A metal cup relines the socket, creating a new, smooth and durable joint.
In a total knee replacement, the arthritic rough surfaces at the end of the thighbone and shinbone are replaced with polished metal inlays. A space-age plastic cushion separates the inlays, acting as an artificial cartilage. The kneecap (patella) is preserved and, if worn, is resurfaced with a similar plastic cushion.
The first visit
During a patient's first visit, the surgeon will perform a thorough examination and may ask for further imaging and laboratory tests to provide the best diagnostic information for the treatment plan. This is key to a successful outcome. While at the office, the patient is also likely to meet with the surgical coordinator, who can help with scheduling and logistics, as well as the patient educator and the physician assistant.
The patient will contact the department directly to schedule a pre-surgical testing appointment approximately 21 days prior to surgery. Pre-surgical testing includes a physical examination and further laboratory tests if needed. If the patient is not feeling well for any reason, this should be brought to the attention of the staff. The hospital also requires a medical clearance from the patient's primary care physician and/or specialist such as a cardiologist. These should be obtained prior to the date of pre-surgical testing.
By providing patients with as much information and education as possible before the surgery, patients’ concerns and fears are greatly reduced. The team at the center strives to make sure that patients know what to expect at each stage of surgery and rehabilitation. All patients are encouraged to take the center's patient education class to gain a thorough understanding of what they will experience before and after surgery and rehabilitation. Time for questions and answers is an important part of this educational session. The patient educator has been personally trained by Dr. Krauss to help make the patient experience a positive and productive one.
When preparing for joint replacement surgery, as with any surgery, there are some pre-operative considerations to keep in mind that can help optimize the outcome:
- Exercise - Our bodies tend to heal and regain function faster when they are in good physical and cardiovascular condition.
- Medication - Before the surgery, patients should discuss medications they are currently taking with their physician. Some may need to be temporarily discontinued until after the surgery. This determination can be most appropriately made by the patient's physician or orthopaedist.
- Discharge planning - As with any surgery, the patient should be sure to discuss discharge planning with their physician beforehand. The discharge plan may include instructions on care of the incision, pain medications, activities, special exercises, and other home care instructions.
- Rehabilitation - Persons who have received a total joint replacement can still lead functional, active lifestyles. One major component of many rehabilitation programs is exercise - to restore function, mobility, and strength to the affected joint and surrounding muscles. Patients should discuss with their physician what an appropriate post-operative rehabilitation program should include.
After all the clinical data is reviewed, the patient's doctor will decide on the optimal surgical procedure for the joint replacement. Different patients require different surgical options and each treatment plan is tailored to the patient and their specific needs. The treatment plan will be presented in great detail so the patient understands what is involved.
Surgical options include:
- Minimally invasive techniques – The center's surgeons are skilled in using smaller incisions to perform repairs to the knee and hip.
- Revision surgery – Prosthetic joints used in joint replacement surgery have a finite lifespan. When that time comes, revision surgery replaces previous worn-out joint replacements. These revision surgeries are even more complex than the original surgery and demand the highest level of surgical skills that orthopaedic surgeons, such as those at the center, can provide.
- Anterior approach to hip replacement surgery – The anterior approach means that the surgeon reaches the hip by going between two muscles, rather than by removing and then reattaching a muscle. This can allow for less post-operative pain and faster rehabilitation and recovery.
The surgical experience
The hospital will telephone the patient the day prior to surgery to remind them of the time to arrive at the hospital for the procedure.
On the day of surgery, after checking in to the hospital, the patient's records and all consent forms will be reviewed by the nursing staff and the patient will be brought to the pre-surgical holding area where they will see the surgeon, as well as the anesthesiologist.
The surgeon will personally mark the specific site of surgery and the anesthesiologist will again review the options for anesthesia. The majority of joint replacement surgery is performed under regional anesthesia, however, in some instances general anesthesia is preferred. The final decision is made by the anesthesiologist in consultation with the patient. For those patients undergoing regional or epidural anesthesia, additional sedation can be given during the surgery.
For routine joint replacements, the actual surgical procedure generally takes less than one hour. Immediately after the surgery, the patient will be taken to the Post-Anesthesia Care Unit (PACU) where they will be monitored for several hours before being brought to the hospital room. The patient's family will be notified once surgery is complete and the patient has been transferred to the PACU.
Rehabilitation following joint replacement surgery starts in the hospital within just a few hours of the procedure. Physical therapists and rehabilitation specialists will prescribe exercises to help the patient get out of bed and regain strength as safely and rapidly as possible. Most patients spend two to four days on the orthopaedic surgical floor and are able to walk with a cane or walker and use the stairs independently when leaving the hospital.
Some patients may be admitted for sub-acute care for five to seven days, however most are discharged to home care and do their rehabilitation in their own homes. Depending on the patient’s physical needs, support at home, and insurance coverage, total joint replacement patients are encouraged to continue therapy in an outpatient rehabilitation center. The center's team will follow up on the patient's progress.
Patients and their families have several options for rehabilitation care, and prior to surgery the treatment team will help the patient decide which of the following options is best:
- Sub-acute inpatient rehabilitation - Sub-acute inpatient rehabilitation provides continued therapies and skilled nursing care in an inpatient setting. Therapy intensity will vary (one to three hours per day), depending on a patient’s needs and ability. Lengths of stay will vary and patients may be released to either outpatient or home-based treatment. The North Shore-LIJ Rehabilitation Network offers a variety of care options in multiple locations.
- Home care rehabilitation - The North Shore-LIJ Home Care Network provides comprehensive, specialized joint replacement home care services, with an emphasis on rehabilitation, wellness and recovery in the home setting. Physical therapy will begin within 24 hours of discharge, ensuring a seamless transition from the inpatient facility to the home. Therapy intensity and duration of services will vary depending on the patient's needs, abilities, and insurance coverage. A rehabilitation nurse coordinator will serve as a liaison between the patient's physician and all home care disciplines, enhancing communication and coordination of care.