Total Hip Replacement
Hip replacement surgery is the care for the arthritic or post-traumatic conditions that cannot be treated with conservative techniques. The procedure is initiated with anesthesia and then involves an incision followed by removal of the arthritic and damaged femoral head and replacement of the surfaces with high molecular weight cross-linked plastics and ceramics.
The implants are attached to the bone with titanium components textured to grow on to the bone. We do not use glue or cement. Classic hip replacement uses a posterior approach used in the care of the obese or the patient with complex bone loss or deformity. In almost all cases, there are no restrictions or precautions after the procedure.
Hip replacement surgery takes about 2 hours. The patient then moves to the recovery area for approximately 2 hours, next to the floor or home in the outpatient setting. The stay is overnight at the hospital. After discharge, the patient goes home with therapy services provided at home for a time. The follow-up visit is in our office at six weeks with Brian Johnson, Nurse Practitioner, for an x-ray.
Direct Anterior Hip Replacement
This newer, more advanced technique, is performed on the appropriate patients. This technique is approximately 60% of the hip replacement surgeries in my practice. Anesthesia can be by spinal or general anesthesia. The direct anterior approach is a much less invasive procedure that requires specialized techniques and use of the Hanna table.
The technique finds a true interval between musculature and avoids the injury to the surrounding tissues. The Direct Anterior Hip Replacement Surgery is the same hip replacement procedure is performed through this advanced approach with removal of the femoral head and replacement with ceramics, super plastics, and titanium implants without cement. This approach is most appropriate for those patients who are not obese and have more predictable complexity and limited bone loss.
The procedure takes 2 hours and then the recovery room for 2 hours. The patient remains in the hospital overnight and now even more often moves from the recovery are to home on the same day at the North Atlantic Surgical Suites. The return to the office is at six weeks with the Nurse Practitioner, Brian Johnson.
Total Knee Replacement
Total Knee Replacement is the care for the knee arthritis or post-traumatic conditions that have not responded to any other conservative care. The procedure is through an approach in the front of the knee. A trained spinal or general anesthesiologist will perform the necessary anesthesia.
During the procedure, we will only remove the damaged bone and cartilage, roughly 9 mm of bone. The surfaces are covered with highly polished metal implants with super cross-linked plastics. The knee cap is retained – but is resurfaced to prevent pain.
The surgery takes 2 hours and then to the recovery room for another 2 hours. The hospital stay is one day during which the patient learns physical therapy and pain management, or advanced patients return to home from the North Atlantic Surgical Suites. The patient is discharged to home or infrequently to the rehab and revisit in the office four weeks after the surgery with my Nurse Practitioner, Brian Johnson.
Partial Knee Replacement
Partial knee replacement is the care for the knee arthritis isolated to the inner compartment of the knee when conservative care fails. A spinal or general anesthesiologist will perform the necessary anesthesia. Dr. Van Flandern performs the procedure through a reduced incision to the front of the knee.
The procedure removes only the diseased bone and cartilage from the involved inner side of the knee. This procedure is limited to appropriate patients with the isolated disease and intact ligaments.
During your consultation, we will make a recommendation for partial knee surgery. Dr. Van Flandern will make the final decision during the operation when the knee is exposed.
The surgery takes 2 hours and then 2 hours in the recovery room. The patient then will spend the night at the hospital, or advanced patients return home after the recovery room from the North Atlantic Surgical Suites. Return to the office at four weeks for an x-ray with the Nurse Practitioner Brian Johnson.
Hip arthroscopy is a specialized technique for the care of cartilage or labral tears in the hip. It is also used to treat deformities related to damages to preserve the hip joint. The procedure requires general anesthesia and takes about 2 hours.
During the procedure, traction is applied to the affected leg, and the arthroscope is inserted. Repair of the labrum is accomplished and then appropriate treatment of the deformities that may have caused the labral injury. The procedure is followed by 2 hours in the recovery room – and then home. I ask for patients to use two crutches for six weeks – and have some very mild limitations of their motion in that time. When comfortable, patients can return to driving, work, and other activities while partial weight-bearing for the six weeks with two crutches.
At two weeks, the patient will return for suture removal with Brian Johnson and therapy is begun. The patient is then seen again at six weeks after the operation for an x-ray and release from the crutches.
Outpatient Hip and Knee Replacement
Dr. Van Flandern provides progressive outpatient hip and knee replacement techniques at the boutique North Atlantic Surgical Suites ( NASS ). The advanced techniques provided allow patients to return home the same day. Anesthesia is most often spinal and recovery very rapid. General anesthesia is used in some circumstances.
After the anterior hip, hip, knee or partial knee replacement – patients recover under the guidance of the NASS team and then return home. Physical therapy is provided at the center and then at home the next day. Patients progress at home and revisit the usual hip or knee schedule.
NASS allows patients to return directly home instead of having to remain in the hospital waiting for services and discharge. Recovery is in the comfort of your own home.