I am really excited to let all of you know about the new practice I am joining, but first, some history.
When I was training to be an orthopedic surgeon, total joint patients spent a minimum of 3 nights in the hospital. Not only were hospital stays longer, but over half of the patients would end up going to some sort of rehab facility once they left the hospital.
Not only did it take along time to recover, but patients always dreaded the surgery. They knew they needed to get it done, but they were afraid of that prolonged and often painful recovery.
What Changed?
For many years, the research on hip and knee replacement focused on trying to simply make the procedure work. The questions being asked included, how do we get stable fixation of the metal implants? How do we get the implant to last longer than 10 years? How do we get ligament stability? How do we prevent the hip from dislocating?
As these questions were answered, our focus shifted from implants and surgical techniques to patient recovery. The questions changed to how do I make the process easier on the patient? How do I help people recovery more quickly? How do I help patients get back to the things they want to do faster?
Once we knew how to make the joint work well and last longer, we could focus on getting patients better quicker.
Anterior Total Hip
I saw this personally when a friend of mine learned how to do anterior hip replacement in 2006. He spent a year training with the surgeon who pioneered the technique and came back to Louisville, KY and started performing the procedure. It was amazing to watch how quickly his patients were able to recover after undergoing this muscle sparing surgical approach.
Recognizing the benefits, I decided to learn how to do the procedure myself and have seen similar results. It has been amazing to watch patients do so well after this procedure.
Tourniquet Free Knee
The same process happened in my total knee patients as well. I wanted the same quicker recovery in knee replacements as I was seeing in my hip replacements. I kept looking for any way to help patients recover more quickly and then I realized that one of the things making it harder for patients to recover was the tourniquet.
Most surgeons use a tourniquet during total knee replacement. The tourniquet goes around the thigh and prevents blood flow to the knee during the surgery. While tourniquets are “safe” to use, they can, as you can imagine, cause some temporary injury to the muscles and nerves of the thigh. While this temporary injury does not typically cause long term issues, it can make recovery a slower, longer, and more painful process.
I gave up using the tourniquet and started seeing the same type of quicker recovery for my knee patients as I did with my hip patients.
Outpatient Total Joints
As my patients were getting better faster, their stay in the hospital was also decreasing. I would typically have my patients spend 1 night in the hospital. A common scenario is that I would walk in that morning and patients would say they have little to no pain. And they would ask how soon they could go home.
I realized that these surgeries could be done as a same day discharge. More and more of my patients would go home within a few hours of having the surgery.
At Northside Hospital we have an incredible outpatient total joint program that nearly every patient to go home the same day without increased risk of infection or readmission to the hospital.
Multimodal Pain Management
A key component of helping patients get better faster is how we manage pain. In the past, our only strategy was to give patients narcotics. There were two major problems with this. The first is that narcotics did not help patients get better, it only masked the pain. Narcotics do not address the issue causing the pain at all.
The second issue is that when we take narcotics, we get temporary relief of pain, but then our bodies respond once the medicine wears off with increased pain.
At Northside Hospital, we have partnered with our anesthesia group to bring a completely different strategy to pain management. We have developed a multi-modal strategy to minimize pain without heavy use of narcotics. Our goal, in fact, is to see if our patients can undergo the surgery without needing any narcotics.
Enabling Technology
Not only are we helping patients with what we do at the hospital or surgery center, but also by what happens at home. We live in an age in which we have access to all sorts of information. Our smart phones give us new tools.
At Arthritis and Total Joint Specialists we offer the use of an app called Force Therapeutics to help you in your recovery. Designed by physical therapists, this app gives patients information about what to expect in the process of their recovery. It informs them of things they can do, such as remove a dressing or what exercises can help them get better. And it is also a tool for patients to get information back to me by recording their pain control or sending me pictures of their wound or leg.
Arthritis and Total Joint Specialists
This journey that I have been on as an orthopedic surgeon has been fun and exciting. It has led me to this new group of physicians who have the same philosophy that I do with regards to total joint replacements making us the leader in total joint replacement in Georgia.
Total joint replacement has changed completely from the days of my training. We have come a long ways in helping patients get better. Our goal is to provide patients with the best possible surgical techniques and helping them to recovery quickly minimizing the pain and dysfunction that can occur with joint replacement surgery.
I made this change because it allows me to provide better care to my patients.
I am excited about what the future holds. I can’t wait to meet you and to go on this journey of hip or knee replacement with you.
Thank you,
Jeremy Statton
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