Abbott Northwestern Hospital

After making up her mind to have the surgery, she and Mike, her husband and coach-to-be, attended a class that prepared them for what to expect during their time at the Joint Replacement Center and Debi’s recovery at home.

According to Debi, the greatest care component of the Joint Replacement Center is the group emphasis. Group activities, therapy and support all contribute to the patient's mindset, which has a positive impact on recovery. “At my first therapy session, I could barely move,” Debi said. “Seeing another patient who had had the same surgery as me up and walking on day three of her recovery was really motivating.” It helped her to hear that others were having the same struggles and triumphs as she was.

During her stay, she struck up a friendship with another patient who also had bilateral knee replacement. They exchanged phone numbers and kept in touch a few times a week after they went home. Having a new friend to lean on and compare notes with was a welcome and unexpected outcome of her hospital stay.

The joint care coordinator and other staff from the Joint Replacement Center prepared Coach Mike to make Debi’s recovery as quick and painless as possible. “Because of her independent nature and being a nurse, Debi is used to taking care of herself,” Mike commented. “It sounds strange, but being her coach was the first time in our marriage that I felt she really needed me. She couldn’t have done this without me and it’s a great feeling to know I helped - we did this together.” From being with her every day for therapy sessions to keeping her on track with her therapy at home, Mike’s coaching helped Debi every step of the way. He even built a tray for her walker so she could transport important items – ice packs and Diet Coke® - around their house.

Today, Debi is fully recovered and feeling better than ever. “I had learned to take the pain and let it slow me down. What a difference now – I only have mild post-operative healing discomfort. I’m telling everyone I see about the program.”

As for her friend, his recovery went well, too. Laughing, Debi said, “He went on a vacation in California. Here I am back at work. I’m looking forward to giving him some grief about that when he gets back.”

Joint replacement surgery has long been done at Abbott Northwestern, but the Joint Replacement Center has adopted a new approach. It aims to provide thorough preparation for patients and families; aggressive pain management; early rehabilitation; and responsive, compassionate care—all focused on helping patients recover as quickly as possible.

For Schmidtbauer, that translated to being “treated like a king. I’ve been hospitalized before, and nothing compares to the care I received at Abbott Northwestern,” he says. It began with the presurgery class he attended with his wife. “They walked us through the procedure and told us what to expect,” Schmidtbauer says. His wife was encouraged to spend the first night at the hospital with him and was involved in his recovery as his coach.

“We involve the family so they understand what challenges the patient will face and will feel confi dent about their ability to help care for the patient at home,” says Scott Anseth, MD, the orthopedic surgeon who operated on Schmidtbauer. Support and encouragement also came from fellow patients. Group therapy is an important part of the program, Anseth says. “The patients share their experiences and go through it as a team.” Anseth notes that instead of treating patients like they are sick, the Joint Replacement Center treats patients “more like injured athletes. They get up and get dressed every day, have meals together and participate in therapy together.”

As part of their patient-centered approach, Joint Replacement Center surgeons and anesthesiologists have collaborated to find the best combination of pain management strategies. “Our philosophy is that if you can control the pain early on, you can start therapy and rehabilitation sooner—and that leads to a better outcome and quicker recovery,” Anseth says. “We are committed to making the surgery as close to pain-free as possible.”

Like many patients with joint problems, Schmidtbauer was accustomed to pain. “The pain I experienced after surgery was nothing compared to the pain I was in before surgery,” he says. A special catheter was inserted near his knee that delivered pain medicine directly to the joint. This catheter remained in place throughout his hospital stay. After three weeks, the pain was minimal, and by six weeks, Schmidtbauer felt fully recovered.

The new approach is making a difference in patients’ recoveries. Before the Joint Replacement Center opened, 50 percent of patients were sent to skilled nursing facilities after discharge from the hospital. That rate has decreased to 20 to 25 percent of patients

“That’s a huge step,” Anseth says. “If our patients can go directly home after the hospital, it’s clearly benefi cial for them. The reason I do joint replacement surgery is that it is a life-changing surgery. For someone like Mike, who is missing work because of pain, it allows him to get a good portion of his life back. Others in their 70s and 80s think their best years are behind them—all of a sudden, they are traveling and getting back out into the community with family and friends.”

Joint cartilage is a tough, smooth tissue that covers the ends of bones where joints are located. It helps cushion the bones during movement and because it is smooth and slippery, it allows for motion with minimal friction. Osteoarthritis, the most common form of arthritis, is a wear and tear condition that destroys joint cartilage. Sometimes as the result of trauma, repetitive movement, or for no apparent reason, the cartilage wears down, exposing bone ends. This can occur quickly over months or develop over a number of years. Cartilage destruction can results in painful bone-on-bone contact, along with swelling and loss of motion.

A knee replacement is really a bone and cartilage replacement with an artificial surface. The knee itself is not replaced, but rather an implant is inserted on the bone ends. This is done using a metal alloy on the femur and a plastic spacer on the tibia and patella (kneecap). This creates a new, smooth cushion and a functioning joint that can reduce or eliminate pain.

A hip replacement is an operation that removes the arthritic ball of the upper femur (thighbone) and damaged bone and cartilage from the hip socket. The ball is replaced with a metal ball that is fixed solidly inside the femur. The socket is replaced with a plastic or metal liner that is usually fixed inside a metal shell to create a smoothly functioning joint.

Your orthopaedic surgeon can determine if you are a candidate for the surgery based on your history, exam, X-rays and response to conservative treatment.

Results will vary depending on the quality of the surrounding tissues, the severity of the arthritis at the time of surgery, your activity level and your adherence to your health care team’s orders.

While uncommon, complications can occur during and after surgery. Some complications include infection, blood clots, implant breakage, malalignment, dislocation, and premature wear, any of which may necessitate implant removal/replacement surgery. While these devices are generally successful in attaining reduced pain and restored function, they cannot be expected to withstand the activity levels and loads of normal healthy bone and joint tissue. In most cases, implant surgery is extremely successful. Some patients will still experience pain and stiffness. No implant will last forever, and factors such as a patient’s post-surgical activities and weight can affect longevity. Your surgeon will discuss all of the risks with you.

In many cases, patients with joint replacement think the new joint feels completely natural. However, it is a good idea to avoid extreme position or high-impact physical activity.

You are encouraged to participate in low-impact activities such as walking, dancing, golf, hiking, swimming, bowling and gardening. High-impact activities like running and basketball or activities that increase your likelihood of injury, such as downhill skiing are not recommended. You should discuss any specific restrictions with your physician.