Charleston Orthopaedic Charleston Orthopaedic Charleston Orthopaedic
Charleston Orthopaedic
Charleston Orthopaedic
Charleston Orthopaedic
Charleston Orthopaedic Charleston Orthopaedic Charleston Orthopaedic
Charleston Orthopaedic Charleston Orthopaedic Charleston Orthopaedic
Charleston Orthopaedic
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Q: What is an orthopaedic surgeon?

A: An orthopaedic surgeon is a medical doctor with extensive training in keeping your bones, joints, ligaments, muscles, tendons, cartilage and, spine in good working order. Together, all of these parts of our bodies make up our musculoskeletal system.

Q: Who becomes an orthopaedic surgeon?

A: Orthopaedic surgeons are men and women from a variety of backgrounds who all share the desire to help people improve their quality of life through improved musculoskeletal health.

Q: Why would you see an orthopaedic surgeon?

A: Orthopaedic surgeons have the greatest knowledge of and experience with the wide range of conditions and treatment options available in musculoskeletal care, many of which do not involve surgery. Musculoskeletal injuries and conditions are the most common reason why we see a doctor.

Q: How long will my total joint replacement last?

A: We expect most hips and knees to last more than 20 years. Long-term studies have shown that 90% of knee and shoulder replacements and 85% of hip replacements are functioning well at 20 years. However, this is not a guarantee. A second replacement, or revision surgery, may then be necessary.

Q: What is the artificial joint made of?

A: It is usually a combination of a metal allow and a high density plastic which fits together to give you your new joint.

Q: What are the results of joint replacement?

A: Over 90% of patients achieve good and excellent results with relief of pain and maintenance of mobility.

Q: Is it possible I could be made worse?

A: Yes. Complications such as infection could result in a worse situation. However, the chances of this happening are 1% or less.

Q: What are the major risks of surgery?

A: Most surgeries go well, without any complications. Infection and blood clots are two of the complications which concern us. To avoid these, we give antibiotics and blood thinners before and after the surgery. We will ask you to sign a consent form before the surgery, outlining these and other potential risks.

Q: Do I really need surgery?

A: After your orthopaedic surgeon decides you are a candidate for this surgery, you then must decide if your pain and disability justify undergoing it. There is no harm in waiting if conservative, non- operative methods are controlling your pain.

Q: Am I too old for surgery?

A: Age is not a problem, if you are in reasonable health and have the desire to continue living a productive, active life. You will be asked to see your personal physician for his/her opinion about your general health and readiness for surgery.

Q: How much does the surgery cost, and will my insurance pay for it?

A: Insurance companies typically pay for the costs of surgery, however, there are some plans that have restrictions on the amounts they pay and who they pay (some only pay the hospital, not the doctor, and vice versa).  Some plans may have limitations or exclusions that do not allow for the carrier to pay for certain procedures.  Because of all the different insurance carriers each having different rules and regulations, this is evaluated on a case by case basis.  Before your surgery, we will be able to give you an approximate patient responsibility for Dr. Friedman’s charges.  We can provide contact information so that you can obtain patient responsibility amounts from the surgical facility and anesthesiologists office.

Q: Will I need a second opinion prior to the surgery?

A: The office secretary will contact your insurance company and let you know whether a second opinion is required.

Q: How long does the surgery take?

A: The amount of time needed for surgery depends on the type of procedure being done.  Some cases take as little as 30 minutes, some can take as long as 3 hours.  This will be discussed with you before you schedule surgery so that you know what to expect the day of surgery.  You will be asked to arrive at the facility prior to your surgery time to allow the operating room staff to prepare you for the surgery. 

Q: Do I need to be put to sleep for this surgery?

A: Your may have a general anesthetic, which most people call "being put to sleep". Or you could have a spinal, or epidural anesthetic, which would not require you to be asleep. The choice is between you and the anesthesiologist.

Q: Will the surgery be painful?

A: You will have pain following the surgery, but we will keep you comfortable with appropriate pain medication. Generally most patients are able to stop very strong pain medication within 1-2 days.  Patients will then be prescribed narcotic medication that is not as strong.  Pain medication usage depends greatly on the type of surgery done and is evaluated on an individual basis.

Q: Who will be the one doing the surgery?

A: Dr. Friedman performs all of his surgeries.  An assistant is may be used during the joint replacement surgery, and you will be billed separately by that assistant.

Q: How long will I have to stay in bed?

A: You will stay in bed the day of your surgery. However, on the next day you will get up, and should be walking.  Depending on the type of surgery done, you may be limited in the amount of weight you can put on your legs, or you may be restricted to using a sling.

Q: Can I eat the day of surgery?

A: No. You can have nothing to eat or drink after midnight the night before surgery. You may take certain medications (blood pressure medication, for example) with a small sip of water.  Failure to follow pre-operative directions may result in your procedure being cancelled.

Q: How long will I be in the hospital?

A: Three days for total knee patients, three days for total hip patients, and one day for total shoulder patients. There are several goals that you must achieve before you can be discharged and some people achieve them more quickly than others.  Other surgery, such as knee and shoulder arthroscopy or carpal tunnel release, is considered outpatient surgery; you will go home the same day after recovering from anesthesia.

Q: How long, and where, will my scar be?

A: The scar length will vary with the type of surgery being done.  Arthroscopy surgery usually has 2 to 3 small, quarter inch incisions.  Dr. Friedman does minimally invasive joint replacements, with incisions for the hip, knee and shoulder ranging from 3 to 5 inches. Dr. Friedman can advise you at your appointment what he would expect to encounter for your particular procedure.

Q: Will I need a walker, crutches, or a cane?

A: After knee and hip replacement surgery you will need a walker and then progress to a cane.  You may borrow them or the hospital can arrange for them to be delivered to your home after discharge.  For knee arthroscopy surgery, you may want to have a pair of crutches on hand.  Typically, patients do not need crutches after this type of surgery.  Dr. Friedman can give you his recommendations based upon the repair needing done.

Q: Will I need any other equipment?

A: For patients having hip and knee replacement surgery, you may need a high toilet seat and shower seat, which the hospital can arrange to be delivered to you or you may rent or borrow. There is other equipment that the hospital will supply with instructions for use.  These are used for approximately two to three months.  For patients have shoulder surgery, you may be required to be in a sling after surgery until your follow up appointment at Dr. Friedman’s office.  If the office knows ahead of time that you will need a sling, we will try to give you one to bring with you on the day of your surgery.  Otherwise, should one be needed, the surgical facility will provide one for you.

Q: Where will I go after discharge from the hospital?

A: Most joint replacement patients are able to go home directly after discharge. In special circumstances your physician may transfer you to a rehabilitation facility for a few days.

Q: Will I need help at home?

A: Yes. The first several days, or weeks, depending on your progress, you will need somebody to assist you with meal preparation, etc. Joint replacement patients will have a home health care nurse come to your house for the first two weeks that your are at home. Family members or friends should be available to help.

Q: When will I be able to drive my car?

A: If you had surgery on your left leg, and you have an automatic car, you may be able to drive within a few days. If it is your right leg, or if you have a standard shift car, you may not be able to drive for couple of weeks or more depending on the type of surgery you have had.  Joint replacement patients should expect it to take at least 2 weeks before being able to drive.  If you had shoulder surgery and are wearing a sling, you are not allowed to drive until after Dr. Friedman discontinues the use of your sling.  This applies to shoulder replacement as well as shoulder arthroscopy patients regardless if you have a standard or automatic car. 

Q: Will I need physical therapy when I go home?

A: The hospital will arrange for hip and knee replacement patients to have a home physical therapist to provide physical therapy at your home for the first 2 weeks. Following this, you will probably go to a physical therapy facility 2-3 times a week to assist in your rehabilitation. This should last approximately 4-6 weeks, depending you’re your progress.  If you are having outpatient surgery, usually physical therapy will be prescribed at your postoperative visit.  The length of time you need physical therapy following outpatient surgery depends on the procedure done and the extent of the needed repair. 

Q: Can I shower?

A: As a general rule, most patients can remove the dressings, place band-aids over the small incision, shower, remove the band-aids, pat the wound dry, and re-apply band-aids. Until the wounds are healed and the sutures removed, you should not soak in a hot tub or immerse in a swimming pool.  Surgical wounds are to be kept as clean and dry as possible.

Q: Should I change the bandage?

A: Yes. You will be given directions upon discharge from the surgical facility as to when to change your surgery dressing.   Normally, you will change the dressing the day after surgery and change it at least daily until you return to our office.  Often the dressings will be damp, and there can be a small amount of bleeding present. This is normal and there is no cause for alarm, however, you will need to change the dressing more than daily. Excessive or prolonged bleeding should be reported immediately.

Q: How often will I need to be seen following surgery?

A: Your follow up care will vary with each type of surgery and with the extent of repair done during surgery.  Joint replacement patients will be required to follow up with Dr. Friedman on a yearly basis after they complete normal postoperative care.  It is very important to see Dr. Friedman yearly to evaluate the condition of the prosthesis.  During these visits, you will receive an examination and x-rays to ensure a healthy joint replacement.

Q: When will I be able to get back to work?

A: The timing depends considerably to the type of surgery done and upon your commitment to recovery.  Please discuss this with Dr. Friedman when scheduling your surgery.

Q: When can I have sexual intercourse?

A: The time to resume sexual intercourse should be discussed with your orthopaedic physician.  Joint replacement patients will have certain restrictions of their motion at certain points of their recovery. 

Q: Will I have any restrictions following this surgery?

A: Yes. You may be restricted from performing high-impact activities, such as running and basketball. You will also be restricted from performing contact sports, such as football. Low impact activities such as dancing, golf, hiking, swimming, gardening, may be appropriate.  This, again, depends on the type of surgery performed and the extent of repair needed and should be considered on an individual basis.

Q: What are Advance Medical Directives?

A: Advance Directives are a means of communicating to all caregivers the patients' wishes regarding health care. If a patient has a Living Will or has appointed a Health Care Agent, and is no longer able to express his or her wishes to the physician, family or hospital staff, the Medical Center is committed to honoring the wishes of the patient as they are documented at the time the patient was able to make that determination. There are different types of Advance Directives: 

LIVING WILLS are written instructions that explain your wishes for health care if you have a terminal condition or irreversible coma, and are unable to communicate. 

APPOINTMENT OF A HEALTH CARE AGENT (sometimes called a Medical Power of Attorney) is a document
that lets you name a person (your agent) to make medical decisions for you, if you become unable to do so. 

HEALTH CARE INSTRUCTIONS are your specific choices regarding use of life sustaining equipment hydration and nutrition and use of pain medications. On admission to the hospital, you will be asked if you have an Advance Directive. If you do, please bring copies of the documents to the hospital with you so they can become a part of your Medical Record.

Charleston Orthopaedic
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Shoulder & Knee Anthroscopy
Shoulder Replacement
Hip & Knee Replacement
Reverse Total Shoulder Replacement
Hip Resurfacing Replacement
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