John Alper, 51, didn’t hurt his knees during an intense weekend warrior game, skiing, or even from a fall—but they gave out over time. Alper has always been active, running and playing racquetball and golf, but he didn’t think these activities would have such an impact on his knees that he would need to consider joint replacement surgery at his age. “I guess all of that activity and walking a lot in my job caused my knees to eventually wear out,” Alper says. “I felt like I was walking around like an 80-year-old man.”
Alper missed long days on the golf course and his favorite activities, so he sought the expertise of Texas Health Center for Diagnostics and Surgery’s total joint replacement team. The center has a new program led by medical director Dr. Donald Hohman that, in just four years, has already made a remarkable difference in hundreds of patients’ lives. The program is ranked in the 98th percentile for an overall hospital rating and in the 99th percentile for an overall patient satisfaction rating. Alper wound up getting one knee replaced in 2019, and the other in 2020. Within 10 days after each surgery, he returned to work, and within a few weeks of the surgery, he was back in full swing on the golf course, pain-free.
The Texas Health Center for Diagnostics and Surgery Joint Replacement Program, established in 2016, is dedicated to helping patients, from start to finish, who require all types of joint replacement surgery. Developed in conjunction with Dr. Hohman, the joint replacement program focuses on providing patients with the essential knowledge necessary to be successful post-surgery—an aspect that hasn’t always been a part of joint replacement surgery. To aid in their journey, a dedicated joint replacement coordinator works closely with each patient, before, during, and after their surgery, to ensure they are completely prepared for their recovery process. This advanced orthopedic program places a strong focus on individualized education and empowers patients to become more involved in their plan-of-care, along with collaborating with a team and surgeons for successful outcomes. To date, 100% of the patients in the program have completed a joint replacement education class prior to surgery. The established protocols are successful, as 100% of total joint replacement patients are walking one day after surgery.
“It has been great to have the hospital willing to work with me and help support and develop my vision for what this program should be,” Dr. Hohman says. “Having a joint replacement of any kind is a big deal. It’s a major operation, and it takes a village to ensure each patient has a successful outcome. People aren’t always sure what they will be able to do after surgery. Will they be safe at home? When can they resume activities? How can we be sure they will do the prescribed physical therapy? Once we determine someone is a candidate for the surgery and they are ready to move forward, there are still many steps, which is why we have a specialized team in place to help get them through the operation in an efficient manner. Having the right process in place with the right team of high-quality professionals is key and pays dividends down the line.”
A key member of this team is Mary Anne Browne, RN. She, literally, gets the patients moving again after surgery. “Our accelerated program begins before the patient has surgery,” Browne says. “We reach out to them and start the education process, talking to them about what they will need at home, helping them prepare, and helping to reduce any anxiety they may feel. We give them the power of knowledge, which makes them feel confident and helps them to be successful. We also share what the expectations are and work with them and their families to facilitate a plan designed specifically for them. Not every patient will have the same needs or be in the same situation. We cater to patients before, during, and after the surgery and follow them throughout. They’ll see me before surgery and when they get discharged. It is truly a multidisciplinary program between the fellowship-trained physicians, nurses, anesthesiologists, staff, and physical therapists. We always say we are here to truly serve the patient—not just for their orthopedic needs, but their complete care as they go through this journey.”
Most patients, like Alper, stay only one night in the award-winning hospital after total joint replacement surgery and go home relieved to know that further care is ahead. The hospital is known for its outstanding care and has even been recognized with a Guardian of Excellence Award by Press Ganey for Employee Engagement, Physician Engagement, and Excellence in Patient Experience for inpatient care. “The team checks up on you a lot and makes sure you are doing your physical therapy,” Alper says. “In fact, they have someone come to your house the day after you get home to follow up. Because of their guidance and doing physical therapy three times a day, my recovery was accelerated. My knees feel great. I can get around and play golf every day if I want to.”
This unique multidisciplinary program also calls for specific, specialized equipment. For instance, a muscle-sparing total hip replacement requires a specialized table and training the medical professionals who use it. “The hospital was agreeable and understood the advantages of having this expensive piece of equipment,” Dr. Hohman says. “They were willing to help me put together the pieces of the puzzle to make this idea a reality and bring it to Dallas. Now we are doing several cases per week, and it’s the best experience I have every week knowing what a difference this surgery can make in patients’ lives.”
The program utilizes computer navigation and cutting-edge advances for each patient’s unique situation. Each patient enrolled in the Texas Health Center for Diagnostics and Surgery Joint Replacement Program is offered an advanced technological approach specifically crafted for them. This results in more predictable outcomes, more reproducible results as evidenced by low complications, and superior satisfaction. Collaboration between radiology, an education team, and other specialists on staff is critical to the success of the program, and each team member recognizes how their role affects the overall outcome for the patient.
For instance, anesthesiologists help orchestrate a multimodal pain regimen so that patients can go through the process without ever needing narcotic pain medication, even post-surgery. Dr. Hohman also works with a team of other surgeons and radiologists on planning the surgeries with an advanced 3D protocol, which is especially beneficial for patients who have had previous spine surgery and may be prone to dislocation and postoperative complications. An optimal positioning system helps identify the best positioning for their implant. “I have never agreed with a ‘this is how we have always done it approach,’” Dr. Hohman says. “I look at new technology as a way to help us do something even better. Each patient is an individual and has unique circumstances. This technology can help us determine what will work best for them.”
Alper is a perfect example of a patient who benefited from a surgery that was customized just for him. Outside of working through some stiffness now and then, he says his new knees feel like they have been there all along—only better. “I wish I had done this earlier,” he says. “There was a year of my life where I really couldn’t get around well, and this program made all the difference. It is amazing to me that these doctors can go in and create a brand-new knee that specifically fits each person’s body. I have a new appreciation for what they can do, and a new appreciation for getting around without pain.”
To learn more about the Texas Health Center for Diagnostics and Surgery Joint Replacement Program and to determine if you are a candidate for the surgery and the accelerated recovery program, visit the website.