Written by John Ferrari | Photographed by Vincent Rios
Spring is here. You’ve been exercising and practicing for your favorite
outdoor activities. You should be at the top of your game, but that joint
pain isn’t going away. In fact, it’s getting worse. Whether
it’s rheumatoid arthritis, osteoarthritis or a sports injury, it
may be time to consider orthopedic surgery for a partial or total hip,
knee or shoulder replacement. But when?
“You’re going to know when it’s time,” says
Todd Shrader, MD, a joint replacement surgeon and sports medicine specialist with Torrance
Lundquist Orthopedic Institute. “It’s when your quality of life is suffering and other options
are not working.” If joint replacement is in your future—as
it is for an increasing number of Americans—there’s good news:
It’s one of the most successful and effective surgical procedures
The Lundquist Orthopedic Institute is at the forefront of advances in the
field of joint replacement. Emphasizing comprehensive, patient-centered
care, the institute also provides a full range of expertise in specialized
fields including general orthopedics; sports medicine; hand, wrist, foot
and ankle care; and pain management.
The care and attention the institute’s specialists devote to each
patient shows in the distinctions it has received. Ranked by U.S. News
& World Report as one of the nation’s top centers for orthopedic
surgery, the Lundquist Orthopedic Institute also has earned Blue Cross
Blue Shield's Blue Distinction Center designation for joint replacement
and spine surgery.
According to the Centers for Disease Control and Prevention’s National
Center for Health Statistics, more than 1 million total joint arthroplasties
(the reconstruction or replacement of a joint) are performed in the United
States each year. That number is predicted to rise to nearly 4 million
over the next 10 years. Here in the South Bay, the Lundquist Orthopedic
Institute’s specialists perform more than 1,200 hip and knee replacements—more
than double any other hospital in the area, according to 2018 data from
the Office of Statewide Health Planning and Development.
“The population is getting older, so there are more and more people
who have arthritic joints,” explains Lundquist Orthopedic Institute
Don Sanders, MD. “Also, people are staying more active as they get older; that creates
more wear and tear on joints. The large Baby Boomer population is now
right smack dab in the middle of where they’re requiring joint replacements.”
As Baby Boomers have aged, joint replacement surgery has really come of
age. The last two decades have seen major advances. “We’ve
been able to develop more minimally-invasive techniques,” Dr. Sanders
says. “The concept is we do less damage when we’re doing the
surgery”—thereby reducing recovery times significantly.
Dr. Sanders helped pioneer the direct anterior approach for hip replacement
surgery—a technique that leaves the muscle attachments intact, allowing
patients to recover faster and more completely. First performed at Torrance
Memorial in 2004, the technique now accounts for 80% of hip replacements
at the hospital. Similarly, the subvastus approach for knee replacement
surgery avoids cutting into the quadriceps, speeding patient recovery.
Another even more recent innovation is robotic-assisted surgery. The Lundquist
Orthopedic Institute started using the Mako Stryker robotic system last
year to assist with knee replacement surgery. “We’re starting
to develop evidence of patients having less pain and better recovery using
the system,” says Dr. Sanders.
The system doesn’t actually perform the surgery, Dr. Sanders explains.
“We use the robotic arm to assist in the surgical procedure.”
Specifically, the system allows surgeons to operate with greater precision.
“That’s critical to achieve successful joint replacement,”
says Dr. Shrader. “The robot aligns the joint implant perfectly
and balances the soft tissues, both critical factors for a successful
total knee replacement.”
A third advancement—to anesthesia and pain blocks—helps patients
get back on their feet as soon as possible. Local pain blocks, similar
to epidurals, are administered before and during joint replacement surgery.
Reducing pain and discomfort after surgery has a practical benefit. “Patients
who get up sooner recover quicker,” explains Lundquist Orthopedic
Institute orthopedic surgeon
John Andrawis, MD. “They can usually have a physical therapist see them within a few
hours of surgery. Torrance staffing allows that to happen.”
“We’ve been at the forefront of pain management,” adds
Dr. Shrader. “Patients wake up with very little to no pain. We want
patients to walk the day they have the surgery. It lowers the chance of
getting a blood clot. Plus it helps them go home [faster], and it’s
much better to recover at home.”
Although most patients remain at Torrance Memorial overnight after joint
replacement surgery, “the large majority go home the next day,”
says Dr. Sanders. For some patients, there’s even the possibility
of going home the day of the surgery.
“It really depends on the patient,” adds Dr. Andrawis. Some
younger patients—generally those younger than 70—may choose
joint replacement surgery as an outpatient procedure. However, he says,
“it’s not your chronological age, it’s your physiological
age” that determines whether outpatient surgery is a possibility.
Getting back on her feet after a bilateral hip replacement was a priority
for 47-year-old yoga instructor Jill Lynch. “My hips started bothering
me more than five years ago,” she recalls. “I tried to fix
the problem and alleviate the pain with strength work and neurological
work. I did every possible thing I could do ahead of time, but eventually
I had to admit to myself there was something wrong and the only option
was surgery. I did some research beforehand, and given how important my
hips are to my career, I knew I wanted the direct anterior approach and
I knew Dr. Sanders was the best.”
Lynch was using a walker four hours after her surgery. Five days after
her surgery, she was walking without crutches, and after a month she and
Dr. Sanders agreed she could resume her yoga work. “I feel fantastic,”
she says. “I was in a lot of pain leading up to surgery. I feel
like I have my life back.”
Lynch’s background in yoga helped her recovery, but Torrance Memorial’s
goal is to give every patient the best experience and easiest recovery possible.
“We have an extensive pre-op process,” Dr. Andrawis says. “This
year we’re working on a pre-op clinic so we can coordinate better
patient care—especially patients with multiple medical issues. And
before surgery and rehab, we have prehab for fitter patients. Our patients
have a month-long presurgical process. The goal is to educate people on
what to expect, which allows them to be more successful in their recovery.
There are all these touchpoints at Torrance Memorial.”
Successfully combining exceptional surgeons, advanced surgical techniques
and the latest technology with comprehensive care and the convenience
of a local hospital has earned the Lundquist Orthopedic Institute another
impressive distinction. It’s ranked in the top 10% of hospitals
nationwide for patient satisfaction in a 2018 survey conducted by the
Centers for Medicare and Medicaid Services.
After all, Torrance Memorial patients like Lynch don’t choose the
Lundquist Orthopedic Institute just because it’s convenient; they
choose it because it’s the best.