Archive December 2018 XIX, No. 12

How to Optimize Knee Replacements

Focus on these essential elements to send patients home happy and healthy.

Jared Bilski


Pamela Bevelhymer, RN, BSN, CNOR
HOME TEAM Creating core groups of OR teams improves efficiency and turnover time, and reduces surgical risk.

Any good orthopedic surgeon believes he's in complete control of how well knee replacement patients will fare after he replaces old bone with new titanium, but (between you, me and the OR wall) some of the keys to achieving excellent outcomes are largely out of his skilled hands. It takes constant communication with patients, effective pain management, instrument and staff standardization, and technology-assisted implant placement.

1. Constant contact

Keeping patients informed about what will happen on the day of surgery and during their recovery motivates them to be active participants in their care. It's never been easier now that you can easily email or text patients. Brett R. Levine, MD, MS, a hip and knee reconstruction and replacement specialist at Rush University Medical Center in Chicago, Ill., partners with a text-messaging service that lets him send essential information to patients before and after surgery.

"My team and I studied about 100 patients to determine their most common questions and concerns," says Dr. Levine. He then created customized text messages to each one. Now his patients receive automated reminders and information about, for example, how they should prepare for surgery and what to expect afterward. He's even able to send them videos of exercises and physical therapy routines to keep their recoveries on track.

The messaging service also provides patients with answers to questions about relatively minor post-surgery concerns that in many cases they used to call him about or for which they ended up in the ER for unnecessary treatment.

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