Hip & Knee Replacement Surgery During COVID: Don’t Wait in Pain

When it comes to knee replacements, Marla Graves is a veteran. Her two artificial knees served her well for many years — until last year, when the left knee started giving her trouble. When the pain became severe, an X-ray revealed that the joint had become loose and was sliding sideways.

“The doctor said it was very unstable,” says Ms. Graves, adding that she was told her condition could lead to a serious fracture. “So, we scheduled the surgery. Unfortunately, it wasn’t long after that the COVID-19 shut down (elective) surgeries.”

Ms. Graves, 66, is right at the average age of a knee replacement patient. Joint replacement patients, in general, tend to be in the older age group – the same group most vulnerable to serious COVID-19 infections, says Alexander van der Ven, M.D., orthopedic joint replacement surgeon with Miami Orthopedics & Sports Medicine Institute, who oversees the joint replacement surgery program at Doctor’s Hospital.

“Obviously, COVID is a very serious concern, but Baptist Health is taking extensive safety measures to ensure both our patients’ safety, as well as our staff’s,” said Dr. van der Ven.

When elective surgeries resumed in May, Ms. Graves had no hesitation about moving ahead with her procedure at Doctors Hospital. It was performed by orthopedic surgeon Carlos Alvarado, M.D., of Miami Orthopedics & Sports Medicine Institute. “A lot of people said to me — ‘Aren’t you concerned about going in?’ And I told them no because there are more precautions now than there probably ever have been before,” she says.

According to Dr. van der Ven, those precautions include mandatory COVID-19 testing of all patients before admission to the hospital, mask use by all personnel and patients, social distancing measures and the highest standards of hygiene and infection control. In addition, patients who test positive for COVID-19 are kept in a separate wing which has its own ventilation system. “I actually feel safer in the hospital than I feel in most places, and I truly believe that,” he says.

Ms. Graves agrees. “From start to finish, nothing has been missed in making it safe for the public to come in. Everything is so well thought out and well done and everyone is so professional and caring. I had exemplary care at Doctors Hospital.”

While Ms. Graves spent one night in the hospital after surgery, inpatient treatment is often unnecessary, as Dr. van der Ven explains.

“We’ve really been encouraging patients to use our outpatient joint replacement program, where they can go home the same day. They can often leave within eight to ten hours of arriving at the hospital, therefore being able to sleep in their own beds, eat their own food and be with their family members.”

Since the innovative program was implemented in 2016 by Dr. van der Ven and a team of nurses, therapists and social workers, approximately 90 patients have benefited from same-day procedures that let them immediately start recuperating at home. Home can be the site of most follow-up appointments too, with telemedicine visits reducing the need to travel to the doctor’s office.

Surgery is not the only option when it comes to treating joint pain. Miami Orthopedics & Sports Medicine Institute’s new arthritis clinic, located on the campus of Doctors Hospital, offers a comprehensive range of services, including injections, to help ease pain and improve function and quality of life for those who want to avoid surgery or for whom it is not medically safe.

As for Marla Graves, she’s very pleased with her decision to proceed with her knee revision surgery as planned.

“I’m doing well. My pain level is so far down. My knee is already bending and it’s more flexible,” she says, adding: “I’d encourage anybody that needs to have surgery to get in there and get it done!”