Geoffrey Westrich, MD

When elective surgeries resumed in New York City in June, it was a relief for patients with severe hip or knee arthritis who had made up their minds to have joint replacement surgery. Many people needed to wait when the procedures, considered elective, were put on hold due to the pandemic. Some patients were in so much pain, they wanted to have the procedure as soon as possible. But a number of them were surprised to learn they would have to wait, in some cases up to three months, because they had received an injection of a steroid or hyaluronic acid in their joint at another doctor’s office. There are two issues for patients. First, the injections do nothing to relieve pain when someone has bone-on-bone arthritis and is a candidate for joint replacement, or if they provide any pain relief at all, it is very short lived. The other problem is that anyone who has received a steroid or hyaluronic acid injection must then wait approximately three months from the date of their l...

At the height of the pandemic, people displayed good judgment and stepped up to the challenge, staying at home to stop the spread of coronavirus. Although many locations are beginning to see a slow return to the “new normal,” many doctors’ offices are only open on a limited basis. Elective surgeries, such as joint replacement, are still on hold in New York City. Since March, many people with arthritis have gone without physical therapy or injections at their doctor’s office to relieve pain. Those scheduled for joint replacement surgery had their procedure postponed. People with arthritis can adopt good practices to help lessen pain while they wait for treatment. While staying at home, people may have gotten into the habit of watching a lot of TV or spending hours online. In the current pandemic climate, that’s understandable. But it’s good for those who have arthritis to engage in mild exercise or take a walk, if they can. If you sit around too much, your joints can become s...

More than 350,000 hip replacements are performed in the United States each year to relieve pain and restore mobility. Overall, it's a highly successful procedure and has given many people a new lease on life. However, as with all surgeries, the risk of a complication exists, and dislocation is one of the most common. At Hospital for Special Surgery, we conducted a study that found that an implant known as an anatomic dual mobility (ADM) hip replacement significantly lowered the risk of dislocation, reducing the need for a revision surgery. My colleagues and I evaluated almost 200 hip replacements with the dual mobility implant and found no dislocations at follow-up of at least five years. The research appears online as an ePoster as part of the American Academy of Orthopaedic Surgeons Annual Meeting, which was transformed into a virtual experience due to Covid-19:  https://aaos.apprisor.org/epsAbstractAAOS.cfm?id=2 A hip replacement implant is a ball-and-socket mechanism, d...

During the coronavirus pandemic, many doctors’ offices are closed for non-emergency care and more patients are embracing telemedicine. Over the past few weeks, I’ve seen an increase in virtual consultations among both established and new patients. One of my knee replacement patients had an in-office follow-up appointment on the last day it was open in early March, but given the choice, he opted for a telehealth consultation. He told me his online follow-up appointment after knee replacement was easy to set up, and it worked well. While consulting in front of his computer screen, he was even able to show me his knee.      I’ve also had telemedicine consultations with several new patients seeking an orthopedic surgeon for a hip or knee replacement. Although they can’t have the surgery right away, they’ve already been told that the best option for pain relief is a joint replacement, and they’re planning ahead.  Although elective surgeries, including hip and ...

Supreme Court Justice Ruth Bader Ginsburg fell in her office this week and fractured three ribs. She was hospitalized, but fortunately, is now back home now and doing well, according to news reports. Although the details of how the 85 year-old Supreme Court Justice fell have not been released, the mishap shines a spotlight on how serious a fall can be. It fact, a fall can be devastating for older adults in particular because their bones are more fragile. They often break a hip, sustain a severe head injury... or worse. I would like to take this opportunity to wish Justice Ginsburg well and remind everyone that measures can be taken to prevent falls indoors. In your own home, or in the home of a loved one, these strategies can help prevent an accident and keep people safe. Some of these measures can be applied to the work environment, as well: Ensure that the home is free of hazards such as slippery floors, rugs that are not secured and poorly lit areas. Install handra...

Hip replacement surgery is highly successful in relieving pain, restoring mobility and improving quality of life. More than 330,000 procedures are performed each year in the United States, and that number is expected to almost double by the year 2030.  As with all surgical procedures, the possibility of a complication exists, and dislocation is the most common problem. The risk of dislocation is higher in patients who have had a second hip replacement, known as revision surgery. Some people need a revision surgery many years after their first hip replacement when the original implant wears out. Hip instability after joint replacement is another reason a patient might need a revision surgery.     Research conducted at Hospital for Special Surgery, where I am director of research of the Adult Reconstruction and Joint Replacement Service, and other joint replacement centers indicates that a newer type of artificial hip known as a “modular dual mobility” implant coul...

More than 330,000 hip replacement surgeries are performed in the United States each year. Overall, it is a highly successful procedure. However, as with all surgeries, a risk for complications exists.  Dislocation is one of the most common complications after hip replacement and the number one reason for revision surgery. A study we conducted at Hospital for Special Surgery (HSS) found that patients who received a newer implant known as a “dual mobility” hip replacement had zero dislocations.   In comparison, study patients who received a traditional fixed bearing hip implant had a dislocation rate of 5 percent. The research, which focused on patients under 55 years old, was presented last month at the American Academy of Orthopaedic Surgeons Annual Meeting in New Orleans.   We were especially interested in seeing how the younger patient population fared because they are generally more active and put more demands and stress on their hip after joint replaceme...