Geoffrey Westrich, MD

Having a hip or knee replacement and going home from the hospital the same day is becoming more common. The surgery is generally performed early in the morning, and the patient goes home at the end of the day. Five years ago, outpatient joint replacement was almost unthinkable. But advances in technology, surgical technique and pain management over the past few years have made same-day hip or knee replacement a viable option for patients who meet certain criteria. During the pandemic, many people find this appealing since they leave the hospital more quickly and can spend their first night after surgery in the comfort of their own home. These days, much smaller incisions and robotic-assisted joint replacement, which allows for ultraprecise positioning of the implant, benefit patients who wish to go home the day of surgery. A study in the Bone & Joint Journal in 2018 by researchers in the United Kingdom found that robotic-assisted total knee replacement was associated with decrease...

Over the past two decades, I have seen many advances in joint replacement surgery that have benefited patients. I believe robotic-assisted knee replacement, which allows for an ultra-precise procedure, is one of the most exciting.  I recently reached a milestone when I performed my 500 th robotic-assisted knee replacement. I use the MAKO robotic system, which is FDA-approved for both total and partial knee replacements. Joint replacement is highly successful in relieving arthritis pain and improving quality of life, and robotic system allows us to really customize the procedure for each patient. The MAKO system allows for optimal alignment and positioning of the knee implant, as well as optimal ligament balancing, all critically important for the best outcome and long-term success of the surgery. Such precision could potentially lead to a longer-lasting knee replacement. Over the past few years, I've seen more patients in their 40s and 50s with arthritis. The main concern for ...

John Schieck wanted to dance at his daughter’s wedding, and he wasn’t going to let the pandemic stop him. But his severely arthritic hip was another matter.  So, when the Long Island resident learned he could schedule a hip replacement when elective surgeries resumed at Hospital for Special Surgery (HSS), he didn’t hesitate. Before the pandemic, he had a knee replacement at HSS. In May of this year, he came to see me for a regular follow-up exam. Mr. Schieck’s knee was fine, but his hip pain and gotten much worse.  He had trouble sleeping at night and found himself limping at work. Mr. Schieck, who is 65, went ahead with hip replacement surgery at HSS in June, and two months later, he attended his daughter’s wedding. “My hip pain was gone. I danced with my daughter, my wife, my friends. I was a ‘dancing machine’,” he recalled. For others suffering from arthritis pain who are reluctant to schedule surgery, HSS has instituted extensive precautions to ensure that patients, visito...

Snow storms and freezing temperatures can turn streets into obstacle courses, and hazardous conditions  can lead to a fall if  people aren't careful. It's something people don't always think about when they are  focused on shoveling snow or in a hurry to get somewhere. Even after much of the snow and ice are removed, there are always some slippery surfaces to watch out for. Here are some safety tips when out in bad weather or on slippery streets after a snow storm: * Wear shoes or boots that provide traction on snow and ice, such as those with rubber and neoprene composite soles. Avoid plastic and leather soles, smooth-soled shoes and, of course, high heels. * Walk at a safe pace. Give yourself enough time to get to your destination without rushing. * When given no choice but to walk on ice, take short steps or shuffle for stability. * Look where you're going. Watch for icy patches, especially on the north side, that remain even if the sidewalk or parking lot has been c...

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...