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One significant advancement in the last 10 years has been around pain management and early recovery protocols. The goal is to minimize the amount of narcotics patients require after surgery. Today, we manage pain through many different types of medicines in addition to narcotics.

There’s been a lot of success recently with joint (intra-articular) injections of anesthetic around the hip or knee joint at the time of surgery. This injection limits the amount of pain patients have when they first wake up from surgery. We know that if you limit that first pain sensation, it helps with the whole pain management process going forward.

Another significant advancement is infection prevention. Patients’ skin is now pre-operatively prepped with the antiseptic and disinfectant chlorhexidine both at home prior to surgery and at the hospital as well. In addition, we assess and then optimize patients’ nutrition and health pre-operatively.

These two improvements have drastically cut down on infection rates. We did not use to address patient nutrition. If a patient is at a higher risk for nutritional deficiencies – those with chronic illness, diabetes or poor appetite, we then work in conjunction with a nutritionist so their infection rates are lower.

There also have been steps to increase to patient safety. Standardized protocols, safety checklists and quality control monitoring have increased successful outcomes for joint replacement patients.


In the past, different implants were used based on age, but most surgeons use the same type of implants no matter the age. Occasionally, a patient with poor bone quality will require different implants. There is long-term data on our current implants and techniques that shows them to be functioning extremely well.