Moving Forward

Top Hospitals and Healthcare 2016: Carilion introduces outpatient total hip replacements.

From left: Ryan Harris, D.O., Thomas Shuler, M.D., Michael Wolfe, M.D., department of orthopaedic surgery chairman, Joseph Moskal, M.D., Trevor Owen, M.D., and Benjamin Coobs, M.D.

“I started out with what I thought were only knee issues … never dreaming it was my hip because I was only 48 years old,” says Steven Pittman of Bedford, who works in corporate security following a 25-year career as a police officer. 

Pittman, who had suffered progressive pain for several years in both his arthritic knees and his hips, went to see an orthopaedic surgeon at the insistence of his wife, Erika, a surgical technician at Carilion. He discovered he needed a total hip replacement on his left side. There was a silver lining: Because of his age and good health, he had the option of having it performed as an outpatient.

Carilion Clinic began a same-day surgery program for hip replacements in early 2016 for people like Pittman. “The patient needs to be a little younger, they need to be active, in good or excellent health, and have a supportive caregiver who will be able to help them when they return home,” says Dr. Joseph Moskal, an orthopaedic surgeon and Carilion’s chair of orthopaedics. 

Before the surgery, patients take part in “prehabilitation.” They begin an exercise routine and lose weight if necessary. They also take a class covering topics such as presurgical nutrition, hydration and preparing their home for their return from the hospital. 

According to Moskal, “The other factor is … we’ve made tremendous strides with our surgical techniques and technologies that we’re using so our procedures are causing less tissue damage and leading to a quicker recovery.” 

Other medical personnel ensure necessary protocols are followed to decrease blood loss and for anesthesia, pain management and therapy. Such team-based efforts are at the heart of Carilion’s $32 million Institute for Orthopaedics and Neurosciences, which opened in January. The 116,000-square-foot facility brings together under one roof orthopaedic surgeons, neurosurgeons, pain management and physical medicine specialists, radiology, therapy and dietary services, along with professors and researchers affiliated with Virginia Tech and Virginia Tech Carilion School of Medicine. 

Benefits of a same-day hip replacement include cost savings for the patient and a lower risk of hospital-acquired infections. Additionally, says Moskal, “I think most patients actually would prefer to recover in their own home. And so, we put together and implemented all of the necessary steps to do this in a very safe way.”

Dr. Benjamin Coobs performed Pittman’s surgery last November. Recovery went smoothly, and he was back at work in four weeks.

Pittman still marvels that he went in one Friday morning for his surgery, and was home that same night. “By 7:00 p.m., I was in the car, stopping by Starbucks with my wife.” CarilionClinic.org/ion


Orthopaedics News

UVA Health System has welcomed two pediatric orthopaedic surgeons to the UVA Orthopaedics Culpeper team. Dr. Hamid Hassanzadeh specializes in treating patients with herniated discs and scoliosis, as well as performing minimally invasive spine surgeries. Dr. Mark Romness specializes in caring for those with cerebral palsy and spina bifida. 

The orthopaedics department at Inova Alexandria Hospital recently installed an innovative new surgical table to improve surgeries for total hip replacement. The Hana® Surgery Table allows surgeons to position the leg in such a way that hip replacements can now be completed without disconnecting soft tissues and by making only a single incision, providing more post-op stability of the joint and reducing recovery times.

In June, Virginia Commonwealth University celebrated the opening of its new Neuroscience, Orthopaedic and Wellness (N.O.W.) Center. The facility comprises 111,000 square feet and more than 80 exam rooms. The VCU N.O.W. Center is the first in the region of its kind. Services at the center include neurosurgery (pre- and post-surgical care), neurology, orthopaedics, sports medicine, physical medicine and rehabilitation, rheumatology, pain management and radiology.

As of March, Sentara Northern Virginia Medical Center offers stemless shoulder replacement surgery, which is designed to preserve bone and reduce complications in patients suffering osteoarthritic pain. In addition, the Medical Center also has new surgical suites with state-of-the-art equipment in which these procedures are done.


Orthopaedics Top Honors 2016


Inova Mount Vernon
Alexandria, Inova.org, 703-664-7000

UVA Culpeper Hospital
Culpeper, UVACulpeperHospital.com, 540-829-4100

Augusta Health
Fishersville, AugustaHealth.com, 540-932-4000

Johnston Memorial
Abingdon, MountainStatesHealth.com, 267-258-1000

Sentara Princess Anne
Virginia Beach, Sentara.com, 757-507-10000

See all of our top hospitals for 2016, below.



Cancer
LewisGale Regional Cancer Center
UVA Cancer Center


Cardiology
VCU Pauley Heart Center


Dermatology
Inova Melanoma and Skin Cancer Center


Diabetes
EVMS and Sentara Heart Hospital


Gastroenterology
Centra Lynchburg General Hospital


Geriatrics
Riverside Center for Excellence in Aging


Neurosurgery
Bon Secours St. Mary's
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