FAQs

Osteoarthritis is the wearing away of articular cartilage, which is the protective covering found at the end of bones.

Many cases of osteoarthritis can be treated with nonsurgical, conservative measures, such as weight loss, activity modification, physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs) and injections. After all conservative measures have been exhausted or in cases of severe or advanced osteoarthritis, surgery may be indicated.

Your surgeon will take into account your history, physical exam findings and imaging studies before making any formal treatment recommendations. Generally, nonsurgical measures are advised before surgical intervention. Surgery may be recommended if nonsurgical measures have been exhausted or in cases of severe or advanced arthritis, when symptoms are unlikely to respond to conservative measures.

Generally, your first appointment with the surgeon will involve an evaluation that takes into account your medical history, current symptoms and an examination of the injured area. If X-rays are required, they can be taken the same day. In some cases, additional tests will be recommended and, once authorized, can be scheduled for a later date.

Any relevant medical information, including diagnostic reports and images, will help us better evaluate your condition. If you have these available as digital files, please bring them with you to your first visit.

Additionally, please bring the following:

• Insurance card

• Photo ID

• Outside medical records

• Outside slides with pathology reports

• Referring physician contact information
• Primary care provider contact information

• Pharmacy contact information


Please plan to arrive at least 15 minutes before your scheduled appointment to allow for the registration and insurance verification process. We understand staying on schedule is important to our patients, and your early arrival helps ensure that we can see all our patients in the timeliest manner possible.

Insurance policies differ from patient to patient, and coverage will depend on both the procedure and your individual policy. The surgeon’s office will always obtain authorization in advance of any surgical procedure; however, we advise you to speak with your insurance representative to discuss patient responsibility, co-pays and other important coverage details.

If changes to your insurance coverage are due to occur before or near the date of your surgery, please notify us immediately. Authorization, which can take time, may need to be obtained from your new insurance company. Failure to inform us of these changes could result in the cancellation or postponement of your surgery.

Yes. Generally, there are a number of individuals who can assist you with forms and paperwork. Often, it is best to bring these materials to your surgeon’s office before surgery. Please consult your surgeon for specific instructions.

Surgery is an invasive procedure that carries inherent risk. Prior to obtaining your written consent, your surgeon will discuss the surgery’s risks, benefits and alternatives. Risks related to anesthesia will be addressed by a member of the anesthesia team. Please speak with your surgeon or a member of their team if additional clarification is necessary.

Preparing for surgery is, to some extent, personalized and will depend on the procedure being performed as well as your medical condition. Some patients will need to obtain medical clearance from their primary care provider prior to surgery. On occasion, additional clearance from relevant specialists will be required to ensure patient safety. Preoperative testing—like blood work, electrocardiograms (EKGs), urine tests and chest X-rays—may also be necessary. Your surgeon or a member of their team will explain everything that's necessary in advance of surgery.

Please do not eat or drink after midnight on the evening before your surgery. Consuming food or liquids prior to anesthesia can be dangerous and, for safety reasons, may result in the postponement or cancellation of your procedure. If you have been instructed to take certain home medications on the morning of surgery, it is safe to do so with a sip of water. Pediatric patients may be allowed to have clear liquids, such as water, up to three hours prior to surgery. Milk and other non-clear liquids cannot be consumed after midnight on the evening before surgery. Please speak with your surgeon or a member of their team if additional clarification is necessary.

It depends. There are medications that need to be continued the morning of surgery and there are medications that must be discontinued. Prior to surgery, our nurses will advise which medications you should or should not take before your procedure. Please speak with your surgeon or a member of their team if additional clarification is necessary.

If you have digital files of your preoperative imaging, please bring them with you on the day of surgery. In addition, it is helpful to bring a list of medications you are currently taking. We also recommend that you bring something to read or occupy yourself with while you wait. For your own safety, we require that a friend or family member accompany you home following the surgery.

Please leave any jewelry, watches or other valuables at home for safekeeping. Although cell phones and clothing are stored in locked storage during surgery, we strongly advise against bringing valuables and other non-essentials with you.

Montefiore Einstein has multiple surgical sites. The majority of our joint replacement surgery is performed at the Montefiore Wakefield Campus, located at 600 East 233rd Street, Bronx, NY 10466. In some instances, your care will be provided at one of the other surgical sites. Prior to surgery, your surgeon’s office will provide you with specific instructions on where to go and when to arrive.

Generally, patients are required to check in one-and-a-half to two hours prior to surgery. The night before surgery, our staff will call to inform you at what time to arrive. If surgery is scheduled for a Monday, you will be contacted on the Friday before surgery. If surgery is scheduled following a national holiday, you will be contacted on the last day the hospital is open prior to your surgery. If you do not receive a call by 4:00 p.m. on that day, you should contact your surgeon’s office or the Ambulatory Care Registration at 929-263-3477, as directed.

Regional anesthesia is generally utilized for joint replacement surgery. Your surgeon, together with the anesthesiology team, will take into account your individual medical condition and decide which approach is most appropriate for you.

The duration of your surgery depends on the procedure being performed and individual patient characteristics. On average, joint replacement surgery takes from one to two hours, and additional time is required for preparation and anesthesia. Please speak with your surgeon or a member of their team if additional clarification is necessary.

Post-operative hospital stays vary from patient to patient and depend on the procedure performed, as well as other variables. The average hospital stay for a total joint replacement is one to two days; however, more complicated procedures may require a slightly longer stay. Your surgeon will discuss the anticipated post-operative management plan that is most appropriate for you.

Pain medication is often helpful after surgery but is not always necessary. If medication is required, your surgeon will provide you with a prescription. As most prescriptions are electronically submitted directly to the pharmacy, you will be asked to provide your pharmacy’s contact information in advance.

Post-operative care varies from patient to patient, and specific instructions depend on the procedure performed, as well as other variables. Generally, showers are permitted in the early post-operative period, but your surgeon will likely instruct you to keep the wound clean and dry. Please speak with your surgeon or a member of their team if additional clarification is necessary.

Following surgery, you will be assessed by a team of providers, including physical therapists and social workers, who will help determine what is most appropriate for you. Generally, patients can return home following joint replacement surgery. In most cases, a visiting nurse, physical therapist or other related home services is arranged prior to discharge. In some instances, more intensive assistance is needed, and patients may need subacute rehabilitation for a period of time.

Physical therapy and rehabilitation are frequently ordered after surgery to help maximize a patient’s functional outcomes. Your need for physical therapy or rehabilitation depends largely on the procedure performed and the nature of your condition. For example, physical therapy is an essential component of post-operative care following knee-replacement surgery and critical to realizing optimal range of motion and minimizing discomfort. Please speak with your surgeon or a member of their team if additional clarification is necessary.

Your post-operative care guidelines, including follow-up visits, depend on the procedure performed, as well as other variables. Your post-operative appointment will be arranged either prior to surgery or upon discharge. Please speak with your surgeon or a member of their team if additional clarification is necessary.

Your first post-operative visit will involve an assessment of the surgical site, an evaluation of your range of motion, a review of your physical therapy regimen, and an assessment of your pain and pain-management strategy.

Follow-up appointments are dependent on the nature of your condition and the treatment provided. Please consult your surgeon for more specific details.

Doctors are not able to “clear” patients for driving. This is a decision that must be made by patients when they feel safe and capable. Driving while using narcotic medications, such as prescription pain medications, is dangerous and should not be attempted under any circumstances. Additionally, we recommend that patients refrain from driving if they are experiencing any substantial discomfort that could contribute to or result in an accident. While there is no specific law against driving with a dressing or a cast, we strongly discourage it. Your safety and the safety of others are of paramount importance.

Return to work varies from patient to patient and is dependent on a host of patient-specific factors, including the type of work that you do and the type of surgery you are having. Please consult your surgeon for more specific details.

The duration of recovery time following total joint replacement surgery varies from patient to patient and continues to evolve over time. While many patients realize tremendous improvement in pain and motion in the first three to four weeks, the average length of complete recovery is three to six months. Please speak with your surgeon or a member of their team if additional clarification is necessary.

On average, joint replacements last for 15 to 20 years, and most patients enjoy excellent benefit and longevity following a procedure. Every patient is different, however, and there are exceptions. Please speak with your surgeon or a member of their team if additional clarification is necessary.