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Dr. Barnett Total Knee FAQ's

How long does the surgery take?
Typically the surgery takes around One hour and fifteen minutes.

Are there any special risks with this surgery?
The risks are the same as any other major orthopedic surgery and will be reviewed at your pre-operative visit.

Do you use a computer to assist the surgery?
I routinely do not use a computer to assist the surgery.

Do you use a "minimally invasive" technique?
I do my surgery through a Quadriceps sparing approach called a "mid-vastus" approach. This avoids cutting the large tendon (quadriceps) above the knee cap. This may allow a faster return to activity.

What kind of anesthesia do you use?
Patients can have either a general (breathing tube) anesthesia or a spinal with sedation. Patients with the spinal are sedated and do not remember the procedure or hear any of our work. In general, the spinal has less risk of nausea/vomiting, less risk of blood clots, and a lower risk of having problems with memory loss or confusion after surgery. Not everyone is a candidate and your anesthesiologist will discuss this with you on day of surgery.

Do I have stitches or staples?
The skin is closed with staples that will be removed in our office 2 weeks after surgery.

How do I care for the incision?
The incision may be left uncovered if it is not draining, You can also cover your incision with a dry dressing. Avoid any creams or ointments until the staples are removed. You may leave your incision uncovered for showering as long as there is no drainage.

What do you use to prevent blood clots?
If you are on a blood thinner before surgery this can often be resumed after surgery. Otherwise, you will be on Lovenox (an injection a nurse will give you) while in the hospital. Most patients can then be discharged on Aspirin 325 mg daily for 2 weeks if they are able to take it and are determined to be standard risk for a blood clot by the surgeon. We also ask patients to wear compression stockings (TED hose) for 2 weeks after surgery. These are provided in the hospital.

Where is the surgery done?
The surgery is done at Mission Hospital on the Memorial Campus. All patient rooms are private rooms.

How long will I be in the hospital?
Patients typically stay in the hospital for 1-2 nights. Sometimes patients stay a third night if they need additional therapy.

How long do I need physical therapy?
Most patients will do 2-3 weeks of home health physical therapy and then continue their therapy at an outpatient physical therapy office of your choice.

How long do I need a walker?
Most patients are off of a walker by about 2 weeks and then use a cane for 1-2 weeks.

When can I drive?
I typically tell patients they can think about driving when they are off the walker and off of pain medications. After that they have to be able to press the brake firmly in an emergency. For most patients this is 3-4 weeks after surgery.

When can I resume exercising?
Patients can slowly resume normal activity as their pain allows and under the direction of their therapist.

How long will my total knee last?
No one knows for sure and it will vary among patients, but our expectation is for knee replacements to last 15-20 years.

When do I come back to see Dr. Barnett?
I normally see patients at 2 weeks, 6 weeks and 6 months after surgery. An X-Ray will be done at 2 weeks and 6 months.

When should I call the office?
During normal business hours patients can always call with questions and we will return your call within 24 hours. After hours, phone calls for emergencies will be taken by the physician on call. These problems include sudden change in ability to bear weight, fever greater than 101.5, sudden increase in drainage or redness around incision, sudden increase in swelling, incision opening up, chest pain, or numbness in leg. If these problems arise after normal hours or on weekends you may be directed to you local emergency room. Requests for pain medicine refills will likely not be addressed after hours or on weekends.

Do I need Antibiotics for the Dentist?
We ask that patients take a single dose of antibiotic prior to dental cleaning or other procedures for a minimum of 2 years and recommend considering continuing this for life. These can be provided by our'' office.

Is it normal for my knee to "pop" or "click"?
Total knees can often have a painless pop or click through certain motions due to the metal and hard plastic striking each other. This usually gets better with time as swelling decreases.



Dr. Barnett Anterior Hip FAQ's

How many anterior hips has Dr. Barnett done?
Over 1000. I do all of my total hips through this approach.

Do you use a special operating table for the procedure?
Yes. I use the HANA table to help facilitate the procedure and allow use of X-Ray.

How long does the surgery take?
Typically the surgery takes around one hour.

Are there any special risks with this surgery?
The risks are the same as any other major orthopedic surgery and will be reviewed at your pre-operative visit. One unique risk with this procedure is numbness along the thigh. This can occur due to stretch of a nerve. If it occurs it can take several months to resolve.

What kind of anesthesia do you use?
Patients can have either a general (breathing tube) anesthesia or a spinal with sedation. Patients with the spinal are sedated and do not remember the procedure or hear any of our work. In general, the spinal has less risk of nausea/vomiting, less risk of blood clots, and a lower risk of having problems with memory loss or confusion after surgery. Not everyone is a candidate and your anesthesiologist will discuss this with you on the day of surgery.

Do I have stitches or staples?
The wound is closed with absorbable stitches under the skin that do not need to be removed. It is OK to get the incision wet in a shower as long as it is not draining.

What is the total hip made of?
I use the Depuy Pinnacle acetabulum (socket) and the Corail stem for almost all total hips. The hip socket is lined with a highly cross-linked polyethylene (plastic). In most cases a ceramic head ball is used on the stem. There is no cement used and the prosthesis relies on bone to grow into the prosthesis.

What do you use to prevent blood clots?
If you are on a blood thinner before surgery this can often be resumed after surgery. Otherwise, you will be on Lovenox (an injection a nurse will give you) while in the hospital. Most patients can then be discharged on Aspirin 325 mg daily for 3 weeks if they are able to take it and are determined to be standard risk for a blood clot by the surgeon. We also ask patients to wear compression stockings (TED hose) for 2 weeks after surgery. These are provided in the hospital.

Do I need to donate blood?
No. The risk of blood transfusion is very low (less than 5 %) and the risk of banked blood is very low.

Where is the surgery done?
The surgery is done at Mission Hospital on the Memorial Campus. All patient rooms are private rooms.

How long will I be in the hospital?
Patients typically stay in the hospital for 1-2 nights.

Can I go home or do I need rehab after surgery?
Most patients will be able to go home with home health physical therapy as long as they have someone to stay with them for typically the first week. Patients that are very debilitated before surgery or do not have someone to stay with them may need to go to a skilled nursing facility for continued rehabilitation. The typical duration for this is 2 weeks.

How long do I need physical therapy?
Most patients will do 2-3 weeks of home health physical therapy and then can continue exercises on their own. The primary exercise after hip replacement is walking. Rarely patients need outpatient physical therapy.

What hip precautions do I have?
With the anterior approach there are no formal hip precautions. You should not force your hip into any position and any position or activity that causes pain should be stopped and avoided.

How long do I need a walker?
My average for hip patients getting off a walker and a cane is about 2 and 1/2 weeks.

When can I drive?
I typically tell patients they can think about driving when they are off the walker and off of pain medications. After that they have to be able to press the brake firmly in an emergency. For most patients this is 3-4 weeks after surgery.

When can I resume exercising?
I prefer patients limit their activity to physical therapy exercises and walking or the first 4 weeks. After that patients can typically slowly increase their activity as tolerated.

How long will my total hip last?
No one knows for sure and it will vary among patients, but our expectation is for total hips to last around 25 years.

When do I come back to see Dr. Barnett?
I normally see patients at 2 weeks, 6 weeks, and 6 months post-operatively. An X-Ray will be done at each of these visits.

When should I call the office?
During normal business hours patients can always call with questions and we will return your call within 24 hours. After hours, phone calls for emergencies will be taken by the physician on call. These problems include sudden change in ability to bear weight, fever greater than 101.5, sudden increase in drainage or redness around incision, sudden increase in swelling, incision opening up, chest pain, or numbness in leg. If these problems arise after normal hours or on weekends you may be directed to you local emergency room. Requests for pain medicine refills will likely not be addressed after hours or on weekends.

Do I need Antibiotics for the Dentist?
We ask that patients take a single dose of antibiotic prior to dental cleaning or other procedures for a minimum of 2 years and recommend considering continuing this for life. These can be provided by our office.



Dr. Barnett MAKOPlasty FAQ's

How many MAKOPlasty procedures has Dr. Barnett done?
More than 300. Mission hospital has had MAKO since September 2010 and Dr. Barnett learned the technique during his residency at Wake Forest University.

Does the computer or robot do the surgery?
No. The computer and robotic arm help the surgeon remove only the bone necessary to place the component. The surgeon still controls the robotic arm and performs the surgery.

How long does the surgery take?
Typically the surgery takes around One hour.

Are there any special risks with this surgery?
The risks are the same as any other major orthopedic surgery and will be reviewed at your pre-operative visit. There are 2 small (<1cm) incisions above and below the knee that are required.

What kind of anesthesia do you use?
Patients can have either a general (breathing tube) anesthesia or a spinal with sedation. Patients with the spinal are sedated and do not remember the procedure or hear any of our work. In general, the spinal has less risk of nausea/vomiting, less risk of blood clots, and a lower risk of having problems with memory loss or confusion after surgery. Not everyone is a candidate and your anesthesiologist will discuss this with you on your surgery day.

Do I have stitches or staples?
The skin is closed with staples that will be removed by home health 2 weeks after surgery.

How do I care for the incision?
The incision may be left uncovered if it is not draining. You can also cover your incision with a dry dressing. Avoid any creams or ointments until the staples are removed. You may leave your incision uncovered for showering as long as there is no drainage.

What do you use to prevent blood clots?
If you are on a blood thinner before surgery this can often be resumed after surgery. Otherwise, you will be on Lovenox (an injection a nurse will give you) while in the hospital. Most patients can then be discharged on Aspirin 325 mg daily for 2 weeks if they are able to take it and are determined to be standard risk for a blood clot by the surgeon. We also ask patients to wear compression stockings (TED hose) for 2 weeks after surgery. These are provided in the hospital.

Where is the surgery done?
The surgery is done at Mission Hospital on the Memorial Campus. All patient rooms are private rooms.

How long will I be in the hospital?
Patients typically go home the afternoon of their surgery.

How long do I need physical therapy?
Most patients will do 2-3 weeks of home health physical therapy and then can continue exercises on their own. Rarely patients need outpatient physical therapy.

How long do I need a walker?
Most patients are off of a walker and cane by about 2 weeks.

When can I drive?
I typically tell patients they can think about driving when they are off the walker and off of pain medications. After that they have to be able to press the brake firmly in an emergency. For most patients this is 2-3 weeks after surgery.

When can I resume exercising?
Patients can slowly resume normal activity as their pain allows.

How long will my partial knee last?
No one knows for sure and it will vary among patients, but our expectation is for partial knee replacements with MAKOPlasty to last 1215 years.

When do I come back to see Dr. Barnett?
I normally see patients at 3 weeks and 3 months after surgery. An X-Ray will be done at each of these visits.

When should I call the office?
During normal business hours patients can always call with questions and we will return your call within 24 hours. After hours, phone calls for emergencies will be taken by the physician on call. These problems include sudden change in ability to bear weight, fever greater than 101.5, sudden increase in drainage or redness around incision, sudden increase in swelling, incision opening up, chest pain, or numbness in leg. If these problems arise after normal hours or on weekends you may be directed to you local emergency room. Requests for pain medicine refills will likely not be addressed after hours or on weekends.

Do I need Antibiotics for the Dentist?
We ask that patients take a single dose of antibiotic prior to dental cleaning or other procedures for a minimum of 2 years and recommend considering continuing this for life. These can be provided by our office.