FAQs

General FAQ’s

• How do I make an appointment?
• Do I need a referral to make an appointment?
• Are my medical records kept private and confidential?
• How do I contact Dr. Cien's office after hours?

Joint Replacement FAQ’s

 

General

How do I make an appointment?

Simply call us at during our working hours or you can request an appointment online using this form.

Do I need a referral to make an appointment?

You do not need a referral to schedule an appointment.  However, please check with your insurance company to see if a referral is necessary.

What to bring for your initial consultation?

For your initial consultation you will need to bring a referral letter from your physician if necessary.

Here is check list for your initial consultation

• Driver’s License or a valid ID
• Insurance information
• Referral Letter (if required)
• Reports, X-rays, MRIs, CT scans etc. and any other relevant information
• List of medications (if any)

We encourage you to come to your initial consultation with a written list of questions to ensure you don’t forget to ask them when you are seeing the doctor.

Are my medical records kept private and confidential?

Your medical file is handled with the utmost respect for your privacy. Our staff is bound by strict confidentiality requirements as a condition of employment regarding your medical records. We will not release the contents of your medical file without your consent.

How do I contact Dr. Cien's office after hours?

If you have shortness or breath or chest pain, call 911 immediately or go to the nearest emergency room.  For other urgent questions or concerns, please call (574) 247-9441 for assistance.

Joint Replacement FAQ’s

What is total joint replacement?

Joint replacement is surgery to replace damaged and worn out cartilage on a major joint in the body. It is done using an artificial joint made of metal, ceramic and plastic. Total joint replacement can effectively recreate the function of the joint.

Am I a candidate for joint replacement?

This determination can only be made after a thorough evaluation by your surgeon and involves considering your symptoms, prior treatments, imaging and medical status and social situation.

What is the Direct Superior approach to hip replacement?

The Direct Superior approach, also known as minimally invasive, muscle-sparing hip replacement, is a method of approaching the hip through a smaller incision compared to a traditional posterior approach. This minimized damage to the soft tissues, muscle, and tendons and involves a much smaller incision than other approaches. This can result in reduced pain and shortened recovery times.

Am I a candidate for the Direct Superior approach?

The overwhelming majority of patients can have their hip replacement performed safely through the minimally invasive Direct Superior approach. However, there are rare situations due to anatomy or prior surgery in which the surgery is best performed with an alternate approach.

Is joint replacement surgery safe?

As a very common medical procedure, joint replacement can be performed safely. On an annual basis, almost 300,000 patients undergo hip replacement surgery, and almost 600,000 patients undergo knee replacement surgery in America. Any risks will be thoroughly reviewed with Dr. Cien prior to surgery.

How long will a replacement joint last?

Failure mechanisms for a joint replacement are variable, however, a modern hip or knee implant typically will not fail from "wearing out" for greater than 20 years. It may be shorter or longer depending upon the activity of the patient.

What are the major risks of joint replacement surgery?

While most joint replacement surgeries are performed without incident, joint replacement carries risk of infection, blood loss, fracture, nerve or blood vessel damage, continued pain, stiffness, plastic wear, limb length discrepancy, anesthesia risk and other imponderables. Many of these risks can be lessened through patient optimization and peri-operative medication and protocols. Dr. Cien will discuss the risks and any concerns you may have.

Is there an age limit for joint replacement surgery?

Joint replacement surgery has no age limit. It simply requires that you be in good health to undergo surgery.

Which tests will I need before joint replacement?

Prior to surgery, blood work, EKG, urinalysis, blood typing and/or infection screening may be required. Most patient will be evaluated by a medical doctor prior to surgery and occasionally, specialty evaluation may also be required.

Should I start or stop any medications?

This is a matter to be discussed with Dr. Cien and/or your primary care physician or specialist.

What are my options for anesthesia?

In most cases, patients receive spinal anesthetic for joint replacement surgery with a local anesthetic block placed in the joint. In some cases, patients may receive general anesthetic. These options can be discussed with Dr. Cien and the anesthesiologist prior to surgery.

How long will the surgery take?

Joint replacement surgery can take anywhere from one to three hours or more. This depends on the level of complexity in the surgery.

Will I be in much pain after surgery?

Dr. Cien utilizes a multi-modal analgesic regimen which is very effective in minimizing surgical pain. Most patients experience mild discomfort during the first days following surgery, but this can actually be an improvement over the pain the patient experiences from their osteoarthritis, rheumatoid arthritis and/or avascular necrosis. Most pain will resolve within the first two to three weeks following surgery.

How long will I be in the hospital?

Following joint replacement, patients may go home the same day or have a short hospital stay.  The complexity of the surgery and the exact issue being addressed are factors that contribute to the length of your hospital stay.

Will I need someone to stay full time with me when I go home?

It is ideal to have a friend or family member stay with you for the first several days after you get home. If this is not an option, it is wise to ensure that someone checks on you daily to help with anything you may need. Additionally, the hospital social worker may be able to arrange in-home services or assistance.

Will I need pain medicine after I’m discharged?

Many patients will require a short course of narcotic pain medication to supplement acetaminophen and NSAIDS. However, some patients will manage to avoid narcotics all together. While a short course of narcotic medication is usually prescribed, in general, Dr. Cien recommends minimizing or avoiding narcotic medication. Discuss your expectations with him before surgery to help develop a personalized pain control plan.

When should I remove my bandage?

Prior to discharge from the hospital or surgery center, Dr. Cien or the hospital staff will instruct you on how to care for your incision and Prineo bandage.  The Prineo bandage should remain in place for approximately 10-14 days and then can be removed.  You may shower and briefly allow the bandage to get wet.  However, it should be dried immediately thereafter by gently blotting with a soft towel.  You should not swim or otherwise immerse the bandage in water.

What should I do if the corners of my bandage start peeling up?

If the bandage peels up, becomes saturated or dislodged, you may remove it and cover your incision with sterile gauze or an appropriately sized (20 or 30 cm) Primapore dressing (these can be purchased at Walmart or Amazon).

How long will I need to use my walker, cane, or crutches?

Certain patients will require the use of a walking aid following surgery. This is often needed for only several days to weeks before patients can walk independently. This matter can be discussed with Dr. Cien.

When can I go up and down stairs?

Most patients can ascend and descend stairs before leaving the hospital or surgery center.

When can I drive?

For safety purposes, patients must wait several weeks before driving a car and also until you have stopped all narcotic pain medication. However, many patients can return to driving before that depending upon their recovery. It also depends on which hip or knee was replaced.  Typically, right sided knee or hip replacements take approximately four weeks to return to driving, while left sided replacements take approximately two weeks. It is important that you wait until discussing your return to driving with Dr. Cien.

When can I return to work?

While most patients wait four to six weeks before returning to work, it can be sooner or longer.  The nature of your job may determine how soon you can return to work.  You and Dr. Cien will map out a plan to get you back to work as soon as possible.

How often will I need to see my surgeon?

Follow-up appointments vary from patient to patient. Dr. Cien will typically first see the patient at four to six weeks from surgery, but will see a patient after surgery at any time if there is a question or concern. Contact his office for any questions.

When can I resume sports activities?

Patients will begin light exercise during the recovery process soon after surgery. Most patients can return to mild sports activities within six to eight weeks after surgery and begin to ramp up their activity from there. Longer term recommendations will vary depending upon the exact type of surgery.

When will I be able to engage in sexual activities after surgery?

Patients are able to resume sexual activity when it feels comfortable. In general, they are only restricted by position limitations posed by their physical therapist.

Do I need to take antibiotics prior to dental work or other invasive procedures?

Dr. Cien recommends lifelong antibiotic treatment prior to all dental work or other invasive procedures to decrease the chance of developing an infection in your artificial joint. Please contact his office for a prescription or further information.

Am I a candidate for Robotic knee replacement surgery?

The overwhelming majority of patients can have their knee replacement performed safely through the minimally invasive subvastus approach utilizing the MAKO Robot. However, there are rare situations due to anatomy or prior surgery in which the surgery is best performed with an alternate approach.