Stephen J. Zabinski, MD Shore Orthopaedic University
New knees, new hips–to go Bundled payment is pushing providers to look for ways to control the cost of joint replacements. Is joint replacement going to become outpatient surgery? If you want a hip or knee replaced by Stephen Zabinski, MD, a surgeon at Shore Orthopedics Associates in Somers Point, N.J., you’re in for some homework. If you’re a smoker, that’s got to stop; there will be no surgery if you’re aren’t nicotine-free for at least six weeks. Patients with diabetes must get their HbA1c level under control. Those with sleep apnea must document they are using the CPAP machine as per doctor’s orders. Patients with a body mass index of 45 or more must take off some weight; Zabinski’s threshold is 40 if a patient has certain comorbidities. You may need to do strength and mobility training—so-called prehab—before surgery.
Shore Orthopedics offers support for all the to-do items, but the surgeon is not going to let you off the hook. Patients must sign a contract agreeing to comply with the practice’s “total joint pathway,” and they must designate a “total joint companion” who will help them recover but also hold them accountable for following the rules. In return, Zabinski promises to get them home quickly and avoid detours to a rehab facility. He operates on Medicare patients at Shore Medical Center; some get a same-day discharge while others stay 24 to 48 hours. Most patients younger than 65 never set foot in an inpatient facility.
Knee replacement surgeries are a daily occurrence for Dr. Stephen Zabinski and his fellow orthopedic surgeons at Shore Orthopaedic University Associates (SOUA) in Somers Point. “Knees are by far the most common of all joints that are replaced,” said Dr. Zabinski who has been performing knee replacement surgery for more than 20 years. “Knees are also the joint most commonly affected by osteoarthritis. They are also the most subjective to sports injury and most affected by weight. Those factors can wear the knees away.”
Most patients will visit SOUA with complaints of discomfort from osteoarthritis, though there are many forms of arthritis that negatively impact joints and bones. Osteoarthritis is the most common form of arthritis in the knee. It is a degenerative, “wear-and-tear” type of arthritis where the cartilage gradually wears away. It occurs most often in people age 50 and older, but may occur in younger people as well, according to the American Academy of Orthopaedic Surgeons. Dr. Zabinski added that genetics also plays a factor and said people who tend to sit cross-legged as they eat, or kneel often may have significant discomfort in their knee simply because they are putting a lot of additional stress on the knee itself.
I’ve been seeing Dr Alber for two years for an arthritic knee.
He is very good at explaining the problem and advising on all options prior to knee replacement.
Dr Alber told me “I will know for sure when It’s time”. Dr. Alber performed total knee replacement in July and I immediately felt better. He had me back to normal activities within 6 weeks. Five months later and I’ve never felt better.
I would give Dr. Alber the highest recommendation possible from my experience!
By: Thomas A. Barrett, M.D.
Shore Orthopaedic University Associates
Recognizing a knee problem can occur at anytime. Arthritic knee problems may be related to previous injury, demands placed on it over a lifetime, or a family predisposition.
When to seek help is usually prompted by either severe pain or just that nagging ache that won’t resolve. There are a number of ‘over-the-counter’ remedies that most of us try at some point. Taking time out for a doctor appointment is saved for when other options don’t seem to make much headway toward resolving the problem.
Arthritic pain can become more than an annoyance for some. Giving up activities or declining invitations because the knee won’t “make it” are common concerns. In the worst cases even a good night’s sleep can be difficult.
When To See A Doctor?
If you are suffering from…
Prolonged joint pain
Redness or warmth about the joint
Loss of sleep due to pain
Pain after a period of rest
Diminishing motion or progressive limp
Limitation of normal activities
Inability to participate as desired due to pain
Multiple episodes of pain during a month
Many conditions can cause or contribute to joint pain and many treatments exist.