Frequently Asked Questions

What is Mako Robotic-Arm Assisted Surgery?

Mako Robotic-Arm Assisted Technology provides you with a personalized surgical plan based on your unique anatomy. First, a CT scan of the diseased hip or knee joint is taken. This CT scan is uploaded into the Mako System software, where a 3D model of your hip or knee is created. This 3D model is used to pre-plan and assist your surgeon in performing your joint replacement procedure. In the operating room, Dr. Avino follows your personalized surgical plan while preparing the bone for the implant. Dr. Avino guides the robotic arm within the pre-defined area and the Mako System helps Dr. Avino stay within the planned boundaries that were defined when the personalized pre-operative plan was created.

What are the implants made of?

Metal alloys, durable plastic, and ceramic.

What type of anesthesia will be used?

Dr. Avino typically recommends spinal anesthesia. This is a decision based on many factors. On the day of surgery, you will meet with your anesthesiologist and more information will be provided by the anesthesia team. They will answer any specific anesthesia questions.

How long will I be in the hospital?

Most patients are able to go home the same day as their surgery. Some patients stay in the hospital for one night following joint replacement surgery and are then discharged to home. Surgery is considered outpatient whether you go home same-day or stay overnight.

How long will my surgical incision be?

The size of the incision is based on the complexity of your case, however, the incision for anterior hip replacement is typically about 6 inches long and for knee replacement 7-8 inches.

BEFORE SURGERY

What is a Joint Replacement Coach?

A joint replacement coach is the person who will be providing you support throughout your joint replacement journey. This person should attend preoperative appointments with you as well as bring you to the hospital, pick you up from the hospital, and be with you for the first few days following surgery.

Will Dr. Avino meet with my family before surgery?

We strongly encourage you to bring a family member to your preoperative appointment to meet Dr. Avino and the team. During this visit, we review a lot of important information related to your surgery and recovery.

Will I need any special medical equipment?

You will need to bring with you to the hospital a standard 2-wheeled walker. It will be labeled with your name and will be adjusted appropriately before your discharge. The hospital will not discharge you without a walker. You will also need a cane at home. Physical therapy will let you know when you are ready to transition from the walker to a cane. This is typically 1-3 weeks after surgery. You should not need any assistive devices at home (shower chair, raised toilet seat). Prescriptions are not provided for the walker or cane. These items can be borrowed from a friend/neighbor or can be purchased through our office.

Do I need to stop taking anti-inflammatories or blood thinners prior to surgery?

Yes. These medications must be stopped 10 days before surgery. These include ibuprofen, Advil, Aleve, and fish oil. For prescription blood thinners, your primary care physician or cardiologist will let you know when to safely discontinue these medications prior to surgery.

Why do I need to quit smoking and/or using nicotine-containing products before surgery?

There is a higher risk of wound complications and infections in smokers, and patients who use nicotine-containing products, due to the constriction of blood vessels caused by nicotine. You must stop smoking and the use of any nicotine products (including nicotine gum/patches/pouches) for at least 6 weeks before booking surgery. You will also require dental clearance.

Why is dental hygiene important before surgery?

AFTER SURGERY

How will my family member/friend know when my surgery is done?

Your family member/friend will be with you in the preop area up until your time of surgery. You will provide the pre-op nurses with a name and phone number for Dr. Avino to call after surgery. Once your surgery is complete, Dr. Avino will call your family member/friend.

Do I need someone at home with me after surgery?

Yes, Dr. Avino recommends someone be with you for the first few days after surgery. We designate this person as your Joint Replacement Coach.

Is surgery and recovery very painful?
You are undergoing major elective surgery and pain is to be expected. However, each patient's pain level and pain tolerance are different.

HIP: Pain following total hip replacement has come a long way over the last 30 years. Early range of motion and rapid rehabilitation protocols are also designed to reduce early stiffness and pain, making the procedure in general much less painful than in years past. You may have relatively mild pain following the procedure, or you may have more pain. Everyone is unique and handles and perceives pain differently.

KNEE: Pain following total knee replacement has come a long way over the last 10-15 years with increased use of regional nerve blocks, spinal blocks, and various other modalities used for pain control. Early range of motion and rapid rehabilitation protocols are also designed to reduce early stiffness and pain, making the procedure in general much less painful than in years past. You may have relatively mild pain following the procedure, or you may have a more difficult time than others. Everyone is unique and handles and perceives pain differently.

Keep in mind that while pain management has greatly improved, a pain-free surgery is unlikely.

What will I take to control pain after surgery?

Most patients postoperatively take Tylenol and an anti-inflammatory medication to control pain. Depending on the surgery, additional medications may be prescribed. This will be discussed at your pre-op visit with Dr. Avino the week before your surgery.

How long does it take to recover from surgery?

HIP: Most patients are able to participate in their daily activities after 6 weeks. By 3 months, most patients are able to return to normal activities.

KNEE: It can take up to 3 months to return to most activities, and likely 6 months to 1 year to fully recover to maximal strength and endurance. This depends on your condition before surgery, additional medical problems, and your expectations.

Can I go to a rehab facility once I am discharged from the hospital?

NO. Dr. Avino does not recommend that his patients go to rehab facilities following surgery.

Will a nurse or physical therapist come to my house?

A home health nurse and physical therapist will typically come to your home a day or two after you are discharged. The home health company will coordinate this with you. A nurse will come visit you once or twice. The physical therapist will come 2-3 times a week for 2 weeks. However, depending on your insurance, some patients start outpatient physical therapy immediately following surgery.

Do my surgical bandages need to be changed?

No, your bandages stay on until your first postoperative visit. You can shower but must cover the bandages and keep them dry. (You will not be able to submerge (baths, pools, hot tubs) your incision for at least 6 weeks when the incision is fully closed and healed.)

When will I be seen for follow-up after surgery?

Our team will see you for the first visit between 7-14 days after surgery. Your next visit will be 6 weeks after surgery and then 3-4 months after surgery.

How long before I can drive?

Typically 2-4 weeks. We want to make sure you are not taking any opioid pain medications, you can comfortably get in and out of the car, and you feel strong enough to get your foot from the gas to the brake quickly enough to avoid any accidents. Dr. Avino will let you know when you are cleared to begin driving again.

How long before I can swim or take a bath after surgery?

Dr. Avino recommends against submerging your incision for 6 weeks. At the 5-6 week post-op visit, we will check your incision and, if fully healed, you will be cleared to submerge it.

How long before I can travel?

Dr. Avino advises against traveling for 4-6 weeks after surgery.

When will I be able to return to work?

Dr. Avino will advise you when you are able to return to work. Typically you can return to work 4-12 weeks after surgery depending on your type of work and job requirements.

When will I be able to return to normal activities?

You should be able to gradually return to all of your normal activities without limitations at the 3-month postoperative mark, although full healing can take up to 1 year.

When can I resume sexual activity?

Most patients are able to resume sexual activity 4-6 weeks following surgery. We have a handout about this available upon request.

Will I have to take antibiotics when I go to the dentist?

You will typically need to pre-medicate with antibiotics prior to any dental procedures for the first year after your joint replacement surgery.
The following antibiotics are recommended and can be obtained through our office or your dentist:

1. Amoxicillin 2,000mg (4 pills of 500mg) by mouth 1 hour prior to the procedure.
2. If you have a true penicillin allergy: Clindamycin 600mg (2 pills of 300mg) 1 hour prior to the procedure.

Will my implant set off metal detectors?

Patients with joint replacements may set off metal detectors. It is reasonable for you to inform the TSA screening agent at the airport that you have had a joint replacement; however, you will still require screening and will need to follow the directions of the screening agent.

Why are there fees for work forms?

Work forms require a significant amount of staff time and are not reimbursed by insurance.

Why can’t I have a Handicapped Placard after surgery?

Dr. Avino encourages walking and using your new joint as part of your recovery 🙂

What if I have a concern or question following surgery?

During regular business hours, please email Heather at: teamavino@pboi.com

FAQs