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Health Matters: Providence Mission Hospital | 9 James B. Chen, MD, decided to become an orthopedic surgeon after he experienced a catastrophic knee injury playing college football. A skilled surgeon restored Dr. Chen's knee, which not only allowed him to return to the field but also determined his career path. Today, at Providence Mission Hospital, Dr. Chen provides the same kind of compassionate, effective care to his patients who need a hip or knee replaced. Here he discusses what's important to know about joint replacement. How does a person know that it's the right time to have a knee or hip replaced? It's always an individualized answer, but in short, you should have a joint replacement if you've tried everything and the pain or instability is so much that you can't exercise and live a healthy lifestyle. Should patients worry about waiting too long for joint replacement surgery? In the short term, no. However, if you wait years, we begin to worry about your overall cardiovascular health and muscle strength declining. But I don't want my patients to rush into a joint replacement either. Instead, we typically work together in deciding the right time. How should a patient decide which surgeon is the right one for them? I implore patients to research their condition and take ownership of educating themselves. Look for a surgeon who specializes in your particular surgery. For example, in my elective practice I only do hip and knee replacement surgeries. During my residency, I sought out specific subspecialty training in joint replacement at the Hospital for Special Surgery [in New York City]. I've devoted my career to the perfection of these two surgeries. Another thing you should be asking is "Why is this type of implant good for me?" There is an appropriate type of implant for every situation. I have experience with all the different types of implants, and I've used most of the robotic systems out there, so when I choose a particular implant, it's for a specific reason that makes it best for that patient. What is robotic surgery? Robot-assisted surgery is simply an enabling technology. My philosophy with robotics is such that I aim to customize my approach to the individual patient's unique anatomic variations. How long will a knee or hip implant last? With the newer designs, my goal is to get it to last 30-plus years. There will, of course, be some variation based on a patient's activity level, deformity, implant type and other factors. What is the most important thing a patient can do to ensure a good outcome? Following your surgeon's and health care team's instructions postoperatively is the key to a successful recovery. Read all of the material that your surgeon sends you and don't be afraid to ask questions. There are appropriate exercises for the various stages of the recovery process. After a total hip replacement, the bone needs time to grow into the implant, so typically low-impact exercises are critical for maintaining muscle and flexibility without creating unnecessary pain and increasing your risk for a fracture. Once the bone has grown in, you are free to resume most activity and progressive strengthening. Is it realistic for a patient to expect to recover all function—that is, be "just like I was before"? It depends on when in the past the patient is thinking of and which procedure they have. Total hip replacements recover faster, while total knee replacements tend to take longer and require more work. You have to strengthen and stretch the muscles around the joint. So it can take some time getting back to higher-level activities. Surfing, snowboarding, golf, pickleball, skiing—all that stuff is fine. I want to get you back doing whatever it is that you want to do. After analyzing performance data from more than 4,500 hospitals, U.S. News & World Report recognized Providence Mission Hospital in September 2023 as one of the nation's top hospitals for orthopedic care. Mission Hospital holds the rank of 23rd in the country, 11 places higher than the previous year. A HELPER APP FOR RECOVERY Dr. Chen and his care team offer his patients the option of using the Mymobility app from Zimmer Biomet Connected Health. The virtual care assistant is compatible with Apple Watches and Android devices and tracks patients' progress. The app provides step- by-step instructions for exercises, daily to-do lists and feedback. It allows Dr. Chen's staff to monitor a patient's progress as well. Dr. James Chen

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