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The Center for Joint Replacement at Exeter Hospital

Total Joint Replacement surgery is one of the most common and successful treatments for certain types of arthritis in the hip or knee. The most common cause of pain is osteoarthritis, which occurs when the cartilage between bones wears away. Arthritis deteriorates the joints surrounding cartilage, causing great pain, immobility and stiffness. Joint Replacement surgery replaces the deteriorated joint and cartilage with artificial joints created with the latest technology.

The Center for Joint Replacement at Exeter Hospital provides a comprehensive, patient-driven surgical process assisting patients to regain mobility and relieve pain. Our recovery and rehabilitative program is designed to help patients achieve their maximum potential following joint replacement. The focus is on attending to our patients' needs from the moment surgery is scheduled through the completion of the rehabilitation process. Choosing to undergo total joint replacement can be a big step. We understand and we'll be with you, every step of the way.

A Single Point of Contact

We provide the convenience of a single point of contact from surgery through recovery. Each patient is assigned an Orthopaedic Care Specialist to take the patient from start to finish. Our patient centered approach results in:

  • The highest level of patient care and planning with a streamlined health delivery process
  • A unique, individual and personalized treatment approach
  • Better coordination and efficiency of the patients' surgical experience before, during and after hospitalization
  • The reduction or elimination of unnecessary steps and inconvenience


    • An Experienced Team

     

     

    The team at the Center for Joint Replacement at Exeter Hospital deliver treatments that are innovative, advanced, and in many cases unavailable anywhere else in the seacoast region. Our goal is to provide the best medical care and streamline recovery so patients are back on their feet as soon as possible. Our team of skilled professionals includes:

  • An Orthopaedic Care Specialist to assist with care from start to finish
  • Surgeons specializing in hip and knee joint replacement
  • Highly trained and specialized orthopaedic surgical team
  • Orthopaedic Nurse Case Manager for your inpatient stay and homebound transition
  • Specially trained and certified Orthopaedic Care Nurses
  • Physical and Occupational Rehabilitation therapists


    • Meet Exeter Hospital's Joint Replacement Surgeons:

    Thomas McGovern, MD
    Kenneth Spengler, MD
    Robert Bear, MD


    Who we are

    The Orthopaedic Specialists at the Center for Joint Replacement at Exeter Hospital blend modern technology with compassionate care to provide the latest in diagnosis, treatment and rehabilitation for the patient. This center of excellence is a result of strong patient outcomes because of advanced diagnostic capabilities, state of the art treatment, an integrated team approach, a strong rehabilitation program, monitoring of quality standards and an emphasis on patient education.

    State of the Art Orthopaedic Surgical Suites and Advanced Technology

     


    One of the newest advances in joint replacement is computer assisted surgery using navigation equipment for joint replacement. Thomas McGovern, MD is the only orthopaedic surgeon in the region to employ this technology which allows the surgeon to accurately track, analyze, and monitor instruments to an individual's anatomoy during a surgical procedure, which in turn enhances the patient outcome. Joint Replacemenet surgery is performed in our new state of the art and dedicated orthopaedic surgical suites.

    Read the article in the Advance for Nurses magazine written about computer assisted orthopaedic surgery at Exeter Hospital.

    How our Program Works

    Our comprehensive program ensures you receive the best possible care. The comprehensive pre-operative approach to patient assessment will help the team understand as much as possible about a patient's medical condition, lifestyle, goals and expectations. Here is how the program works. 

    Your Orthopaedic Surgeon will talk with you about your symptoms, medical history and recommended course of treatment. 
    Preparing for joint replacement begins weeks before the actual surgery. In some cases, beginning the process a few months in advance may provide an added benefit.

  • Exercise under your doctor's supervision
  • Stop Smoking
  • Lose weight/Watch your weight
  • Meet with a Physical Therapist for a pre- surgical therapy and exercise program


    • Set up Appointments
    The Orthopaedist' office will assist with setting up your necessary pre-surgery appointments or guide you accordingly.

  • Surgery date
  • Pre-surgery appointments as recommended, including Pre-Admission Testing
  • Physical Exam with primary care physician within 30 days of your operation date
  • Meet with or have contact with the Orthopaedic Care Manager, your single point of contact
    •  
  • A Physical Therapist through a Visiting Nurse Association will visit your home to help ensure that it is safe.
  • Follow recommendations and suggestions to maximize home safety.
    •  
    You and your family can attend a class at Exeter Hospital to help prepare for surgery and after surgery. Classes are conducted two times per month by the Orthopaedic Team.

    Sign up and attend the Pre-Surgery Class by calling 1-800-4-EXETER(1-800-439-3837) 
    The Orthopaedic Surgeon and specialized team at Exeter Hospital will perform your surgery. The actual surgery last approximately 60-90 minutes.

    Our caring nurses will prepare you for your procedure, assist the physician in the pre-operative areas, and provide specialized care following the surgery. As a patient, you can expect to spend a minimum of three days in the hospital following surgery. 
    A therapist will work with you two times a day during your hospital stay, but you must perform exercise on your own between therapists visits. Your goals for discharge from the hospital are as follows:

  • Getting safely in and out of bed without assistance
  • Getting safely in and out of a chair without assistance
  • Knowing your precautions so you will continue to protect your new joint after you leave the hospital
  • Performing your exercises as instructed by your therapist to increase strength and independence
  • Walk a functional distance using a walker or crutches
  • Performing stairs (if indicated)
    •  
    Your doctor will decide if you will be able to return directly home after discharge from the hospital, or if you would benefit from the care at a skilled rehabilitation facility(short term stay) before returning home. Age, overall barriers, physical barriers at home and insurance coverage may determine discharge destination. Your orthopaedic case manager will help you make that transition as well.

  • Discharge to a skilled nursing facility or
  • Discharge to home care services which may include nursing, physical and occupational therapy
    •  
    After discharge from the hospital, and or skilled nursing facility(short term stay), and homecare, your physician may recommend Physical Therapy to assist you with further improvement for strength, range of motion, and ambulation. Physical Therapy is often essential for your full recovery.

    Exeter Hospital has several outpatient rehabilitation centers in the community where you can receive the best care close to home.

    You may also benefit from aquatic therapy in a heated pool, which is offered at AthletiCare. Your doctor and Orthopaedic Care Manager will help you schedule your therapy program based upon your individual needs. 
    Exeter Hospital has many resources conveniently located at the hospital and throughout the community to help you maintain the gains you made through surgery and rehabilitation.

  • Choose an individualized exercise program
  • Continue to exercise, strengthen and condition
  • Join a Fitness Center
  • Attend nutrition and weight control classes
  • Quit smoking
    •  
    Preparing for surgery includes preparing your home. It is important for an easier and safer recovery process. Preparing your home before surgery makes less work for your family while you are in the hospital and also makes your discharge smoother.

    Storage: Avoid Reaching

  • Store all food and other supplies between your waist and shoulder level
  • Remove items from top shelves and place at counter level
  • Do not use step stools or reach for objects on your tiptoes
  • Stock up on frozen food and canned goods

    • Rearrange: Easy Access

  • If you normally sleep on the 2nd level, try to go upstairs only 1x per day if your surgeon says it is OK
  • Prepare a room on the 1st floor with all your needed supplies
  • Place the phone within reach
  • Attach a bag or lightweight basket to your walker to carry light items

    • Arrange: Help

  • Make arrangements, if possible, for someone to stay with you, especially at night for the first 2 weeks
  • Ask a friend or family member if they will be able to buy groceries, run errands for you or drive you to your appointments
  • Request help from others with cooking, bathing, and exercises

    • Clean up: Remove Rugs and Clutter

  • Remove any throw rugs in your house so that walking will be safer during your recovery
  • Look around the room for electrical cords, footstools, pets and other obstacles that may be a safety hazard after surgery
  • Rearrange your furniture to allow a clear path for your walker
  • Make sure your pets are in a secure place while you are walking to avoid injury
    • Because every patient recovers differently, your surgeon will prescribe equipment that is best for your individual recovery. Some of this equipment is optional, and insurance coverage varies. Your case manager will help you to understand your insurance coverage and order the prescribed equipment for you as indicated.

  • Walking aids: to help steady your gait and provide support
  • Elevated toilet seat: to use on your toilet at home to reduce stress on your hips and knees
  • Set cushion: to use on a chair to elevate the seat to the appropriate height
  • Bath seat: Extends over the side of the tub to help you bathe safely and maintain precautions
  • Long handled bath sponge: to assist you in washing and to avoid bending; you can wrap a towel around the sponge to help with drying off
  • Dressing stick: to assist you in dressing yourself when you cannot bend; combination of hook-pusher on one end helps you pull on slacks or skirts, or remove socks
  • Sock aid: put the sock over the end of the sock aid, and pull on most of the sock. Lower the aid down to your foot by suing the straps, and place your foot into the opening of the sock. Pull the aid until the sock is all the way on. The sock aid pulls out of the top of the sock
  • Long handled shoehorn: the handle on this shoehorn has been extended to avoid unnecessary bending when putting your shoes on. Place the shoe horn inside the back of your shoe and push your heel down into the shoe
  • Elastic shoelaces: Lace the elastic shoelaces into your shoes and tie them. These rubber/rayon laces provide firm support yet stretch to allow your feet to slip in or out of the shoes without having to untie and retie them

    • Do:

  • Use a walker or crutches to assist with walking
  • Continue normal walking activities at home
  • Use a pillow between your legs in bed
  • Continue your therapy exercises
  • Get help to put on your shoes and socks, or use the aids described in physical therapy
  • Use an elevated toilet as instructed
  • Take your medication as directed
  • Keep your return appointment with your doctor

    • Do Not:

  • Do not overdo your activities
  • Do not bend your hip more than 90 degrees
  • Do not sit in low or overstuffed chairs
  • Do not bend over
  • Do not cross your knees
  • Do not sit in the bathtub. Take showers or sponge baths
  • Do not drive until approved by your doctor

    • Call your surgeon if you develop any of these symptoms:

  • Fever
  • Drainage from the incision
  • Swelling around the incision
  • Redness around the incision
  • Chest pain
  • Chest congestion
  • Difficulty breathing

    • Frequently Asked Questions

    Ambassador Program

     

    Meet our ambassadors up close and personal.

     

    The Ambassador Program at Exeter Hospital's Center for Joint Replacement provides those who are considering joint replacement a chance to talk about the decision with an experienced individual-someone who has had the surgery at Exeter Hospital.

     

    Our Ambassadors are volunteers who provide guidance and information by sharing their personal surgical and recovery experience, thereby helping to pave the way for others to achieve a healthier, more active lifestyle. Ambassadors attend the pre-surgical joint replacement class and speak with patients and their families, as well as answer questions. The ambassadors can also be available by phone for questions if you are considering joint replacement.

     

    For more information on the Center for Joint Replacement at Exeter Hospital, call 1-800-439-3837 or Loree Hazard, Orthopaedic and Arthritis Service Line Administrator. Our team is here to assist you with your questions and concerns.



    In the News:

    Don't Let Heel Pain Slow you Down (Healthy Perspectives, Winter 2010)

    Exeter Hospital Awarded Blue Distinction Center of Excellence for Knee and Hip Replacement(SM) (PR Newswire, February 10, 2010)

    Spengler Joins Core Physicians (Foster's Daily Democrat, October 20, 2009)

    Rapid Recovery for Total Joint Replacement (Healthy Perspectives Magazine, Spring/Sumeer 2009)

    Total Joint Replacement with Rapid Recovery (Monthly Physician Column - Atlantic News, March 13, 2009)

    Additional Health Links:

     

    American Academy of Orthopeadic Surgeons

    Virtual Knee Surgery

    RadiologyInfo

     



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