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Facing orthopedic surgery? Here's what to ask

Newsday site helps in selecting a physician

BY KATHLEEN KERR | kathleen.kerr@newsday.com

May 27, 2008

Patients planning surgery to repair ailing knees, hips and shoulders need a recovery strategy and a good orthopedic surgeon who can tell them what to expect.

"The doctor should explain the success rate for the procedure, what kind of pain relief you'll get, will the pain return, will your strength return," said Dr. Charles Ruotolo, chairman of the orthopedic department at Nassau University Medical Center in East Meadow.

Ruotolo said patients need to know whether postoperative physical therapy will be necessary and whether it should be done at home or in a rehabilitation facility.

Surgeons should also explain the success rate for orthopedic procedures, Ruotolo said, and whether patients can expect to resume all normal activities.

"If you play baseball, you need to know if you can never throw a ball again," Ruotolo said. "If a doctor walks in a room and just says you need surgery, you have to wonder how he formulates that opinion."

Dr. Michael Carroll, an orthopedic surgeon at New Island Hospital in Bethpage, agreed. "The surgeon knows what the pros and cons of any surgery is, and you have to relate that to the patient," Carroll said.

Before hip replacement, for example, a surgeon should explain what kind of artificial hip will be implanted and why. And, Carroll said, it's helpful to use joint models when explaining surgery to patients.

A patient also should also for experience in a specific procedure, said Dr. Brian McGinley, a surgeon specializing in sports medicine and joint replacement at St. Charles Hospital in Port Jefferson. A patient seeking shoulder surgery should find a surgeon experienced in that specialty - not someone who mostly does knee replacements.

"You need to know how many procedures they've done," McGinley said. "If you've only crocheted one sweater, you're going to be OK at it but not as good as at your hundredth."

Surgeons also should tell patients when they can expect to return to work or resume playing a sport, McGinley said. And he advises patients to bring a friend or relative along to consultations - one might pick up what the other misses. He also suggests a second consultation shortly before surgery to make sure the patient understands what will happen.

Dr. Stanley Asnis, orthopedics chairman for North Shore University Hospital in Manhasset and Long Island Jewish Medical Center in New Hyde Park, says orthopedic surgery should be part of a team approach, which can help avoid complications.

For example, heart patients should visit their cardiologists to discuss the risks of surgery. And the cardiologist should consult with the surgeon.

"They should go to an orthopedist who listens to them and someone who they feel communicates with them," Asnis said. "He should tell them the risks or problems that can be a complication of surgery."

LONG ISLAND'S TOP DOCTORS

LI doctors selected by Castle Connolly Medical Ltd. To find all 800 top LI doctors, with complete information on hospital affiliations, board status and medical education, go to newsday.com /topdoctors.

ORTHOPEDIC SURGERY

Dr. Scott Alpert,

33 Walt Whitman Rd.,

Huntington Station; 631-423-4090

Dr. Glenn Douglas Arvan,