As a practicing orthopedic surgeon who has dedicated my 25-year career to learning and mastering the art and science of total joint replacement, I read "Back from a nightmare" [News, Jan. 8] with as much interest as concern. Infection is certainly the potentially disastrous nemesis of total joint replacement, but it can be mitigated, and the risks greatly reduced, by applying excellent surgical principles.
This starts by educating our patients and their families about the entire joint replacement procedure and experience, as well as educating and developing a team to care for these patients. Selecting the right candidates for surgery and obtaining the appropriate medical evaluations before surgery are very important. Using a preoperative skin prep the night or morning before surgery, as well as selecting the appropriate prophylactic antibiotics, also have been shown to lower the risks of infection.
With the MRSA (methicillin-resistant Staphylococcus aureus) bacteria becoming more common in our homes, schools and workplaces, preoperative nasal swab screening has helped to identify carriers, so that their prophylactic antibiotic selection can be custom-tailored.
Our techniques in performing a hip or knee replacement have evolved so that surgery which required four to six hours, with a 3-week hospital stay, now requires 60 to 90 minutes, with a 3-day stay. This has also lowered the risks.
The public should know that overall today, total joint replacement is a very successful and safe operation with an extremely high patient satisfaction rate.
Dr. Jan Albert Koenig, Rockville Centre
Editor's note: The writer is the director of orthopedic surgery at Mercy Medical Center in Rockville Centre.