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FAQs
Frequently Asked Questions
1. What is Shared Decision Making?
In
shared decision-making,
you and your doctor or care team work together to choose the care that’s right for you. Together, you review your options for care, risks/benefits, and your concerns and goals, then develop a plan that fits both the medical evidence and what matters to you. In many cases, patient decision aids like Joint Effort provide information and help patients reflect on their preferences before deciding on surgery. Joint Effort also enables patient centered collaborative care.
2. What are some of the reasons patients seek a second opinion about hip or knee pain?
Patients choose to have a second expert review of their hip or knee pain for many reasons, including seeking confidence in their treatment plan, help with understanding their situation (especially if they have received conflicting advice), and support in timing and preparation for their surgery. In addition, many times patients are told that they are
not a candidate
for surgery
but still have pain!
3. Why should I seek a second opinion?
Seeking a second opinion is very common and can provide you with additional confidence that you are making the best possible decision for you. In a recent study of second opinions obtained by patients who were recommended knee arthroplasty, over 90% of patients reported their satisfaction with the second opinion as good or very good.
4. Why is a Joint Effort Second Opinion different than other second opinions?
You can do it from the comfort of your own home. It’s an inexpensive process using all the information you already have: the surveys are easy and quick, and you should already have had the proper x-rays.
5. How do I obtain x-rays from my provider or hospital?
We will make this process as easy as possible for you! You can request your x-rays directly from your doctor’s office, imaging facility or hospital. Most facilities provide the images on CD, USB drive, or through a patient portal. If you have a CD or USB, you can directly upload the files from your computer.
If you prefer to mail the files to us,
we will upload them for you
. Please send them to the following address:
Dr. Tony DiGioia
Attn: Joint Effort Second Opinion
300 Halket Street, Suite 1601
Pittsburgh, PA 15213
6. How should I use this information with my current physician and care team?
Dr. D. has designed this program to support you and your current healthcare providers in making the best possible decision for you. A second opinion supports – not replaces – the partnership between you and your doctor
7. What should I do if I have questions about my report?
Simply submit a question through the Joint Effort portal and Dr. DiGioia will answer any follow-up questions after you receive your personalized report. We will also direct you to additional information on both operative and non-operative treatments located on our comprehensive website:
https://www.pittsburghboneandjoint.com/treatments
8. Is this Joint Effort Second Opinion covered by insurance?
Joint Effort Second Opinions are not covered by insurance. Patients are responsible for the one time fee, and payment is due only when your Joint Effort Second Opinion report is ready to be viewed
9. How much does this service cost?
We are providing an introductory cost of only $100 which saves you from an office visit and those associated co-payer expenses. Dr. D believes that all patients should have access to high-quality care, and the information to support your journey to wellness from hip and knee arthritis.
10. Do I need a referral for this service?
No, a referral is not needed.
What you need to know about after surgery?
How long will my recovery be?
We encourage full activity as soon as possible. On the night of surgery, you will complete a bedside therapy session. The following day you will begin your regular, twice-a-day exercise program. We have no limits on your activities or on how fast you resume your activities. The speed of your recovery depends very much on you.
Will I need a walker, crutches, or a cane?
Patients are able to walk with the assistance of a walker, and some are able to use just a cane. You are permitted to put as much weight as possible on your operative leg and proceed as quickly as you feel comfortable.
How long until I can drive?
The general requirements are that you should require only the support of a cane and should be off your pain medications.
When will I be able to go back to work?
You can begin working when you feel that you are able to do so.
What physical activities will I be able to participate in after surgery?
Low-impact physical activities such as walking, golf, swimming, dancing, hiking, bowling, and gardening are recommended and encouraged. Skiing or snowboarding is permitted with experience and do so with caution. High-impact activities and those associated with injury risk, such as running, basketball, singles tennis are not recommended.
When will I need to see my doctor following the surgery?
Your doctor will see you4 weeks after the surgery. You will then be seen at your one-year anniversary.After this visit, the general recommendation is to get x-rays every 3 years. If the doctor feels that you require more frequent visits, this will be scheduled.
What rehab services are required post-operative after total joint replacement surgery? Inpatient? Outpatient? Or done at home?
Following your in-patient stay, you will receive home physical therapy (PT) for 3 – 7 days, and there after you will start a 4 week course of outpatient PT. Some patients will be able to exercise on their own or go directly to outpatient PT. Outpatient PT can last anywhere from 4 weeks to 8 based on your progress.
How significant is the risk of hip dislocation after total hip replacement surgery? How much does this risk decrease over time?
Dislocations (when the femoral head is dislodged from the cup component) is usually caused by muscle weakness, slow soft tissue healing or positioning your leg into an awkward position. You will be given instructions on how you can prevent dislocations from happening. Dislocations typically happen in the first 2 to 3 months post op because the soft tissues are still healing.
What can cause a feeling of your legs being different lengths after hip replacement surgery?
During hip replacement surgery, many times the leg must be lengthened to tighten up the muscles that hold the joint in place, restore normal mechanics and reduce the chance of a dislocation. It can take a few months to re-adjust and feel"balanced" and many times you may not even notice the differences in the leg lengths.
Learn more About Leg Length Discrepancy
What is the recovery after a hip or knee replacement surgery?
As part of our Rapid Recovery Program you do not have limits on your activities or on how fast you resume your activities.The speed of your recovery depends very much on you and your confidence level.
What are the long term follow up guidelines after surgery?
You will have a one year after surgery follow up and a visit every 3 years after that. When you come in for your one year office visit, you will have x-rays of your joint replacement(s). You will then be evaluated by your surgeon, physician assistant or nurse practitioner. Your surgeon will review all your x-rays as well.
Learn more About Long-term Recovery
Do you use a Continuous Passive Motion (CPM) machines after knee surgery?
A CPM machine will be used post-operatively to improve your range of motion more quickly and to make you feel more comfortable following knee replacement surgery. The use of the CPM machine after your total knee replacement guides tissue healing, increases motion, and helps reduce stiffness. Most importantly, using CPM will reduce your discomfort and allow you to be much more active more quickly, and remember, “new joints love to be moved!”
Learn more About CPM and Ice Therapy
