Answer:  Total hip and knee replacement surgery are designed to relieve pain and restore function.  If your pain has progressed to the point that you are significantly impaired and other methods of treatment have not relieved that pain, then it is time to consider surgery.  The commonly used nonsurgical treatment options that may effectively relieve the pain include:  arthritis medication, walking aids (cane or crutches), or pain medication (Tylenol).  These nonsurgical treatment modalities are usually applied first.  Surgery is not used to prevent a joint from becoming so bad that it cannot be replaced.  There is therefore no need to fear postponing the surgery.  If nonoperative treatment is successful, surgery is postponed until the pain returns and is no longer relieved.   At that point patients should not be afraid to go ahead with surgery.   Total joint replacement has become successful and the complications so uncommon that most people would choose to go ahead with surgery rather than continue to live with the pain.   

Answer:  Complication associated with surgery is uncommon.  Most people have absolutely no problem after the operation.  This is not to say that complications never arise.  Any major surgical procedure can potentially carry with it one or more of many complications.   Some people would consider nausea, vomiting, sedation, or fatigue after surgery a complication.  They are not really complications, but side effects of the anesthesia and medications given for pain relief.  The events that change the result of the operation or negatively impact a person’s quality of life are the real complications.   Obviously the worst problem would be death.  This is so rare that it is almost not worth mentioning.  The most common of the uncommon significant complications are infection and deep venous thrombosis (DVT).  Infection occurs in less than 1% of cases.  Preventative antibiotics are given before surgery to decrease the risk of infection.  Additionally, the surgery is done in a special room with sterile air to help eliminate contamination.  Infection is such a concern because if it occurs, it is usually necessary to remove the prosthesis, treat the patient with six weeks of intravenous antibiotics and then reinsert the prosthesis.  This extensive treatment is obviously extremely undesirable and the results after treating an infection are usually not nearly a good as those of a joint that has never had an infection.  Deep venous thrombosis (DVT) is the formation of blood clots in the legs.  This is a problem because it can lead to pulmonary embolism, which is when one of the clots in the leg breaks loose and travels to the lungs. This event can compromise breathing seriously and even cause death.  Since this is a recognized potential problem, steps can be taken to prevent this complication.  All patients are given blood thinners that significantly reduce the risk of clot formation.  These medications that thin the blood are closely monitored so that they do not excessively thin the blood and cause unwanted bleeding (although this is also a possibility). 

Answer:  It is recommended that patients limit their activity after replacement so that the stress on the artificial joint does not cause early failure.  On the other hand, reasonable activity is encouraged to maintain good bone strength and encourage cardiovascular health.  Running, jumping, jogging, skiing, and singles tennis would be discouraged to maintain the integrity of the replaced joint.  Conversely, golf, walking, swimming, biking on flat ground and doubles tennis are recommended as appropriate activities after surgery. It is indeed appropriate and recommended that patients stay active and enjoy their new life without pain.  

Answer:  All board certified orthopedic surgeons learn how to do total hip and total knee replacements during their training.  In spite of this, medicine has become more and more subspecialized.  Today physicians specializing in small segments of their more general training provide much of our medical care.  This is true in orthopedics also.  There are hand, back and sports medicine specialists.  Likewise Dr. Bertin has specialized in total hip and total knee replacement surgery.  He completed a fellowship (a one year research and surgical training program with recognized leaders in a field of study) and has focused his practice since 1984 in hip and knee replacement.  He has been and continues to do this type of surgery every week and lectures on techniques and results in many centers every year.  His research efforts are directed to try and improve the good results that patients currently enjoy.  His curriculum vita references his interests and bibliography.   

Answer:  Yes, new patients are welcome.  Dr. Bertin is a surgeon who helps correct a specific problem and allows a patient’s personal physician to continue to take care of all the other medical concerns.  When the hip or knee is recovered and rehabilitated, the return visits are infrequent (only every year or two to review the joint exam and an xray).  New patients are continually accepted and scheduled for surgery.  Some insurance plans require a referral but others don’t.  The most common insurance, Medicare, allows patients to make an appointment without a referral and approves surgery without any unique preauthorization.