2017-18 Sentara Orthopedics Annual Report

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Differentiated Orthopedic Care at Sentara

Clinical Research

Throughout Sentara Healthcare, we continually embrace the value of groundbreaking clinical research and the difference it can make in patient care. Orthopedic surgeons practicing at Sentara facilities continue to pursue knowledge and improvement by conducting clinical trials and research. They do so through their own local work and through national collaborations. These surgeons present their findings at national association meetings and publish in peer-reviewed medical journals and medical conferences. Most importantly, their findings help shape best practices in orthopedics.

Case Studies: Fitbit and Knee Replacement Outcomes

Wearable activity trackers help follow total knee arthroplasty recoveries in real-time. It’s a pressing question for many of our patients: “How soon can I get back to my normal activities after a knee replacement?” At Sentara Orthopedics, we now have real data to back up our response.

Traditionally, physicians have asked their patients a series of questions before and after joint replacement that focused on physical ability. Answers to these “yes” or “no” questions rarely provide a full picture, though, for two reasons: Patients do not always accurately recall or report how well they have been doing. And they must choose from a limited number of set responses.

With those challenges in mind, we studied whether fitness trackers — in this case, the Fitbit Flex — could provide data for greater specificity and objectivity. Forty patients undergoing knee replacement at Sentara Martha Jefferson Hospital wore a Flex starting at least a week before surgery. They continued for six weeks after, a standard point for evaluating whether previous activity levels have been reached.

The Fitbits recorded our patients’ physical activity through the number of steps taken, distance walked and calories burned. By starting the study before surgery, we captured a baseline for each patient that we could continuously reference during recovery.

At the end of the study, the results showed that, on average, patients had not returned to their baseline levels six weeks after surgery and needed more time. Study results also backed previous research showing that on average, men recover faster than women, as do patients 70 and under.

Perhaps more importantly, we showed that wearable technology can provide a significant benefit for recovery. Not only are the devices affordable and widely available, but they can also quantify individual progress with continuous, objective measurements, set against a baseline.

In other words, they can help manage expectations and provide a clearer look at what’s really going on during recovery. Physicians, patients and caregivers can then plan and adjust. Establishing reasonable goals and providing better ways to meet them means our patients are happier and healthier.

On the Road to Recovery

Most literature recommends that patients undergoing right knee replacement wait at least four to six weeks to drive. At Sentara Orthopedics, we’ve learned that you can get behind the wheel much sooner — at least if you get your surgery with us.

We know that patients can’t drive immediately afterward — the effects of surgery slow brake reaction time to the point that safety is compromised. Still, we wondered how long patients needed to wait. We started testing brake reaction time before and after surgery using a driving simulator at Sentara Martha Jefferson Hospital. We’ve found that most patients return to their preoperative brake reaction time just a week after surgery.

Sentara Colonial Half Marathon and 5K with William & Mary

In 2018 more than 700 runners participated in the 40th annual race to benefit the College of William & Mary track, field and cross-country programs. The annual Sentara OrthoJoint 1Mile Walk was also included in the Colonial Half Marathon event with more than 100 past joint replacement patients, their coaches and family members from Sentara Williamsburg Regional Medical Center and the Orthopaedic Hospital at Sentara CarePlex.

The Annual Sentara OrthoJoint Center® 1K Walk

For the past several years, Sentara has invited past joint replacement patients, their coaches and family members to participate in annual strolls at the campuses of the Orthopedic Hospital at Sentara Leigh and the Orthopaedic Hospital at Sentara CarePlex.

Outpatient Hip and Knee Replacement

At Sentara Healthcare, we strive to make our patients as comfortable as possible during their stays in our facilities. But we also recognize that they’d prefer to recover at home, and that as long as they’re healthy enough to do so, that’s the best place for them. So we work to get them home as soon as possible following a procedure.

Sentara hospitals have embraced the Express Track program that prepares patients for a shorter stay. Patients that meet criteria are given the option to go home the next day or even the same day of surgery.

That quality of life includes the tendency of people to sleep better where they’re most comfortable, in their own beds. Not only does sleep support a healthy immune system, but it also helps the body recognize physical pain and assists with recovery.

“At Sentara Orthopedics, we’re always measuring and self-assessing. After all, that’s the goal of research.”

Megan Swanson, MD
Orthopedic Surgeon
Co-Chair, Sentara Orthopedics High Performance Team