HIP & KNEE

LCO offers two board certified and fellowship trained surgeons in joint reconstruction and hip and knee surgery. Dr. Richard H. Zimlich, MD and Dr. Eric S. Stem, MD have specializations in arthroscopy of the hip and knee, sports injuries, ligament reconstruction, joint replacement of the hip and knee including partial replacement, resurfacing, total replacement and revision joint replacement.

Expect expert care from your first evaluation to final procedure. With just one referral, we will attend to all joint reconstruction needs.

Dr. Richard H. Zimlich is a board certified Orthopaedic Surgeon who specializes in joint reconstruction and replacement surgery. He joined Lowcountry Orthopaedics in 1998 after completing a fellowship in Adult Reconstructive Surgery. Through the years he has performed numerous knee, hip, and shoulder replacements, allowing patients to return to a more active lifestyle.

Experienced in dealing with failed joint replacements and difficult deformities, Dr. Zimlich and his staff are qualified to assist patients with their entire knee and hip problems. He has had training in arthroscopic surgery, cartilage transplant surgery, joint replacement surgery, and revision joint replacement surgery of the knee, hip, and shoulder.

Dr. Zimlich was born and raised in Louisville, Kentucky, where he returned for medical school after attending the University of Notre Dame. He enjoys time with his family, the golf courses and water activities around Charleston.

How do I know when I am ready to have a Hip replacement?

The primary reason to have a joint replaced is pain. Patients that have pain that limits their daily activities and Xray findings of arthritis generally are candidates for replacement surgery. Other indications for surgery include deformity and stiffness.

Will my implant set off metal detectors?

The majority of implants do set off metal detectors. Unfortunately there is no identifying document or card that the TSA recognizes.

How do I arrange for inpatient therapy?

A counselor from the hospital will contact you prior to your surgery and review your situation to determine if you would qualify.

What if I live alone or do not have help at home?

The majority of patients go home after their hospital stay. You will require someone to be available to assist you with your daily needs for at least one week. It is important to make these arrangements with your family or friends prior to surgery. Patients that do no have assistance at home may qualify for an inpatient rehabilitation center. It is best to arrange this prior to your surgery.

Where will I have PT after surgery?

We prefer patients to attend a certified outpatient program three days a week. If a patient lacks transportation or there are no PT locations close to home, in home therapy will be arranged three days a week. A case manager from the hospital will help you to arrange this.

Will I need a walker or cane at home?

Yes, if you do not have them already, we will supply you with a walker and cane in your pre-op visit.

When will I start Physical Therapy (PT)?

Typically we will try to start PT the day of surgery. That may involve moving from your bed to the chair with assistance, performing exercises while seated, or possibly walking with a physical therapist using a walker. You will continue to work with PT in the morning and afternoon the day after surgery. In those sessions you will complete exercises, walk with a walker, and practice going up and down steps.

How long will I be in the hospital?

The typical stay is 1-2 nights. For example: Patients having surgery on Monday would go home either Tuesday afternoon or Wednesday morning.

Will I get a card or letter to allow me through the airport?

Cards are available if requested but they are not recognized by the TSA or any other government agency.

When can I shower?

Once the incision is dry, patients can shower. You will be given specific instructions upon discharge from the hospital.

How do I know if I have an infection?

If you are concerned about an infection, you should see your surgeon. Signs of infection include drainage from the incision, redness, pain, and swelling.

Will I need a blood thinner after surgery?

Yes, a medication to protect against blood clots is necessary for up to 35 days after a Total Hip Replacement. We will give you this prescription at your pre-op visit. You will not need to fill this prescription if you are going to an inpatient rehab facility.

How do I know if I have a blood clot?

If you are concerned that you may have a blood clot, you should see your surgeon. Signs of blood clots include pain and swelling in one or both of your lower legs.

How do I avoid a blood clot?

While blood clots are a risk factor after surgery, there are things you can do to help prevent them. It is important to complete your full prescription of blood thinning medication and to perform exercises that are shown to you in your class prior to surgery and taught to you in PT.

Do I need to attend the class before surgery?

Attending the joint replacement class allows patients to familiarize themselves with the hospital, nursing staff, and physical therapist. The class includes: reviewing the operation, scheduling therapy, and pain management. Studies have shown that patients who attend class have shorter more productive hospital stays.

How will my pain be controlled?

Pain is typically well controlled with oral and IV medications while in the hospital. Once a patient goes home after surgery, their pain will be controlled with oral medication. You will receive a prescription for pain medication for after surgery at your pre-op visit.

Will I have any activity restrictions following hip replacement?

The approach your surgeon uses will determine what restrictions a patient will have. It takes several months following surgery for the muscles to heal and strengthen. You will learn more about specific restrictions in the class and in PT.

When will I be able to drive?

Most patients can return to driving in one month, however we ask that you do not drive until we see you at your first follow up appointment after surgery.

When will I be able to return to work?

This varies on the type of work you are returning to. Most patients can return to non-strenuous work activity in 4-6 weeks. It will take longer to return to work that requires climbing, squatting, and heavy lifting.

When will I see my doctor after I leave the hospital?

You will have a follow up appointment scheduled 2 ½ – 3 weeks after surgery. If you have any questions during that time, please contact your doctor’s office.

Where can I find more information online?

More information including animations of surgical procedures and videos can be found online on our website: www.lowcountryortho.com

How do I know when I am ready to have a knee replacement?

The primary reason to have a joint replaced is pain. Patients that have pain that limits their daily activities and xray findings of arthritis generally are candidates for replacement surgery. Other indications for surgery include deformity and stiffness.

How long will I be in the hospital?

The typical stay is 1-2 nights. For example : Patients having surgery on Monday would go home either Tuesday afternoon or Wednesday morning.

When will I start Physical Therapy (PT)?

Typically we will try to start PT the day of surgery. That may involve moving from your bed to the chair with assistance, performing exercises while seated, or possibly walking with a physical therapist using a walker. You will continue to work with PT in the morning and afternoon the day after surgery. In those sessions you will complete exercises, walk with a walker, and practice going up and down steps.

How long will a Knee replacement last?

Artificial knees are mechanical parts that have a limited lifetime. The lifetime of an artificial knee is dependent on the amount of force placed across the joint as well as the activity level. Highly active patients tend to have higher wear rates. It is recommended that patients avoid engaging in high impact activities. These activities include running and jumping. Studies show some implants have lasted beyond 15 years.

Will my implant set off metal detectors?

The majority of implants do set off metal detectors. Unfortunately there is no identifying document or card that the TSA recognizes.

Will I get a card or letter to allow me through the airport?

Cards are available if requested but they are not recognized by the TSA or any other government agency.

Does a partial knee replacement last longer than a total knee replacement?

Not necessarily. All implants have a limited life expectancy depending on a individual’s age, weight, and activity level.

Can I have a total knee replacement after a partial knee?

Yes. Conversion of a partial knee replacement to a total knee replacement is very similar to a first time knee replacement.

Why would I have a partial knee replacement?

A partial knee is typically used for patients who have osteoarthritis in limited parts of their knee. Studies suggest partial knee replacements may give the individual a more natural feel to their knee.

Will I need a walker or cane at home?

Yes, if you do not have them already, we will supply you with a walker and cane in your pre-op visit.

Where will I have PT after surgery?

We prefer patients to attend a certified outpatient program three days a week. If a patient lacks transportation or there are no PT locations close to home, in home therapy will be arranged three days a week. A case manager from the hospital will help you to arrange this.

How much motion should I have after a Knee Replacement?

The biggest predictor of motion after replacement is the amount of motion a patient has prior to surgery. If you have limited motion, your doctor may prescribe outpatient PT or home exercises prior to surgery to try to improve your range of motion. We strive to have every knee bend at least 90 degrees. In knees that are stiff and lack significant bend prior to surgery, achieving full motion can be a challenge. Most often this is due to stiffness of the ligaments and tendons which can be improved on to some degree with surgical releases. Participation in a comprehensive PT plan following surgery is essential in order to maximize motion.

What if I live alone or do not have help at home?

How do I arrange for inpatient therapy?

A counselor from the hospital will contact you prior to your surgery and review your situation to determine if you would qualify.

When can I shower?

Once the incision is dry, patients can shower. You will be given specific instructions upon discharge from the hospital.

Is it normal for my knee to feel warm after surgery?

Isolated warmth of the skin after knee replacement is not unusual and can persist for up to six months. This is though to be due to increased blood flow during the healing process.

How do I know if I have an infection?

If you are concerned about an infection, you should see your surgeon. Signs of infection include drainage from the incision, redness, pain, and swelling.

Will I need a blood thinner after surgery?

Yes, a medication to protect against blood clots is necessary for twelve days after a Total Knee Replacement. We will give you this prescription at your pre-op visit. You will not need to fill this prescription if you are going to an inpatient rehab facility.

How do I know if I have a blood clot?

If you are concerned that you may have a blood clot, you should see your surgeon. Signs of blood clots include pain and swelling in one or both of your lower legs.

How do I avoid a blood clot?

While blood clots are a risk factor after surgery, there are things you can do to help prevent them. It is important to complete your full prescription of blood thinning medication and to perform exercises that are shown to you in your class prior to surgery and taught to you in PT.

Do I need to attend the class before surgery?

Attending the joint replacement class allows patients to familiarize themselves with the hospital, nursing staff, and physical therapist. The class includes: reviewing the operation, scheduling therapy, and pain management. Studies have shown that patients who attend class have shorter more productive hospital stays.

How will my pain be controlled?

Pain is typically well controlled with oral and IV medications while in the hospital. Once a patient goes home after surgery, their pain will be controlled with oral medication. You will receive a prescription for pain medication for after surgery at your pre-op visit.

Will I have any activity restrictions following hip replacement?

The approach your surgeon uses will determine what restrictions a patient will have. It takes several months following surgery for the muscles to heal and strengthen. You will learn more about specific restrictions in the class and in PT.

When will I be able to drive?

Most patients can return to driving in one month, however we ask that you do not drive until we see you at your first follow up appointment after surgery.

When will I be able to return to work?

This varies on the type of work you are returning to. Most patients can return to non-strenuous work activity in 4-6 weeks. It will take longer to return to work that requires climbing, squatting, and heavy lifting.

When will I see my doctor after I leave the hospital?

You will have a follow up appointment scheduled 2 ½ – 3 weeks after surgery. If you have any questions during that time, please contact your doctor’s office.

Where can I find more information online?

More information including animations of surgical procedures and videos can be found online on our website: www.lowcountryortho.com