Adirondack Health and Lake Placid Sports Medicine Nurse Practitioner Chris Theobald, right, sits down with a joint replacement patient at Adirondack Medical Center to discuss his treatment plan. (Provided photo — Lisa Keegan)

SARANAC LAKE — Adirondack Health’s joint replacement program has been reaccredited as a “Total Joint Center of Excellence” by the Accreditation Commission for Health Care. The program first earned this accreditation in 2019 and has achieved the highest level of distinction each time since.

The top level of distinction certifies that Adirondack Health completes more than 350 joint replacements a year and that the program is committed to research, continuously reviewing quality data and making programmatic improvements in real time.

“This accreditation means we hold ourselves to a higher standard of patient care,” said Chris Theobald, a surgical nurse practitioner, who has been with Adirondack Health for 25 years — 18 of which have been focused on orthopedic-related surgeries in the operating suite. “I think we do a phenomenal job for our patients, and what I hear from them — even when we talk a month or six months out — is that they are so happy with their results, and that makes a world of difference.”

Adirondack Health is consistently ranked one of the top hospitals across the state and country in terms of patient outcomes for joint replacement surgery. Last year, the local health system achieved rankings of number one in New York state and number five in the United States.

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Pre-surgery education

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This starts with making sure the patient is a good fit for joint replacement through a consultation that includes imaging and lab work. The patient is then provided with the education they need to promote health and safety before and after their surgery. This takes place at a pre-operative class where patients meet with Adirondack Health’s physical therapists, as well as nursing and pharmacy staff. Patients are provided with information detailing how to prepare their bodies and home environments prior to surgery, medications, rehabilitation exercises and assistance obtaining equipment and services necessary for post-surgical recovery. It’s also an opportunity for participants to voice their questions and concerns.

“This class is crucial to making sure our patients are well prepared when they come in for surgery,” Theobald said. “Our goal is to reduce our patients’ anxieties related to surgery. It’s a significant surgery and we want to make sure they are well-educated. By this point, our patients have well-established relationships with their surgeons. The class is an opportunity for us to get to know them and for them to get to know us.”

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New OR suites

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Adirondack Health constructed a new surgical services wing in 2018. It’s comprised of six high-tech operating rooms and an elevator that transports surgical instruments to and from the central sterile processing unit below, where they are cleaned and sterilized. The OR suites are located directly behind the ambulatory surgery unit, which provides patients with pre- and post-operative care, and the endoscopy unit where many surgical outpatient procedures are performed.

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Provider and staff excellence

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Adirondack Health’s joint replacement surgical team consists of Dr. Eugene Byrne, Dr. Daniel Bullock, Dr. William Smith and Dr. Bartlomiej Szczech.

Adirondack Health’s staff embrace a team-based approach to surgical care. Every member of the team receives ongoing education and hands-on training to improve their skills, enhance patient safety, meet certification and licensing requirements, and ensure they’re up to date with advances in medical care, technology and best practices.

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Mako surgical robot

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Since 2019, Adirondack Health has offered robotic-assisted total knee and total hip replacements with Stryker’s Mako System. The 3D Mako allows surgeons to create a surgical plan even before entering the operating room. It affords increased accuracy during the operation, which allows the surgeon to preserve more of the patient’s actual native bone and protect soft tissues and ligaments from damage.

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Post-surgery support

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When Adirondack Health’s patients are discharged following their surgeries, there is a process in place to ensure they can always get in touch with someone from their care team to address questions or concerns.

Each patient will also return to see their surgeon for post-operative care.

“Our patients come to us sometimes from an hour or two away, and I want them to know that when they leave this hospital, we have a process where they can always reach one of us,” Theobald said.

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Rehabilitation

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Adirondack Health’s rehabilitation team begins working with joint replacement patients either the afternoon of, or morning after, surgery. Early mobility following joint replacement surgery has been shown to be safe and effective at minimizing the risk of complications, maximizing the function of new joints and decreasing lengths of stay in the hospital. Physical therapy is scheduled twice daily, along with occupational therapy, as needed.

Physical and occupational therapists will also work with patients, their surgeons and case managers to ensure patients have access to all necessary equipment and recommended services at the time of discharge, based on the patient’s individual progress in therapy. Most patients are in the hospital for one or two nights after surgery, before being discharged home with either outpatient or in-home physical therapy.