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INTRODUCING WEIR ORTHOPAEDICS

Weir Orthopaedics is a private concierge practice dedicated to providing a better experience for our clients. We perform our signature procedure, Weirplasty Knee Resurfacing, in the comfort of a private surgery center with our select team. A personal care concierge will be assigned to you by Dr. Weir to guide you from initial consultation through final rehabilitation. The goal is for you to receive something different than a traditional hospital surgery: an exceptional experience where you return to the activities you love with confidence and comfort.

COMMON QUESTIONS ABOUT WEIRPLASTY PARTIAL KNEE RESURFACING

What kinds of activities will I be able to do after partial knee resurfacing?

The goal of partial knee surgery is to reduce knee pain and be more active. Most patients enjoy a return to a high level of function and can do most activities they enjoy. Your individual ability to do an activity after partial knee resurfacing will depend on your overall strength and conditioning and how demanding the activity is.

How long will my partial knee last?

92% of people needed no other knee surgery for 20 years in a study of partial knee patients.

Will my partial knee need to be changed to a full knee resurfacing down the road?

This is unlikely. You may have heard other people tell you that partial knees need to be converted to total knees. The type of partial knee that usually needs to be converted to a total knee is a fixed-bearing, manual partial knee not a robotic-assisted partial knee or a mobile bearing partial knee. Dr. Weir does not perform the type of partial knee surgery that has often required conversion to a full knee.

ABOUT YOUR SURGERY

The goal of a robotic-assisted Weirplasty Knee Resurfacing is to eliminate the arthritis you have and restore your knee’s natural movements. This helps you eliminate knee pain and lead an active lifestyle.

THE MONTH BEFORE SURGERY

• You will receive a preoperative CT scan that will be used by your surgical team to custom fit your new knee to your individual anatomy based on our breakthrough Weirplasty surgical process. Dr. Weir’s office will make arrangements for you to have this scan at an imaging center.

• See your primary care doctor (or cardiologist) for your preoperative clearance

• Gently ride an exercise bike for 15 minutes a day to help build strength in your muscles. Stop riding if it bothers your knee.

TWO WEEKS BEFORE SURGERY

• Stop taking anti-inflammatories (Motrin, Aleve, Ibuprofen, Advil) and vitamin E capsules, flaxseed, glucosamine and fish oil unless directed otherwise by your doctor

• Stop taking GLP-1 Inhibitors like Wegovy or Ozempic 10 days prior to surgery.

• A nurse from the surgery center will call you to discuss details about your upcoming surgery, including what time you should plan on arriving at the center.

ONE WEEK BEFORE SURGERY

• Stop taking aspirin, plavix or coumadin if allowed by your cardiologist. Dr. Weir strongly encourages discontinuing these medications 7 days prior to surgery if approved by your cardiologist.

• Pick up your prescription medications at your local pharmacy. Start taking two tablets of acetaminophen (Tylenol) every 8 hours to help with pain after surgery. Start taking Meloxicam at night before surgery if it has been prescribed for you. Do not take the other prescribed medications until after surgery.

• Start washing your whole leg with Hibiclens (4% CHG) soap once a day when you shower. (You may use dial soap as an alternative.)

• The supply company of the continuous passive motion (CPM) machines will call you if you have requested a CPM machine for after your surgery.

• Stop taking the blood-thinning medication Xarelto or Eliquis 3 days before surgery if allowed by your cardiologist.

THE DAY BEFORE SURGERY

• Stop taking “bridging” medications like lovenox or heparin by at least 8 am the day before surgery.

• Drink plenty of fluids. You may eat normally during the day unless told otherwise by the pre-operative nurse. Do not eat or drink anything after midnight unless otherwise instructed.

• Sleep well - your virtual surgery has already been performed by your surgical team and they are prepared for your robotic procedure tomorrow.

CONCIERGE CARE

Weir Orthopaedics is a private concierge practice dedicated to providing personalized care. As part of your concierge care, you receive:

• A personal care concierge to assist you with needs that arise.
• After-hours access to Dr. Weir for urgent concerns during your perioperative period through our patented smart dressing. Tap your phone to your knee to connect directly to Dr. Weir.
• Priority surgical scheduling for your procedure to be booked sooner, or on specific dates you request.
• Your choice: a Breg circulating ice machine or a supply of Silagen scar-refinement lotion.

Your concierge care begins four weeks before surgery and continues for two months afterward. Our goal is to ensure the best possible patient experience. For pricing information, please review the “How to Talk to Your Insurance” worksheet at the end of this packet.

DISCHARGE AFTER SURGERY

Most of our patients prefer to be discharged home after surgery. You will need a reliable support person (friend, family or neighbor) who can stay with you for the first few days after surgery. There may be an option to recover at a nursing facility if you feel that same-day surgery is not right for you.

SUPPORT PERSON

You will be able to walk around your house, use the bathroom and eat and drink independently after outpatient surgery. A support person provides you with additional help you may need during your early recovery. A support person should be able to drive you home after your surgery and stay with you (or be immediately available) for the first four days after your procedure. Please let us know if you do not have a support person as you may be better served by traditional, hospital-based surgical care.

WALKERS

Your doctor has prescribed a walker for you to use after surgery. It will be delivered to the surgery center on the day of your procedure by a local medical supply company. You may bring your own walker if it is a two-wheeled, rolling walker that has been prescribed and fitted to you within the last 5 years.

CONTINUOUS PASSIVE MOTION MACHINES

A continuous passive motion (CPM) machine is a tool that helps you work on bending your knee during the first few weeks after surgery. Many patients find using this machine helpful but it is not always covered by insurance. Please contact the office at least two weeks prior to your surgery if you would like a CPM machine and we would be happy to coordinate it for you.

OUTPATIENT PHYSICAL THERAPY

Outpatient physical therapy usually starts two weeks after surgery. We will help coordinate physical therapy for you at a quality therapy facility close to your home.

HOSPITAL-BASED CARE

Dr. Weir and his team provide their care in our private surgical facility and outpatient clinic. If you require hospital-based care you will be connected to one of our hospital affiliated colleagues.

SWELLING & NUMBNESS

Swelling in the knee and numbness on the side of the incision is normal and will improve. Minor symptoms of swelling and numbness can continue after 6 months especially after prolonged activity. Fifteen minutes of icing followed by a heating pad for 10 minutes while laying flat with your foot elevated on three pillows will be the most effective way to reduce this type of swelling. This can be done 4 times a day. Remember to always place the ice in a covered bag to protect your skin from the cold. If the swelling persists after this treatment please call the office for other recommendations.

DRIVING

You will need to be off narcotic pain medication and feel safe to operate a motor vehicle before you start to drive. Most patients feel this way after a few weeks, depending on the type of surgery and the leg they had surgery on.

ACTIVITIES

The goal of knee surgery is to reduce knee pain and be more active. Most patients enjoy a return to a high level of function and can do most activities they enjoy. Your individual ability to do an activity after knee resurfacing will depend on your overall strength and conditioning and how demanding the activity is.

KNEELING

Patients can do most activities as long as it does not produce pain or swelling in their knee. This is true for kneeling, too. You can kneel after knee surgery, provided that kneeling does not cause you pain or discomfort. Most people find kneeling for brief periods of time on a padded surface tolerable. Some people find kneeling uncomfortable and they choose not to kneel.

RECOVERY TIME

Patients can expect to be walking on their new knee on the day of surgery. Patients usually feel comfortable driving after a few weeks. Most patients return to work after they start driving. Patients usually return to recreational activities like golf, tennis and skiing at three months. Patients who state their knee resurfacing feels like their natural knee usually get that sensation after six months.

ANTIBIOTICS AFTER JOINT RESURFACING

We do recommend taking an antibiotic prior to procedures that may introduce bacteria into your bloodstream. These procedures include: any dental procedure, sigmoidoscopy, tonsillectomy, bronchoscopy, liver biopsy, genitourinary instrumentation, prostate or bladder surgery, kidney surgery, gynecological procedures, barium enema or any other infection. We recommend waiting three months after your joint resurfacing before any non-urgent procedure. Most physicians or dentists performing these services provide antibiotics prior to their procedures. You can call our office if you need help with an antibiotic prescription.

FOR DIABETIC PATIENTS

Having good control of your glucose around surgery will decrease the risk of complications with surgery. Risks of surgery in people with uncontrolled diabetes include infection and wound complications. You should try to have well-controlled glucose prior to surgery. Talk to your family doctor about making sure your blood sugar is as well-controlled as possible.

NICOTINE

Nicotine products have been shown to increase the risk of complications with surgery. Risks of nicotine use with surgery may include wound healing problems, anesthesia problems and circulation issues. You should try to eliminate tobacco products as much as possible prior to surgery. Talk to your family doctor if you need medical assistance in quitting or reducing nicotine.

BODY WEIGHT

Obesity has been shown to increase the risk of complications with surgery. Risks of surgery in people with obesity issues include infection, wound complications and anesthesia issues. You should try to reduce excess body weight as much as possible before surgery. Talk to your family doctor if you need medical assistance in reducing body weight.

OTHER NOTES

We have dedicated our lives to treating joint pain. Through this, we have created or partnered with organizations that help us do this better. In addition to owning our private practice, Dr. Jared Weir is a paid consultant for the Stryker Corporation. He is an owner of Weir Ortho ASC. We wanted you to be aware of this as you may have interactions with these entities during your care. If you have any questions about our specialty practice or how it may apply to your situation, we would be happy to discuss them with you.

Determining what health insurance covers is complicated and is always changing for both us and our patients. We have provided this worksheet to help you better discuss the potential costs of joint resurfacing with your insurance.

Many of our Medicare Advantage plan patients have found that “original Medicare” offers better coverage than Medicare Advantage plans. You can often easily switch from a medicare advantage plan back to original Medicare by calling 1-800-MEDICARE or by going to www.medicare.gov.

Please take this sheet to the pharmacy to receive a discounted price on your medication if prescribed for you.