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Joint Replacement

Total Joint Replacement Program

Contact Us at 845.987.5400

WMCHealth announces that elective outpatient ambulatory surgeries, office visits and medical tests have resumed at St. Anthony Community Hospital, under an Executive Order from Governor Andrew Cuomo.  

Governor Cuomo’s Executive Order allows for resumption of elective outpatient ambulatory surgical services -- those for which the patient enters and leaves a surgical facility on the same day, without an overnight stay -- based on the status of coronavirus impact, including a drop in COVID-19 cases in specific counties.

At Bon Secours Charity Health System, our patients’ health and safety are our top priority. As we expand our surgical services from the COVID-19 era, we are actively working to provide quality care to serve our patients, families, and staff. 

Please read Our Patient Information for more detail on scheduling elective outpatient ambulatory procedures and tests, visitation and what to expect in preparing for a surgical procedure. 

 

  

Welcome!  Thank you for choosing St. Anthony Community Hospital. Orthopedic surgery can be daunting, but trusted surgeons committed to timely, exceptional medical care means a patient can confidently look ahead to restored health. That passion guides the Orthopedic Surgery team at St. Anthony Community Hospital.

The Orthopedic team, led by John Juliano, MD, Orthopedic Surgeon and Chief of Surgery, offers patients a range of exemplary surgical skills and a commitment to patients’ optimum health. The team’s surgical expertise is continually sharpened by their passion for the latest treatment techniques and technology.

“Our priority is to get our patients back to resuming activities they love as quickly as possible,” said Dr. Juliano. “Whether that’s playing a sport or going on a daily walk.”

The orthopedic surgeries performed at St. Anthony Community Hospital range from:

  • Traditional hip and knee joint replacements
  • Patient-specific CT-guided 3D model shoulder replacements
  • Our orthopedic doctors specialize in a wide variety of:
    • Knee
    • Shoulder
    • Hand
    • Foot
    • Elbow
    • Sports injury surgeries.

The orthopedic staff takes pride in achieving high patient satisfaction scores. To ensure that these patients receive the best care after surgery, St. Anthony Community Hospital has a dedicated orthopedic unit that is staffed with highly trained nurses, case managers and rehabilitation staff.

The Sports Medicine and Orthopedic Team sees a range of cases, from pediatric to geriatric, and giving personalized attention to each of their patients is a top priority. This echoes St. Anthony Community Hospital’s commitment to providing the very best care, right where patients live.

Please utilize our website as a reference for any questions you may have in regards to The Total Joint Replacement Center or call 845.987.5400.


Education and Mindfulness

Joint Replacement Program Class

View the Joint Replacement Program Class Materials 

Mindfulness For Pain Control, Healing and Stress Reduction Mindfulness

Meditation Practice Reported:

  • Better pain control
  • Reduction of severity of pain
  • Less anxiety and tension Improved healing (four times faster)

Participate in a mindfulness meditation here

Read Our Dietary Planning Education 

Meal Planning

Fiber Content of Food


Success Stories

Jim McIntyre

 

 

Jim McIntyre can now climb mountains without hip pain. Photo by Kenneth Gabrielsen

Minimally invasive hip-replacement surgery allows a retired teacher to resume his super-active life.

As seen in the May 2021 Issue of Advancing Care.  |   By Laurie Yarnell

Last summer, orthopedic surgeon John M. Hardcastle, MD, received a photo of his patient Jim McIntyre atop Mount Yale, a 14,200-foot mountain in Colorado. This was just four months after Dr. Hardcastle replaced the 67-year-old’s right hip at St. Anthony Community Hospital, in Warwick, a member of the Westchester Medical Center Health Network (WMCHealth).

McIntyre, a retired teacher, is an active man who hikes mountains, climbs glaciers and skis. In January 2020, the Summitville resident was climbing in Ecuador “pain-free and on all cylinders.” Soon after, however, he started experiencing severe hip pain, which made it difficult for him to even walk. He consulted Dr. Hardcastle, who had been treating him for several years for osteoarthritis and degenerative joint disease. “You’ll know when it’s time to replace your hip,” he had advised McIntyre. That time had come.

“Despite the pandemic,” says Dr. Hardcastle, “Jim was wise not to delay his care; many safeguards had been put into place to ensure patient safety.”

Smaller Incisions, Quicker Recovery

Dr. Hardcastle used a minimally invasive posterior approach for McIntyre’s surgery. Typically an outpatient procedure, it lasts 30 to 60 minutes. “We take out the ball, or femoral head, which no longer has any cartilage, and replace it with a ceramic one,” says Dr. Hardcastle. “We then remove the socket and replace it with a plastic-and-metal one.” Because this approach requires smaller incisions and results in less handling of soft tissue and less damage to muscle than the more traditional approach, it means quicker recovery and less pain.

Immediate Relief

Shortly after waking from the procedure, McIntyre walked down a hallway with a physical therapist and a walker and then up and down a flight of stairs. “I was already in less pain than before I came in,” he recalls. “I felt better than I had in three years.” This surgery typically requires follow-up doctor appointments and six to 12 weeks of physical therapy.

Now, McIntyre is making plans to hike to the Mount Everest base camp in 2022. “I still have so many things I wanted to accomplish, and I was letting the pain stand in my way,” he says. Reflecting on the procedure that got him back to his active lifestyle, he notes, “The staff at St. Anthony Community Hospital was tremendous. Dr. Hardcastle is also an athlete, so he understands how important it is to get back to an active life. He’s a terrific human being and surgeon.”

‘Pain Is a Treatable Condition’

With a population that is living longer and remaining active, the volume of hip-replacement surgery is on the rise but still underutilized, says Dr. Hardcastle. “Oftentimes, people will deal with the pain and think it’s just part of aging,” he adds, “but hip pain is a treatable condition. Anyone with significant hip pain that’s impacting their quality of life and movement should consult their doctor, even if they think they’re not a candidate due to their age or health conditions.”     

Harry Knebel Jr.

Finding Freedom From Chronic Shoulder Pain With 3D Imaging

A highly experienced surgeon and advanced 3D imaging technology power a construction professional’s escape from chronic shoulder pain.

By Brandon O’Connor
As seen in the July/August 2019 issue of Advancing Care

Despite enduring pain for almost three years, Harry Knebel Jr., 66, was unsure he wanted to have shoulder replacement surgery. His procedure was scheduled for late November 2018, but in the weeks leading up to it, the Warwick resident was having second thoughts. Constant pain, difficulty sleeping, trouble getting dressed and other limitations on his daily activities were commonplace. But the notion of a six-week recovery gave him pause.

“I was really depressed until my 18-year-old grandson, Robbie, told me he didn’t like the depression I was in,” Knebel recalls. “That’s when I decided I was going to do it. My mind made a complete 180 – and after that point, I was eager to have it done.”

Unlike knees and hips — weight-bearing joints that wear out frequently — shoulders typically only have to be replaced in people whose lifestyle places extra stress on them. This can include weightlifters, athletes and manual laborers like Knebel, who spent more than 25 years working as a construction contractor.

Emboldened by his grandson and spurred by multiple recommendations, Knebel decided to see Daniel Tomlinson, MD, Director of the Sports Medicine and Shoulder Program at St. Anthony Community Hospital, a member of the Westchester Medical Center Health Network (WMCHealth).

At that appointment, Knebel learned that shoulder replacements are the best option to ease osteoarthritis pain in the shoulder. Knebel held off for a few more months but returned to see Dr. Tomlinson when he could tolerate the pain no longer.


Knebel with Dr. Tomlinson

Dr. Tomlinson performs 80 to 100 of these procedures annually. His extensive experience, coupled with recent technical advancements, have led to continuously improving results for his patients.

“Basically, the goal of any joint replacement is to restore the optimal function of the joint by recreating the patient’s anatomy as close to normal as possible,” Dr. Tomlinson says. “Years ago, shoulder replacements only came in a few different sizes to choose from, so there were a lot of surgeries done that didn’t precisely match the patient’s native anatomy.” Today’s expanded size options, says Dr. Tomlinson, result in implants virtually indistinguishable from the natural joint they replace.

Unlike knee- and hip-replacement joints, which have shorter lifespans due to frequent use, shoulder replacements were more likely to come loose from the shoulder socket.

In recent years, the mechanism for attaching the stem and socket to the bone has improved. However, the biggest advancement has been the improved ability to precisely align the implant.

Placement of a socket even just a few millimeters off can drastically impact shoulder function. Until a few years ago, doctors were forced to partially estimate the placement, because doctors were unable during surgery to see the entire shoulder blade, just the socket. This is because the scapula, or shoulder bone, is covered in soft tissue and muscle. Arthritis also can change the shape of the socket. During surgery, the goal is to recreate the patient’s pre-arthritis anatomy.

“Before using a CT in our planning, we would look at pre-op studies, like a CT or MRI, and make our best guess as to what the correct position is during the surgery,” Dr. Tomlinson says. “Usually we could get pretty close, but for someone who does not do many replacements, this can be challenging.”

 
Knebel with wife Jayne

The new CT scans enable doctors to create a three-dimensional model of the shoulder, virtually place the implant into the model on a computer and adjust it until it is placed with exactness, based on the patient’s anatomy. This offers the surgeon a patient-specific plan for the procedure. The computer model is then used to create a physical 3D printed model of the patient’s shoulder with guides that attach during surgery, to ensure the implant is placed precisely in the right position.

Dr. Tomlinson has been using the 3D mapping for roughly three years, including on Knebel, who said he was completely pain-free after a week. By his six-week checkup, he had regained half of his range of motion. Three months after surgery, he had regained full mobility.

“By placing the shoulder in a more exact position, there’s better overall function,” Dr. Tomlinson says, adding that the biggest frontier now is “to make these shoulders last longer.”

Shoulder replacements can take up to a year to fully heal, although 90 percent of the recovery takes place in the first six months, says Dr. Tomlinson. And though Knebel continues to heal, he would recommend Dr. Tomlinson to anyone.

“I am in no pain or discomfort,” Knebel says. “I can do things with my arm and shoulder that I couldn’t do before. I am very happy I had this surgery done.”