At The Leone Center for Orthopedic Care, we value the doctor-patient relationship and consider it to be as important as the surgery itself. We take pride at the Leone Center in having created an environment where patients feel comfortable asking questions and then getting a personal response or help. This begins with the first phone call and visit through post-operative care. We’ve learned that patients that go into surgery with more knowledge and confidence have less anxiety, get well faster and have a better experience.
Once a decision is made to proceed with surgery, The Leone Center for Orthopedic Care help patients’ navigate the pre-operative education and medical clearance processes as efficiently as possible. Dr. Leone’s entire team is engaged and involved in every step of the process. This may include help completing medical forms, managing preoperative clearance, creating an optimal discharge plan or arranging for private rooms and VIP meals and other enhanced services if desired.
Once a date for surgery is scheduled, there are a number of simple steps to be taken in preparation. We provide all patients with a variety of resources, including pre-operative packet of materials, including hard copies of Dr. Leone’s “Preparing for Your Hip Surgery” or “Preparing for Your Knee Surgery” booklets as well as digital versions which can be downloaded from the website. These help educate and ensure that all necessary steps are completed pre-operatively so that each patients’ surgery, hospitalization and recovery goes smoothly.
Dr. Leone and his staff are always available to answer individual patients’ questions. All questions are good questions. One recent patient who was preparing to undergo a total hip replacement inquired about the length of his incision. His co-worker had hip replacement surgery a few years prior and claimed his procedure only left him with a one inch scar, compared to the old days when the procedure created greater trauma that resulted in a longer recovery period and scars 10-12 inches long.
While this patient wondered whether his question was vain, Dr. Leone thought it was important and answered him promptly.
Below is Dr. Leone’s full response:
My team passed on your question regarding the length of your incision. I don’t consider your question vain. It’s important to go into surgery with knowledge and confidence.
Your operation will be performed with as minimally an invasive technique as possible, without compromising your recovery or the ultimate result.
Recognize that making a 3-4 inch incision (I’m sure your friend’s incision was not actually one inch) when a six inch incision more appropriate often results in more soft tissue trauma (tissue is torn or bone fractured when the surgeon doesn’t have the exposure they need), more post-operative pain (tissue is traumatized and ripped), more difficult/painful recovery, and often the final scar/incision doesn’t look cosmetically optimal (puckered and uneven). The length of the incision is often a marketing ploy under the guise of minimally invasive. I recommend not getting side-tracked by that.
Typically the length of the incision is dictated by how much tissue exists over the greater trochanter. I.e. if it’s just a little (say one inch) your incision is short; if it’s a lot (say 6-9 inches) then the incision is longer. It’s also dictated by how large or small the skeleton is and how stiff or flexible the hip joint is before the reconstruction.
With that said, I think the meticulousness of the reconstruction needs to also be reflected in the meticulousness of the closure. Your incision will be closed with a running subcuticular stitch. This is typically how a plastic surgeon closes their wounds. I do not use staples which are most often used. The running subQ suture creates a better seal (I encourage you to shower as soon as you go home), a better cosmetic appearance and some studies have reported a lower infection rate.
The patient greatly appreciated the personalized answer and went into his surgery fully prepared and confident. He has since recovered extremely well and is back on his feet.