Specialization, Collaboration and Education Are Key to Treating Complex Joint Conditions at WellSpan Health

By Josh Garcia
Thursday, April 25, 2019

From physical therapy to joint replacements, WellSpan is well equipped to meet the needs of local patients.

Judith Kopinski, MD, surgeon, WellSpan Orthopedics

Like other orthopedic surgeons at WellSpan, Judith Kopinski, MD, specializes in only a handful of procedures, including hip preservation surgery, partial knee replacements, and total hip and knee replacements. She and her colleagues are all fellowship-trained in their specialties.

“Many orthopedic surgeons at WellSpan have years of specialized practice under their belts, which leads to them being accomplished in specific procedures,” Dr. Kopinski says. “I perform joint replacement and preservation procedures, but if someone comes in with hand arthritis, it’s easy for me to make a referral and get that person to the proper specialist.”

Solutions Sans Surgery

Though Dr. Kopinski performs complex surgeries, she and other physicians at WellSpan follow a conservative approach to treatment, only introducing surgery when absolutely necessary.

Decreasing pain and improving patients’ quality of life are the goals of the program, according to Jenny Fowler, RN, BSN, ONC, Total Joint Program Director at WellSpan. She adds that if the orthopedists and team can achieve these goals without surgery, that’s typically best for patients.

Conservative treatments include physical therapy, steroid injections, anti-inflammatory medication and lifestyle changes to help delay or entirely avoid joint replacement surgery. In some cases, specialists will refer patients to other WellSpan providers for certain treatments.

“For every person we consider for joint replacement, we have to satisfy that we’ve tried conservative management first,” says Gary Zartman, MD, surgeon with Lancaster Orthopedic Group and Co-Director of the Total Joint Program at WellSpan Ephrata Community Hospital. “For example, if a patient is experiencing joint issues as a result of another condition, we’ll make a referral to address that condition before resorting to surgery.”

Prehab and Preparation

If arthritis has taken its toll and joint replacement is unavoidable, WellSpan helps patients prepare for surgery through its “prehab” program and other educational resources.

“We perform two different sessions with patients prior to surgery,” Fowler says. “One is the formal joint education class, which shows patients how to get their home ready for recovery, how to prevent infection and what to expect at the hospital.”

Dr. Kopinski and her team lead the formal joint education class in York and the total joint coordinator leads a similar class in Ephrata.

“Managing expectations upfront helps decrease anxiety,” Dr. Kopinski adds. “We also ask patients to bring their family members and support system with them so that everyone is prepared.”

During prehab, the care team performs an evaluation to predict how long a patient will need to be in the hospital and what type of therapy he or she will require after surgery. This evaluation also gives physicians a pain and mobility baseline they can use to show patients how much they have improved postsurgery. Additionally, patients learn physical therapy exercises they will use during rehabilitation.

If patients need to review what they’ve learned or find more information, they can refer to a total joint packet they receive at the start of the process. The packet is filled with information tailored to each patient’s specific surgery and treatment plan. Patients can also use an online platform if they prefer to access the information digitally.

Dr. Kopinski reviews her diagnosis with a patient.

Surgery and Rehabilitation

Preoperative conferences are held regularly so that physicians can go over patient cases, gain insight from colleagues and finalize surgical and rehabilitation plans. Due to improvements in pain management and rehabilitation techniques, many patients can expect to return home soon after their procedure.

“The average length of stay for our patients is 1.4 days,” Dr. Kopinski says. “And the majority of our patients — over 90 percent — go home the day following surgery.”

Once patients are discharged, they are encouraged to begin physical therapy within five days of leaving the hospital. Outpatient physical therapy sessions are performed two to three times per week, with patients performing exercises at home in between sessions. If patients have a difficult time leaving their house — for example, if they live on the second floor of a building — therapists can visit them at home for physical therapy sessions.

“We excel in providing individualized care,” Fowler says. “We take into account pre-existing conditions, such as diabetes, and work with internal and external primary care physicians to make sure they are kept up to date regarding their patients.”

Whether communication is through a patient’s EHR or other methods, including telephone, scans and faxes, everyone will be working with the same information.

“We try to be as open as possible in our practice,” Dr. Kopinski says. “In addition to being transparent about care plans, I also lead community talks that are open to patients and providers to learn more about the services we provide.”

WellSpan Surgery & Rehabilitation Hospital

WellSpan’s orthopedic specialists recognize that the challenges brought on by an orthopedic injury, spine condition, stroke or trauma require specialized care. WellSpan Surgery & Rehabilitation Hospital is a modern, patient-centered facility that offers:

  • Advanced orthopedic, spine and neurosurgical surgeries
  • Inpatient rehabilitation for patients who need extra attention before returning to their homes and resuming their lives
  • Specialized outpatient rehabilitation to support patients who have returned home but require ongoing therapy

To learn more about WellSpan’s orthopedic services across our health system, visit WellSpanSpecialists.org/Ortho.