Q: What does MIS stand
A: MIS is the abbreviation for Minimally
Q: How does the MIS
procedure differ from the usual/traditional procedure for hip
or knee replacement?
A: When using the MIS procedure, Dr. Penenberg
makes a significantly smaller incision,
and cuts less soft tissue. The result is significantly less trauma
to the soft tissue at the
surgical site. This means significantly less bleeding, less pain,
and less swelling. Less
pain and swelling results in a shorter hospital stay, and a quicker
recovery. You may
be able to return to your regular activities within 3 to 5 weeks,
as opposed to the 3 to 4
months it takes to recover from the traditional approach.
Q: Is the MIS approach the same as arthroscopic
A: No. Arthroscopic surgery is performed on the soft tissue using
a camera through a tiny
incision. It is not applicable to joint replacement surgery.
Q: What are the risks of joint replacement surgery?
A: There are three risks associated with joint replacement;
1. Hip dislocation - when the replacement ball pops out of the replacement
We have not seen this occur while using the MIS
2. Infection - Dr. Penenberg takes active measures to reduce the
risk of infection.
Joint replacement surgeries are performed in special operating rooms
with laminar flow - an air exchange system that cleans the air;
he also administers intravenous antibiotics before and after the
procedure to protect against infection.
3. Deep vein thrombosis (DVT)/ postoperative blood clots - Dr. Penenberg
blood thinning medication the day after surgery. These medications
the formation of blood clots. The MIS
procedures allow the patient to be more
active, sooner after surgery. The increased mobility is also a significant
in decreasing the incidence of blood clots.
Q: How do I know if I'm a candidate for the MIS
A: Dr. Penenberg can determine if you are a candidate for the MIS
hip or knee procedure
on your initial evaluation. Xrays will determine if there is bone
joint replacement, and the xrays and the examination can determine
if you are a
candidate for the MIS approach.
Q: Will my insurance cover MIS joint
A: You can contact our billing department directly to answer any
MedNet Billing, Inc. 310.322.4278.
Q: How long will I be in the hospital?
A: For primary joint replacement patients (hip or knee), the hospital
stay is 2 to 3
days. Patients having revision surgery may have a shorter or longer
stay depending on
the necessary procedure.
Q: Do I need to donate my own blood before surgery?
A: No. The MIS procedure results in less
trauma to the tissues, and less blood loss.
Q: How long does the surgery take?
A: Dr. Penenberg performs the MIS joint
replacement surgery in a little over an hour.
Actual time in the operating room is about 2 hours given the setup
time and the time
the anesthesiologist is working with you.
Q: What should I bring to the hospital?
A: Personal toiletries.
CD player/ book/magazine - to help pass the waiting time getting
ready to go into the
Loose fitting, comfortable clothing.
Insurance cards/ photo I.D.
A list of all the medications you are taking - prescription and
over the counter. The
only medication you should bring is prescription eye drops or inhalers.
Shoes or slippers that enclose the entire foot - no mules, clogs,
or flip flops.
Walker/crutches/cane - do not bring on the day of surgery. Ask a
or friend to bring the next day.
Q: Will I be able to climb stairs after surgery?
A: Yes! The Physical Therapist at the hospital will instruct you,
and you will practice
Stairs, before you leave the hospital.
Q: Will I stay in the hospital for rehabilitation?
A: Cedars-Sinai Medical Center does have an inpatient rehabilitation
patients having one joint replacement rarely qualify for admission.
recover quickly, and do not need this service. Patients usually
go home with home
Physical Therapy (set up by the hospital). If you need inpatient
will provide you with a list of rehabilitation centers. If you have
it is IMPERATIVE that you contact your
insurance company to learn which
rehabilitation facilities are covered by your policy.
Q: How long will the prosthesis last?
A: The hip prosthesis is expected to last 25 years or more. The
knee prosthesis is
expected to last 15 - 20years. Components can be replaced as necessary.
Q: Will the prosthesis set off the metal detector at the airport?
A: The prosthesis can/may set off the metal detector. To date, there
have been no
problems with delays, or missing flights. You are simply "wanded,"
Q: Am I able to resume sexual activity after surgery?
A: You may return to your regular activities as soon as you feel
able, but with some
caution. The joint will be tender, and it is best to keep pressure
off of it while the
soft tissue heals. Ask the surgeon or the nurse about safe positions
accommodate your new joint.
Q: How long will I have to be in Physical Therapy?
A: The time spent in Physical Therapy depends on the individual
and the demands of
his/her activities and occupation.
Q: Can all orthopedic surgeons perform MIS
A: No. Surgeons must receive specialized training.