Q: What does MIS stand for?
A: MIS is the abbreviation for Minimally Invasive Surgery.

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 surgery?
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 socket.
We have not seen this occur while using the MIS approach.
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 starts
blood thinning medication the day after surgery. These medications help prevent
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 factor
in decreasing the incidence of blood clots.

Q: How do I know if I’m a candidate for the MIS procedure?
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 damage necessitating
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 replacement surgery?
A: You can contact our billing department directly to answer any finanacial questions.
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
operating room.
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 family member
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 unit. However,
patients having one joint replacement rarely qualify for admission. Most patients
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 rehabilitation, we
will provide you with a list of rehabilitation centers. If you have private insurance,
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,” then allowed
to proceed.

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 that will
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 joint replacements?
A: No. Surgeons must receive specialized training.