Orthopedics

How we can help

We offer surgical and non-surgical options to help relieve pain and get you moving again. Each of our doctors and physician assistants specializes in a certain area of the body: hips, knees, spine, or upper extremity.

Typical surgery types

Our surgeons perform many different types of surgeries including:

• ACL reconstruction
• Arthroscopy
• Carpal tunnel
• Disk replacements
• Fracture reductions
• Ligament repair
• Microsurgery
• Rotator cuff repair
• Spinal fusions
• Total joint surgeries on shoulders, knees, and hips
• Trigger finger release

Do I need a referral to be seen in Orthopedics?

A physician referral is not required. We accept patients who self-refer to the Orthopedics Department. However, your insurance may require a referral to provide coverage.

How do I receive follow-up lab or imaging work?

Orthopedists often use images to help evaluate medical problems. To save you time, our clinical team may call you to schedule an x-ray appointment a few minutes before your visit. That way, your provider will have your images when they see you. For more complex imaging (MRI/CT), your provider will put in a referral, and a scheduler from Radiology will contact you to arrange an appointment. A follow-up visit will be scheduled with your provider after your imaging appointment is complete so that you can get your results. If you have set up MyChart@TVC, your results will be sent to you. If you have questions, you can discuss them during your follow-up visit with your provider.

Will I need surgery?

Patient care is highly individualized. Just because you see a surgeon it doesn’t mean that surgery is necessary. The physician who performs the type of surgery being considered can go over the pros and cons with you, including the typical recovery time and any rehabilitation needs. It’s important for you to be fully informed before you opt for a surgical solution.

Where do surgeries occur?

Our surgeons perform procedures at Vancouver Clinic’s Ambulatory Surgery Center (ASC) and at Legacy Salmon Creek Medical Center. If your provider recommends surgery, our surgery schedulers will contact your insurance to obtain authorization. They will schedule at the medical center that is most suited for your procedure. All of our surgery sites are local:

• Ambulatory Surgery Center: 700 NE 87th Ave. Suite 320, Vancouver, WA 98664
• Legacy Salmon Creek Medical Center: 2211 NE 139th, Vancouver, WA 98686

When will I know my surgery start time?

Many factors influence operating room availability, so we request that you remain flexible and understanding of changes or delays on the day of surgery. On the day before your planned joint-replacement surgery, the hospital or ASC will contact you with the surgery time and the time you are needed to check-in by.

How much will my surgery cost?

Each surgery is unique and medical insurance coverage varies widely. The best way to determine the cost of a procedure is to contact your insurance carrier for an estimate. Look on the back of your insurance card for your carrier’s customer service number.

Recover in the comfort of home

Vancouver Clinic is pleased to offer outpatient joint replacements in our Ambulatory Surgery Center (ASC) at 87^th Avenue. Low-risk patients can have a total or partial knee or hip replacement and safely leave the day of their surgery to recover in the comfort of their own home.

Patients who have few medical problems, a good support system at home, and a strong motivation to recover tend to be good candidates for this type of surgery experience. If you are interested in foregoing a hospital stay, talk to your doctor to see if you qualify. All patients undergo a full medical screening to determine the best place for their surgery.

Doctors at the ASC use the same robotic surgery techniques they do in the hospital to place implants within one millimeter of their exact target on the body. This leads to longer-lasting implants and better matches to the patient’s anatomy. Minimally invasive technology also shortens recovery time.

Patients in the Total Joint Program receive all their care at Vancouver Clinic. The path to surgery and recovery includes several steps:

• Education: A patient and their support person (“coach”) attend a free class where they learn how to prepare for the surgery and what to expect during recovery.
• Medical clearance: Each patient sees a family nurse practitioner who reviews their medical history and medications and confirms they are in good health. Labs are completed three days before this appointment, and an EKG is done at the appointment.
• Dental clearance: Patients get a dental clearance about 30 days prior to surgery. If there are any issues, such as an infection, surgery is delayed to reduce the risk of a joint infection.
• Imaging: If CT images are required, a scheduler from the Radiology Department reaches out.
• Pre-habilitation appointment: A patient and their coach meet with a clinic physical therapist to learn exercises that strengthen muscles before surgery. They also learn how to use the assistive devices needed after surgery and work on how to safely transfer themselves between the car, bed, bathroom, and other places in the home with minimal support.
• Pre-op appointment: The pre-op appointment is the last stop prior to surgery and an opportunity to raise any lingering questions or concerns.
• Surgery: Before the procedure, it’s particularly important to follow all medication instructions and to not eat after midnight. Clear fluids are okay up to two hours before check-in. After the surgery, the patient receives a meal of their choice via Uber Eats.
• PT and rehabilitation: A physical therapist visits each patient in the ASC to make sure they can move safely enough to return home. During rehabilitation, most knee surgery patients attend physical therapy three times a week for six weeks. Hip surgery patients attend physical therapy twice a week for six weeks.
• Post-operation care: Once a patient starts physical therapy, their provider sees them periodically to ensure their recovery is going well.

Receive care at every step

A hospital is a safe and positive environment for many total joint replacement surgery patients. Individuals who have underlying medical conditions, or who may need more support during their initial recovery, are often best cared for in a hospital. In order to help patients have a safe and successful experience, doctors and staff guide them through several steps.

• Medical clearance: A nurse practitioner from the hospital reviews each patient’s history and current medications and requests lab tests and an EKG to ensure they are in good health before the operation.
• Dental clearance: To minimize the risk of infection, a patient must have a clean bill of oral health and a dental clearance form signed by their dentist.
• Imaging: MRI, CT, and/or x-ray images may be required, depending on the type of surgery. Once insurance has authorized a request for imaging, a scheduler from the Radiology Department reaches out.
• Pre-op appointment: The pre-op appointment is the last stop prior to surgery and an opportunity to raise any lingering questions or concerns.
• Surgery: In the time leading up to the procedure, it’s particularly important to follow all medication instructions and to not eat any foods after midnight (unless otherwise directed). Clear fluids are okay up to two hours before check-in (unless otherwise directed). After surgery, most patients stay in the hospital one to three days.
• PT and rehabilitation: To enable the best recovery, physical therapy is usually required after most joint-replacement surgeries. Depending on need and eligibility, some patients enter a rehabilitation facility.
• Post-operation care: Once a patient starts physical therapy, their provider sees them periodically to ensure their recovery is going well.