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News What You Need To Know About Joint Replacement Surgery

by Dr. Nicholas Bonfilio, MD, Orthopedic Surgeon &
Amanda Murray, RN, WCC, Orthopedic Destination Center Coordinator

Knee and hip replacements are two of the most common elective surgeries performed in healthcare today. Before deciding to have a total joint replaced, several factors should be considered.

Risk for Infection
While uncommon, a total joint implant can become infected within days, weeks, months or even years after your initial surgery. Bacteria within your gastrointestinal tract, mouth, and skin are abundant and regulated by your body’s immune system. However, when you have a surgery that includes an implant, bacteria has a potential place to thrive. The immune system has a hard time attacking bacteria that finds its way to an implant. Because of the potential risk for infection, patients are asked to notify their dentist and doctors of their implant prior to undergoing procedures such as a dental cleaning or colonoscopy. When there is a break in the soft tissue (colon, gums, or skin) bacteria gain a potential entry way into your bloodstream and your risk for infection increases.

Potential signs and symptoms of an infection that you should be aware of after surgery include:

  • Fever greater than 100.5
  • Skin around an incision that is warm, red, or swollen
  • Drainage that has an odor, that has increased in amount, or has had a change in color (normal drainage is clear, pale yellow or pink).
  • Increased pain

Hospital Stay
It is a good idea to ask your doctor if you have any diagnosis that could increase your risk for infection after a total joint surgery. Common diseases that can increase risk for infection include but are not limited to diabetes, rheumatoid arthritis, and illnesses that compromise your immune system. It is important to ask questions and to become familiar with your treatment plan prior to surgery. As a patient you have a right to know the complication rates of the facility and surgeon you are considering. Good questions to ask your doctor are how many procedures do you perform a year? Do you keep documentation of complications such as infection rates? Where are these results posted? Are they reliable? How long have you been tracking data?

Other considerations when choosing to undergo an elective surgery such as a total joint are:

  • How long can a patient anticipate staying in the hospital after a total joint procedure? Where will you go after undergoing a total joint procedure: home, an acute rehab facility, skilled nursing facility, or home with the option of home health?

For example:

-Typical hospital stay after a total joint: National average (3.1 days) Great Falls Clinic (2 days)

Being discharged home is the main goal after your hospital stay. Patients find it to be satisfying when they are up and walking the day of their total joint surgery. It is also important to consider the cost of a hospital stay when looking at options; the less time that a patient stays in the hospital the less expensive it is overall. Studies also reveal shorter hospital stays being associated with a decreased risk of infection. In addition to surgery satisfaction and lower cost, the healing process is the most important step. We encourage our patients to recover at home because the environment optimizes rest and recovery. Having a coach or caregiver to aid in the post-operative period is also something that should be planned prior to surgery.

Patient Satisfaction
How satisfied are past patients that have elected to have their total joint surgery at the facility? Did the hospital offer the tools and knowledge the patient needs to make the most out of their new total joint? Does the facility have a high blood transfusion rate or complications including infection, blood clots, or bruising?

For example:

-Overall satisfaction scores of a facility:
National average (71%) Great Falls Clinic (91%)

– Complication rates including infection, blood clots, and severe bruising:
National average (3.1%) Great Falls Clinic (0.0%)

– Blood transfusions:
National average (3.4%) Great Falls Clinic (0%)

There are risks to undergoing any surgical procedure. Understanding those risks and your facility’s rate of complications are important before choosing your doctor and surgical facility. Be sure to discuss these important details with your primary care provider, surgeon, or request information from the facility itself.

When electing to have a total joint replacement surgery, be sure to find a surgeon and a facility that works best for you. If you have questions, please don’t hesitate to contact us at 406-454-2171 or visit for more information.


Nicholas Bonfilio, MD Orthopedic Surgeon

Nicholas Bonfilio, MD
Orthopedic Surgeon

About Dr. Bonfilio

Dr. Nicholas Bonfilio, MD is an orthopedic surgeon with the Great Falls Clinic since 1995. He is a partner within the physician-owned, multi-specialty clinic and also serves on the Executive Committee. Dr. Bonfilio and his wife Deb enjoy hiking, community events, traveling and spending time with their grandchildren.

Dr. Bonfilio is accepting new patients and physician referrals at the Great Falls Clinic Specialty Center, 3000 15th Avenue South. For more information or to schedule an appointment, please call 406.454.2171.

Data outlined in this article is based on surgeries performed July- September, 2016. Data is collected by an independent third party and is not affiliated with the Great Falls Clinic. National averages and state average data are based on the Marshall Steele surveys collected from patients at post-operative office visits, hospital reported data in the Marshall Steele database, and Medicare and Commercial insurance claims.



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