General
How do I make an appointment?
Simply call us at during our working hours or you can request an appointment online using this form.
Do I need a referral to make an appointment?
In general, you do not have to have a referral but going through this process can be helpful if possible.
Two reasons it is helpful to have a referral:
First, so that we can make sure you are seeing the right specialist try to help make the most effective use of your time and resources for appropriate treatment of your symptoms or condition.
Second, so that there we can help coordinate or arrange insurance approval for your visit and hopefully avoid any surprise billing.
If you have questions about the referral process or if one is even necessary, please call our schedulers for assistance at
What to bring for your initial consultation?
For your initial consultation you will need to bring a referral letter from your physician if required.
Here is check list for your initial consultation:
- Driver’s License or a valid ID
- Insurance information
- Referral Letter (if available or required)
- Reports, X-rays, MRIs, CT scans, etc. and any other relevant information
- List of medications (if any)
A written list of questions can also be helpful to make sure you don’t miss anything you might have otherwise like to have asked.
Lastly, it is very helpful if you come in loose fitting or freely moving clothing, that doesn’t limit motion or the ability to see the underlying skin for physical exam purposes, and that can be easily changed out of if necessary for X-ray purposes.
How long do I need time off work after the surgery?
The post-operative recovery period varies relatively widely based on the surgery. For more straightforward procedures and for patients getting back to a more sedentary job, 3-4 weeks is generally recommended and sufficient. For more invasive procedures, such as revision surgery or if your weight bearing will be limited after surgery, or if your job is labor intense, return to work can be delayed as much as three months. For the majority of Dr. Rainer’s patients, we recommend taking off at least four weeks off of work with the understanding that we will work together to determine the right time to return to work and may need to adjust along the way following your specific hip or knee replacement surgery. Rest assured Dr. Rainer will give you specific instructions to follow for a successful recovery.
How long before I can resume driving?
There are a few rules and guidelines for when to return to driving.
The next guideline is that you should strongly consider avoiding driving while still requiring a gait aid (walker, crutches, or cane) following surgery, which for most patients is 3-6 weeks following surgery. Dr. Rainer’s thought behind this is that if your strength is still such that you need the gait aid to effectively mobilize, it may not be enough to confidently go from gas to brake in every situation that you may need to.
The third guideline is strictly time based. There are studies in the literature that support returning at both 4 versus 6 weeks postoperatively, on the Right side (Dalury, et al. When can I drive?: brake response times after contemporary total knee arthroplasty. Clin Orthop Relat Res. 2011 Jan;469(1):82-6) and as early as 10 days if surgery is on the Left or “non-braking” side (Marques, et al. Does the brake response time of the right leg change after left total knee arthroplasty? A prospective study. Knee. 2008 Aug;15(4):295-8). Discussion with Dr. Rainer will help determine where you fall in this range.
With these things in mind, it is strongly recommended that you wait to drive at least until your 3 week postoperative visit with Dr. Rainer to discuss your progress and readiness to drive. When it is determined that you are ready, it is also recommended that you start in a low risk environment (such as an empty parking lot) WITH someone to monitor you and help determine your readiness before heading to the open road.
When can I resume exercise?
Each patient’s recovery is individualized and can be vastly different. Following surgery, Dr. Rainer will instruct you about exercises – including type, frequency, duration and when/how to advance.
In general, you start “exercising” immediately after surgery with simple exercises such as walking, heel slides for hip and knee flexion, and quad sets for hip and knee extension. While these may seem simple, each patient’s frequency and duration will be different and the more that each can be done over the first 2-3 weeks will make the more intense exercises that come later easier to accomplish.
Once you are seen for your 3 week postoperative visit and Dr. Rainer can ensure appropriate healing of your surgical incision and recovery progress, your activity in general and ability to begin more formal exercises will likely be advanced. Many patients start with a stationary bike at zero resistance and advance slowly, as tolerated. Body weight exercises will also be discussed and available to begin, likely after this 3 week visit. In general, heavy lifting and resistance weight training is put on hold for 3 months after surgery, but every recovery is individualized for each patients’ needs.
While most of Dr. Rainer’s patients do not require formal physical therapy, occasionally this is utilized if it is determined there would be additional benefit from a more structured/monitored approach, or if the expected progress is not being made postop. Referral to a physical therapist can help with strengthening and range of motion exercises following surgery for those that need it.
How do I contact after hours?
Dr. Rainer or his team can be reached through Western Orthopedics and Sports Medicine’s clinic number at . During business hours, this is answered by a representative physically in the clinic and overnight and on the weekends this is maintained by the clinic’s answering service. With this number, there will be a point of contact 24 hours a day for any questions or concerns you may have for Dr. Rainer’s and/or his team.
Medical
What are the non-surgical treatment options?
The non-surgical treatments are numerous and on a spectrum ranging from noninvasive to moderately invasive.
Some options include:
- Activity modification
- A period of rest or diminished activity
- Gait aids such as a cane, walking stick(s), crutches, or walker
- Supportive sleeves or braces
- Glucosamine supplementation
- Physical or Occupational therapy
- Behavioral therapy
- Massage therapy
- Acupuncture
- Oral medications such as acetaminophen, NSAIDs, etc.
- Topical medications such as diclofenac, etc.
- Trigger point injections
- Dry needling
- Corticosteroid Intra-articular injections
- Viscosupplementation intra-articular injections
- PRP intra-articular injections
Ultimately, effectiveness of these modalities is somewhat unpredictable and none offer a cure for osteoarthritis. However, some can be remarkably effective for certain individuals and so in most cases its worth trying in an effort fully exhaust non-operative modalities before having to proceed with surgery.
Will physical therapy be required after surgery?
For the vast majority of Dr. Rainer's patients formal, in-office, physical therapy following joint replacement is NOT required. However, this does not mean that physical therapy itself is not required or that formal, in-office, physical therapy is never used. Everyone’s recovery following surgery is different, it is NOT a race, and a slow steady pace to recovery is much more desirable than something rushed that leads to a complication. Dr. Rainer tends to work with each patient on determining their need for formal physical therapy and in general, most do not.
What are the risks associated with surgery?
Dr. Rainer will discuss the risks associated with your specific procedure with you. In general, risks are put into one of 5 categories, which include Infection and wound healing complications, potential damage to anatomic structures including blood vessels and nerves, implant related complications such as dislocation/leg length or rotational discrepancies/failure of implant fixation, complications from/during anesthesia, from urinary retention (and how this is addressed with catheterization) up to and including death, as well as medical complications following surgery including but not limited to blood clots, electrolyte abnormalities and medication reactions and intolerances.
When can I return to daily activities?
This is similar to when patients can return to work or driving and largely depends on the intensity of the activities. Most patients are up and walking, full weight-bearing, immediately after surgery and can resume light activities including short walks on level ground even just a day or two postoperatively. More strenuous activities including longer walks, use of a stationary bike and going to the grocery store take two to three weeks to be ready for. Activities like hiking, skiing, cycling and more-than-body-weight gym exercises generally take 2-3 months to get back to. In all regards, each activity should be started slowly and cautiously, under the direction of Dr. Rainer, advancing with pain and stability as your guide.
What can happen if surgery is avoided not pursued?
Just as surgery has risks, there are some risks with not having surgery. In most cases these risks are less severe than surgery itself, however can still include things like loss of mobility, continued pain, decreased quality of life, and sometimes bone loss or more severe implant related cases in certain revision surgeries scenarios.
Are my medical records kept private and confidential?
Your medical file is handled with the utmost respect for your privacy. Our staff is bound by strict confidentiality requirements as a condition of employment regarding your medical records. We will not release the contents of your medical file without your consent.