Knee Replacement

Orthopedic surgeons Dr. Dirk Gouge and Dr. Thomas Herschmiller – two of Olympic Medical Center’s 13 orthopedic providers – perform knee replacement surgeries right here on the Olympic Peninsula. Together, Dr. Gouge and Dr. Herschmiller provide world-class knee replacement options for the residents of Port Angeles, Sequim and the greater Clallam County area.

Dr. Dirk Gouge, who grew up in Port Angeles, draws on the experience gained over 23 years as an orthopedic surgeon at Olympic Medical Center. Dr. Thomas Herschmiller joined OMC in 2016 following education and training at distinguished institutions, such as Princeton University, Duke University Medical Center and the Columbia Center for Hip and Knee Replacement.

Olympic Medical Center has invested in state-of-the-art knee replacement technology, the CORI robotic-assisted technology from Smith+Nephew, the only company offering handheld robotic-assisted technology for partial and full knee replacements. The CORI technology is the latest in navigation systems for knee replacement surgery, and it eliminates the need for metal rods, CT scans and MRIs.

Jim’s story: knee replacement at OMC “completely turned my life around”

Eight months after his full knee replacement surgery, Jim Cheney feels like he has his life back. He’s hiking three-to-five miles, biking up to ten miles, and can be up on his feet for three-to-four hours with no pain. Overall, Jim is thankful to his care team at Olympic Medical Center for getting him back on his feet. READ MORE

I can spend time with my wife again on walks and bike rides. I can do all my yard work and climb up ladders and stairs...my knee replacement completely turned my life around. - Jim Cheney

Robotic-Assisted Knee Replacement at OMC

OMC knee replacement surgeons Dr. Dirk Gouge and Dr. Thomas Herschmiller utilize robotic-assisted knee surgery from Smith+Nephew’s CORI surgical system.

“It’s cutting-edge,” Dr. Gouge said. “It’s the newest robotic system on the market.”

CORI helps the surgeons make more accurate cuts, leading to optimal positioning, better soft-tissue balance and, ultimately, improved patient outcomes.

Knee Pain: Arthritis Versus Injury and What it Means for Knee Replacement

If arthritis is preventing you from doing the activities you enjoy, you might be a candidate for knee replacement surgery at Olympic Medical Center. According to orthopedic surgeons Dr. Dirk Gouge and Dr. Thomas Herschmiller, the answer is usually clear: arthritis is what leads to a knee replacement.

4 (Painful) Signs It’s Time to Consider Knee Replacement Surgery

Is knee pain preventing you from everyday activities, like walking or playing with your dog? Is your knee always stiff? Does your knee pain persist even when you’re resting?

If you’ve been dealing with progressing pain over time because of arthritis in your knee, it’s time to consider if knee replacement is the next best step. Here are four signs to watch for.

Dr. Dirk Gouge 

A graduate of Port Angeles High School, Dr. Gouge has been serving residents of the Olympic Peninsula since 1998, providing skilled orthopedic surgery at Olympic Medical Center.

“We have a great team here at Olympic Medical Center,” Dr. Gouge says. “We have a lot of experience. We have been doing joint replacements and taking care of patients for a lot of years.”

Dr. Gouge sees patients who want to play recreational sports or work in their garden or explore the Olympic Peninsula, but pain in their knee from arthritis is keeping them from doing so. For many of those individuals, knee replacement can help them return to those physical activities without the pain they were experiencing.

“I have patients that want to get back to playing golf and hiking and snow skiing and waterskiing and playing tennis…pickleball is huge around here,” Dr. Gouge says. “That’s why they do this [knee replacement] so that they can get back to those things that they want to do everyday that they’ve had to stop doing because their knee hurts too much.

“One of the biggest things about knee replacement is trying to get people back to doing those activities that they want to do.”

Dr. Gouge completed medical school at the College of Osteopathic Medicine of the Pacific before an internship and residency at Botsford General Hospital.

BIO

The CORI system helps us be more accurate with our joint replacements and also helps maintain minimally-invasive techniques. This helps improve patient’s outcomes and longevity of their joint replacement. - Dr. Dirk Gouge

Dr. Thomas Herschmiller

Dr. Herschmiller joined OMC in 2016 following education and training at prestigious institutions. After his undergraduate studies at Princeton University, he earned his medical degree from the University of Sydney in Australia, with honors.

Dr. Herschmiller, who grew up on Vancouver Island, then performed his internship and residency at Duke University Medical Center, where he held the distinguished position of chief resident from 2013 to 2014. Prior to joining OMC, he completed a yearlong fellowship in orthopedic adult reconstruction at Columbia University Center for Hip and Knee Replacement in New York City.

When patients decide knee replacement is right for them, Dr. Herschmiller generally sees those individuals return to their previous level of activity after surgery.

“A knee replacement surgery is, for some people, a new lease on life,” Dr. Herschmiller says. “It enables you to get out and do the things that you want to be able to do more comfortably without pain.”

Dr. Herschmiller adds, “It starts with nurses at the hospital, our surgical techs, anesthesia providers, the hospitalists and physicians who help with medical care and then the Home Health team that helps you afterwards.”

Dr. Herschmiller is a former Olympic athlete, having competed at the 2000 Olympics in Sydney and the 2004 Olympics in Athens, where he won a silver medal in rowing.

BIO

CORI...is the latest cutting-edge technology. We’re very fortunate to have it here at Olympic Medical Center. – Dr. Thomas Herschmiller

Your Knee Questions Answered

What is Knee Replacement Surgery?

  • Is knee replacement surgery right for you?
  • How is the surgery performed?
  • How common are knee surgeries?

How Does a Knee Work?

  • How do bones, cartilage, ligaments, tendons and muscles work together to make your knee function?
  • What separates a healthy knee from a problem knee?

What Causes Knee Arthritis?

  • What causes arthritis in your knee?
  • What are the symptoms of arthritis in your knee?
  • How can arthritis in your knee be treated?
  • Does arthritis in your knee mean you need knee replacement surgery?

What are the Basics of Knee Surgeries?

  • What are the differences between total and partial knee replacements?
  • What techniques and technologies are used in knee replacement surgeries?
  • What materials are used in knee replacements?

When is Knee Replacement Recommended? 

  • How do you know you’re ready to consider knee replacement?
  • At what age do people typically get knee replacement surgery?
  • Who is most likely to get a knee replacement?

Contact Us

If you are interested in learning more about knee replacement surgery at Olympic Medical Center, the first step is to see your primary care provider, who may refer you for an evaluation with one of our orthopedic providers. To get started, call your primary care provider; patients of Olympic Medical Physicians can call (360) 565-0999.

What to Expect

You may be nervous about surgery, but the better prepared you are before surgery, the easier your recovery program is likely to be.  Preparing helps give you the strength and skills you’ll need after surgery.

Before Surgery

Preparing for your recovery

You can make your recovery quicker and more comfortable by following these steps:

  • Building muscles that support your joint to help keep you stable while you’re healing.
  • Strengthening your arms so that it will be easier to use walking aids after surgery.
  • Preparing your home before surgery to make it easier and safer to get around.

Conditioning program

Aerobic activity (exercise that raises your heart rate) can improve fitness. It can also help you reach or maintain a healthy weight, reducing stress on your joints.

Pre-op medication

Talk to your surgeon about any medications you are taking. Your surgeon will provide instructions on which medications to stop taking in the weeks and days leading up to your surgery.

The Day Before Surgery

  • Call your surgeon’s office to confirm your arrival time.
  • You will need to shower twice within 24 hours of your surgery.
  • Review and follow all instructions and materials from your surgeon.
  • Stop eating and drinking by midnight on the day before your surgery.

The Day of Your Surgery

  • Follow the pre-operative diet and medication instructions as given by your surgeon.
  • You will need to shower before coming to the hospital.
  • Wear loose, comfortable clothing and shoes to your surgery.

Why Does My Knee Hurt?

The knee is a joint that operates like a hinge, formed where the thighbone (femur), shinbone (tibia), and kneecap (patella) meet. It is supported by muscles, tendons, and ligaments and lined with cushioning cartilage. Over time, cartilage can wear away due to usage, inflammation or injury. As it does, the knee becomes stiff and painful. Worn, roughened cartilage no longer allows the joint to glide freely, so it feels stiff and painful. As more cartilage wears away, exposed bones rub together when the knee bends, causing pain. With time, bone surfaces also become rough, making pain worse.

Frequently Asked Questions

How long will I be in the hospital?
You will be discharged when you meet certain criteria. Generally speaking, most patients return home the day after surgery. In some cases, patients even return home the same day as their surgery.

What type of car should I go home in?
Most types of vehicles are suitable. A seat that can be adjusted is best. You may bring some extra pillows in your car if needed for comfort.

When can I resume driving?
Most patients should wait for six weeks before driving. However, your surgeon may allow you to drive a little earlier than that if you can do so safely and you have stopped taking narcotic pain medication. The type of surgery, side of surgery (left leg versus right leg), and your overall general condition will play a part in the decision to begin driving again. Do not drive until your surgeon gives you the approval to do so, and never drive while on pain medications.

What infections do I need to worry about after joint replacement?

  • Urinary tract infections. Call your primary care provider.
  • Wound infections. Call your surgeon immediately; do not go to the ER.
  • Tooth abscess, broken tooth, mouth concerns. Call your dentist and surgeon immediately.
  • You do not need to worry about an infection from a cold. However, if your illness becomes worse, call your primary care provider for evaluation and treatment. You may need antibiotics to treat your illness.
  • If you are uncertain, do not hesitate to call our clinic.

When can I return to work?
Most patients wait at least six to eight weeks before returning to full-duty work. Some return earlier if they can do so safely. Discuss your situation with your surgeon prior to surgery and during your post-op appointments.

Should I be concerned if my knee incision feels warm?
As long as the incision is not reddened or draining fluid and you are not running a fever, warmth at the surgical incision will be present for at least 12-to-18 months. This is due to the increased blood flow to the surgical site that aids in the healing process.