FAQs

How do I schedule an appointment?

The friendly staff at the office welcomes your inquiry at   and is ready to provide you with answers. To schedule an appointment, please call our office or you can use our secure online form.

Do I need a referral to make an appointment?

You do not need a referral to see Dr. Harb. He is accepting new patients at this time.

What are the directions to your main office?

The main office is conveniently located in northwest Washington, DC between 18th and 19th Streets on M Street NW. It is located 2 blocks from the Farragut West, Farragut North, and Dupont Circle Metro stations. A parking garage and metered parking are available nearby.

How long do I need time off work after the surgery?

The post-operative recovery period varies based on the surgery. Generally, it is recommended patients take two weeks off work to recover from any surgery and to resume light duty following resumption of work. Dr. Harb will give you specific instructions to follow for a successful recovery.

How long before I can resume driving?

Dr. Harb does not recommend driving for 6 weeks after surgery. You must have full control of your leg and be off narcotic pain medication to resume driving.

When can I resume exercise?

Exercises should be started immediately after surgery. Post operative exercises are included in the joint replacement booklet. You will setup with outpatient physical therapy after your joint replacement to work on range of motion and strengthening exercises.

How do I contact after hours?

If you have an urgent medical need and need to talk to our doctors after our regular hours, please call the Office of at  . A doctor is on-call 24 hours a day. Your call will be returned promptly.

I have a billing question. Who do I call? If you have a question related to your bill or insurance, please contact the billing specialists at the Office of orthopedic Medicine & Surgery at  

What are the non-surgical treatment options?

The non-surgical treatment options include conservative therapy with physical therapy, anti-inflammatory medications, cryotherapy, injections, and physical therapy.

Will physical therapy be required after surgery?

Yes physical therapy will be required to get full range of motion, strength, and flexibility back after surgery. That is where pre-operative exercise, education, and post-operative physical therapy programs come in – to ensure you are physically prepared for surgery and to maximize your recovery after surgery.

Activity

• You are allowed to put all of your weight on your operative leg.
• Be mindful of your pain. If something hurts too much you should stop.
• A walker should be used initially and then you can transition down to a cane.
• From a cane you can transition down to no walking aids.
• The most important goal after surgery is to prevent any falls in the post-operative period.
• Everyone recovers and heals differently and at different speeds.
• There are no restrictions on how much you can walk.
• You can use a pillow between your legs at night to sleep more comfortably, as needed.
• You should receive physical therapy either at home or at a physical therapy facility.
• The goal of the first 6 weeks after surgery is regaining motion, restoring flexibility, and preventing the joint from getting stiff.
• Try to avoid high impact activities until recovered. The best activities are low impact which include stationary bike, water exercises, aerobics, and elliptical.

What is arthritis?

Arthritis is a complex family of musculoskeletal disorders that can affect people of all ages, race, and genders. It takes many forms, but there are three common types of arthritis.

• Osteoarthritis – the most common type of arthritis. It is a progressive degenerative joint disease that involves the breakdown of joint cartilage.
• Rheumatoid Arthritis – a systemic form of arthritis, which is characterized by the inflammation of membranes lining the joint. This causes pain, stiffness, swelling, and may cause severe joint damage.
• Juvenile Arthritis – autoimmune / inflammatory arthritis that can develop in children age 16 and under.

What is joint replacement?

Joint replacement involves removing the worn and damaged portions of the knee or hip and replacing them with an artificial joint. This happens because the cartilage of the joint wears out. Joint implants are typically made of titanium, cobalt chromium, ceramic, and plastic. The goal of the joint replacement is to decrease pain and improve function.

Will I need a blood transfusion?

Modern joint replacement almost never requires a blood transfusion. I use a special medication called tranexamic acid which minimizes blood loss during the operation along with electrocautery.

How long is surgery?

The length of surgery from incision to closure is usually around 60 to 90 minutes. There is extra time associated with getting you into the room, positioning you on the table, as well as waking you up and getting you to the recovery unit. In total you are looking at about 2 hours from the time you enter the operating room.

Will I need pain medications after discharge?

Yes, you will need pain medications after discharge. Our goal is to minimize narcotic pain medications as much as possible while keeping your pain under control and keeping you comfortable. Expect to take anti-inflammatory medications and Tylenol for several weeks after discharge. Opioid medications have negative effects such as constipation, respiratory depression, as well as cause a decrease to tolerance to pain. They can be used for breakthrough pain in the post-operative period. You may need to take extra anti-inflammatory medications and Tylenol before sleeping at night and before therapy sessions. Ice is your best friend after surgery to help decrease swelling and inflammation.

How is a hip replacement performed?

A small minimally invasive incision is made over the front of the hip and a direct anterior approach is performed. The incision is usually 3-4 inches (8-10cm) in length. In certain complex or revision cases an incision over the side of the hip may be performed. The damaged bone is cleared away and the surfaces are prepared and shaped to hold the new implants. The implants are aligned and secured to the thigh bone and pelvis for immediate weight bearing.

How is a knee replacement performed?

A small minimally invasive incision is made over the front of the knee. The incision is usually 3-5 inches in length. The damaged bone is cleared away and the surfaces are prepared and shaped to hold the new implants. The implants are aligned and secured to the thigh bone (femur) and leg bone (tibia) for immediate weight bearing.

What are the risks of joint replacement?

There are potential complications associated with any surgery. These risk are extremely low, less than 0.5%, but it is important that you are aware of them. All precautions are taken to prevent these risks from occurring.

Infection
With all surgery there is a risk of infection. This risk goes up with more medical comorbidities, smoking, obesity, diabetes, and autoimmune disease. Antibiotics are given before and after surgery. The surgical site is cleaned multiple times with antimicrobials prior to incision being made which will further prevent infection.

Blood Clots
To reduce risks of blood clots after surgery I will prescribe Aspirin 81mg twice a day to be taken for a total of 6 weeks. Early ambulation, foot pumps, and compression stockings will help circulate blood and prevent blood clots. Moving around will prevent blood clots.

Dislocation is a very small risk for hip surgery
I perform a direct anterior approach for hip replacement which goes between the muscles and has an incredibly low risk for dislocation. In high energy falls or trauma the hip can still dislocate. Take precautions against having any falls post operatively.

Numbness around the incision
It is not uncommon to have numbness around the incision or over the front of the thigh after surgery. This will fade and improve with time. To many patients this is not noticeable.