Appointment Scheduling Patients are seen by appointment only. To schedule an appointment at USC Orthopaedic Surgery Associates, Inc. please call (323) 442-5860. Our reception staff can assist you in making your appointment.
Office Address
USC Orthopaedic Surgery Associates, Inc
Health Consultatin Center II
1520 San Pablo Street, Suite 2000
Los Angeles, CA 90033
Phone: 323-442-5860
Fax: 323-442-6990
Click Here For Directions
Items Patients Need to Bring to Visit
All old records, x-rays, CT scans, MRI?s. Always bring the actual films if available. Shoulder problem tank top or jog bra Knee problem pair of shorts Elbow problem short sleeve shirt For a new patient’s initial visit, Dr. Hatch will require new or at least recent x-rays of the affected extremity. Please be aware that new patients or those who require x-rays may be asked to come in early to obtain these important studies.
Pre-Sugical Preparation
Surgical Scheduling: Surgical Scheduling is done by Norma Sifuentes (323) 442-5746.
Pre-Surgical Preparation: Do not eat or drink anything after midnight the night before your surgery. On the morning of your surgery, do not apply deodorant under the arm of the shoulder which will be operated. If you are having out-patient surgery and going home after your surgery, make sure you have someone who can drive you home later in the day.
Post-Operative Information
1. What to Expect After Arthroscopic Shoulder Surgery
It is normal to have swelling and discomfort in the shoulder for several days or a week after surgery.
Apply ice bags or use the cryocuff you were given to control swelling. Ice should be applied 20-30 minutes at a time, every hour or two; put a thin towel or T-shirt next to your skin if using ice in a plastic bag. Icing is most important in the first 48 hours, although many people find that continuing it lessens their postoperative pain.
If you had a nerve block, the local anaesthetic may keep your shoulder numb for several hours. You will be given a prescription for powerful pain medication when you are discharged from the hospital. If you find you do not tolerate it well, call our office and we will try another one.
Many patients find that lying down accentuates their discomfort. You might sleep better in a recliner, or propped up in bed. A pillow placed behind your elbow may also help.
Keep the postoperative dressing clean and dry. Unless it becomes wet or too tight because of swelling, leave the bandages in place for at least two days. TWO DAYS AFTER YOUR SURGERY REMOVE YOUR BANDAGES. Cover incisions with Band-Aids to keep from snagging the sutures on clothes. You may shower then, but try to keep the incisions dry for the first 10-14 days. Do not wet your incisions directly (bathing or swimming) until at least 2 weeks postop.
The sutures are absorbable and do not need to be removed.
We would like to see you back in the office 10-14 days after surgery. If you don’t have your first post-operative visit scheduled, call our office to make one.
Start your postoperative rehabilitation/physical therapy right away. Your physical therapy program is key to a successful outcome. It should be started the day after surgery. A separate prescription will outline the protocol. It often helps to call before surgery to make an appointment with your physical therapist. PUMP YOUR HAND AND MOVE YOUR WRIST AND ELBOW TO KEEP THE BLOOD CIRCULATING AND PREVENT STIFFNESS.
Be in the care of a responsible adult.
Abstain from drinking alcoholic beverages and from smoking.
You may eat a regular diet, if not nauseated.
Drink plenty of non-alcoholic, non-caffeinated fluids.
Do not make important decisions or sign legal documents.
Plan to take a few days off work.
2. What to Expect After Other Specific Shoulder Procedures
General Comments
Recovery from shoulder surgery can be lengthy and variable. Frequently it is 6-12 months before maximal improvment is reached. The shoulder joint is highly complex with significant variability among patients both in the severity of the injuries that occur and in their ability to recover and heal.
Arthroscopic Release of a Frozen Shoulder
Patients often remain in the hospital for two days in order to have pain control by intravenous medicines or by a catheter that numbs the nerves down the arm. You should arrange in advance for your physical therapy to start immediately on discharge from the hospital. This is important so as not to lose any motion gained by the arthroscopic release. You should start to use your arm right away and not wear your sling. Therapy is usually ordered for every day (five days/week) for the first two weeks and then adjusted by us after your first office visit.
Total or Partial Shoulder Replacement for Arthrithis or FractureL
Therapy may or may not begin immediately on leaving the hospital. You will be instructed if you can do pendulum exercises on your own and you may see a therapist in the hospital for therapy. This depends on the type of surgery you have. You can use your arm from the elbow down but no active motion of the shoulder until ordered by us. We will review this with you on your first visit after surgery.
Shoulder Stabilization or Labral Repair for Instability
There will be a period of immobilization (no motion) of your shoulder while the repaired tissue heals. This varies from 3-6 weeks. You will be instructed if you can do pendulum type exercises on your own. This depends on the type of surgery you have. You can use your arm from the elbow down but no active motion of the shoulder is permitted until ordered by us. We will review this with you on your first visit after surgery.
Subacromial Decompression or Acromioplasty for Impingement You will be permitted and encouraged to move your shoulder right away and you should plan to start therapy with a physical therapist within a few days of your surgery. The first few weeks will focus on regaining normal motion. After this a strenghtening program will be initiated.
Rotator Cuff Repairs The tendon repair needs 4-6 weeks to heal so active motion of the shoulder is not permitted during this time. Therapy will usually begin after your first visit to us and will be passive motion performed by the therapist. In some cases we will allow you to go in a pool and do motion under water where your arm will be weightless. You will need to wear your sling for 4-6 weeks. After this period you will begin a program of active motion and, eventually, strengthening.
Tendon Transfers for Massive Rotator Cuff Repairs or Shoulder Winging These are highly specific procedures that are tailored to the individual situation. Most are immobilized for at least 6 weeks while the transferred tendon heals. After this period you will begin a program of active motion and, eventually, strengthening.
Fixation of Clavicle (Collar Bone) Fracture with Plate or Pin
There will be a period of immobilization (no motion) of your shoulder while the fractured bone starts to heal. This varies from 1-3 weeks. You will be instructed if you can do pendulum type exercises on your own. This depends on the type of surgery you have. You can use your arm from the elbow down but no active motion of the shoulder is permitted until ordered by us. X-rays will be checked post-operatively to assess healing.
Repair of Shoulder (AC Joint) Separation
The shoulder will be immobilized strictly for six weeks in a sling while the repaired tissue heals. You may use your hand below the elbow but you cannot move your shoulder. Therapy will usually begin at 4-6 weeks with passive motion performed by the therapist. After this period you will begin a program of active motion and eventually strengthening.
Biceps Tendon Tenodesis for Tears or Tendonitis
A sling will be used for for 3 weeks while the tendon is healing. Passive elbow passive range of motion (extension and flexion) is permitted although it is important to avoid pushing extension. At 4-6 weeks active elbow flexion is allowed. Strenghtening begins thereafter.
3. What to Expect After Arthroscopic Knee Surgery
It is normal to have swelling and discomfort in the knee for several days or a week after surgery.Apply ice bags or use the Cryocuff you were given to control swelling. Ice should be applied 20-30 minutes at a time, every hour or two. Put a thin towel or T-shirt next to your skin if using ice in a plastic bag. Icing is most important in the first 72 hours, although many people find that continuing it lessens their postoperative pain.If you had a nerve block, the local anaesthetic may keep your leg numb for several hours. You will be given a prescription for powerful pain medication when you are discharged from the hospital. If you find you do not tolerate it well, call our office and we will try another one.
KEEP THE LEG ELEVATED. This will prevent swelling and help decrease pain. The leg must be elevated higher than the level of your heart. PUMP YOUR ANKLES UP AND DOWN. This should be done several times an hour to keep the blood circulating in your leg and to help prevent blood clots from forming.
Keep the postop dressing clean and dry. Unless it becomes wet or too tight because of swelling, leave the bandages in place for at least two days.
REMOVE YOUR BANDAGES TWO DAYS AFTER SURGERY. Cover the small incisions with Band-Aids to keep them from snagging the sutures on clothes. You may shower then, but keep the incisions dry for the first 10-14 days. Do not wet your incisions directly (bathing or swimming) until at least 2 weeks postop.
The sutures are absorbable and do not need to be removed.
Dr. Hatch would like to see you back in the office 10-14 days after surgery. If you don’t have your first post-op visit scheduled, call our office to make one.
Start your postoperative rehabilitation/physical therapy right away. Your physical therapy program is key to a successful outcome. It should be started the day after surgery. A separate prescription will outline the protocol. It often helps to call before surgery to make an appointment with your physical therapist.
Be in the care of a responsible adult.
Abstain from drinking alcoholic beverages and from smoking.
You may eat a regular diet, if not nauseated. Drink plenty of non-alcoholic, non-caffeinated fluids
Plan to take a few days off of work.
4. Antibiotics after Joint Replacement
PROTOCOL FOR ANTIBIOTICS AFTER JOINT REPLACEMENT
The development of infection following total joint replacement is a serious problem. Although rare, there are documented cases of such infection caused by bacteria introduced into the bloodstream during certain dental procedures. Various approaches can be taken towards preventing this, especially with regard to the use of antibiotics before undergoing a dental procedure. The faculty has recently reviewed the medical literature and advisory statement put forth by the American Academy of Orthopedic Surgeons and the American Dental Association, and they offer the following recommendations.
PROPHYLACTIC ANTIBIOTICS SHOULD BE GIVEN TO:
1) All patients who have had a joint replacement within two years, regardless of the type of dental procedure or patient health status.
2) All patients, who are immunocompromised, have insulin dependant diabetes mellitus, or systemic inflammatory disease such as rheumatoid arthritis or systemic lupus erythematosis, regardless of how long ago they have had surgery.
3) All patients, regardless of health status or how long ago they have had surgery, who are having invasive dental procedures. These include extractions, periodontal procedures, dental implant placement, root canals or teeth cleaning likely to cause bleeding.
Prophylaxis should consist of a single 2-gram dose of amoxicillin or cephalexin given orally one hour prior to the dental procedure. In-patients, who are allergic to penicillin, 600mg of clindamycin may be given instead. If a patient is unable to take oral medications, 1-gram of IM/IV cephalexin or 2-grams of IV/IM ampicillin is recommended. Finally if a patient is allergic to penicillin and unable to take oral medications a single 600mg dose of IM/IV clindamycin should be taken one hour prior to the dental procedure.
If you are undergoing a dental procedure, or even some other invasive procedure such as cystoscopy or sigmoidoscopy, you should inform your dentist or doctor that you have had a joint replacement. Please call our office if you have additional questions or need a precription.
After Hours Process
After Hours Process For questions after hours, please call the office at 323-442-5860 and leave a message. This will be promptly answered the next day. For emergencies, please try to contact Dr. Hatch directly through the page operator. If unsuccessful, please call the orthopaedic surgeon on-call at USC University Hospital If in doubt or in an emergency, please proceed directly to the emergency room closest to your home. Please note that Dr. Hatch provides 24-hour in-house resident and staff coverage by orthopaedic surgeons from USC University Hospital.
Appointment Scheduling Information
Surgical Scheduling for Dr. Hatch: Surgical Scheduling is done by Norma Sifuentes (323) 442-5746. To schedule an appointment with Dr.Hatch please call (323) 442-5860. Our reception staff can assist you in making your appointment.
Additional Information
1. Prescription Refill Policy
Routine medication refills are done ONLY during working hours, Monday through Friday, between 8:30 am and 5:00 pm. Presriptions will not be refilled after hours or on weekends. This policy is designed to enhance proper documentation of prescriptions and prevent medication errors after hours due to inaccessibility of patient’s records.
2. Narcotic Pain Medications
Narcotics are highly addictive pain medications that can create side effects such as constipation and lethargy.Many narcotics, such as Percocet, Darvocet, and Vicodin, also contain acetominophen (Tylenol), which if taken in increasing doses can cause liver failure and even death. Narcotic pain medications are highly addictive and must be used with caution because they cause tolerance, whereby the body adapts to them and, in order to achieve pain relief, the body requires increasing doses.
For these reasons, Dr. Hatch prescribes narcotic pain medications with caution. Nevertheless, in the appropriate situations, such as after an injury or after surgery, Dr. Hatch will provide prescriptions for pain medicines for patients with acute pain.
Dr. Hatch does not specialize in chronic pain management. If pain becomes a chronic problem or if the requests for narcotics become excessive, disproportionate to the clinical problem, or prolonged (greater than 2-3 months from injury or surgery), Dr. Hatch will refer you to a Pain Management Clinic in order to receive specialist care for this area.
Also note, that it is the strict policy of this office that narcotics and other pain medication prescriptions will NOT be refilled on weekends or after hours.
3. Primary Care Physcian (PCP) referrals
Please review your insurance policy requirements to determine if you need a referral from your primary care physician prior to visiting us. If you do not have the approriate referral, you will be charged for the visit or asked to re-schedule.
4. Insurance information
Please remember to bring your insurance card to your appointment. A copy of your insurance card will be requested at the time of check-in. New appointments: In order to expedite your check-in and maintain waiting times to a minimum, we ask that new patients show up 15 minutes before their appointment. This allows for processing necessary administrative information and fill out forms. Patients who require x-rays may be asked to arrive one hour earlier than the appointment with the doctor.
5. Appointment cancellations
Dr. Hatch has a waiting list for appointments. Therefore, we request that patients who must cancel their appointments do so AT LEAST 5 days prior to the scheduled visit, in order to give other patients an opportunity to be scheduled on your cancelled time slot.
6. Bring shorts or tank top
Our evaluation includes thorough examinations on every patient. This is facilitated by good exposure of the extremity being examined. Please bring appropriate clothes to change into, to allow for adequate evaluation.
7. Additional material pertinent to your orthopedic problem
Please bring all pertinent X-rays, operative reports, other clinic notes, and therapy notes when other providers have rendered previous evaluation or treatment. All this additional information can be of importance in your evaluation.
8. Patient Waiting Times
We pride ourselves by minimal patient waiting times in our office. We do appreciate your patience and understanding with delays. We do ask our patients to contribute to efficient patient flow by being on time for their appointment and by bringing all requested materials to the visit. In fairness to other patients, patients who are late may need to reschedule or wait for other scheduled patients that have been on time.
9. Other Accommodations
On-Site X-Ray Facilities at Health Consultation Center II USC Orthopaedic Surgery Associates Office On-Site MRI Scan in same building with USC Department of Radiology Multi-Lingual Staff and Interpreters Available On-site Physical Therapy
10. International Patients
We are happy to assist with all travel and housing arrangements for those traveling from afar. Please telephone us ahead of time so that we can help coordinate your visit. We have interpreter services available for most languages.