Orthopedic & Robotic Surgery

SPINE & ROBOTIC SURGERY

ORTHOPEDIC & ROBOTIC SURGERY

PAIN MANAGEMENT

OPHTHALMOLOGY

BARIATRIC & GENERAL SURGERY

PLASTIC & RECONSTRUCTIVE SURGERY

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Orthopedic Surgery

AVALA and our team of world-class orthopedic surgeons provides patients with the most innovative orthopedic treatments for musculoskeletal care including bone, joint, and muscle injuries and conditions. With the use of cutting-edge medical technology, minimally invasive surgery, and physical therapy, our goal is to reduce your pain and get you moving again.

Orthopedic Surgical Specialties
- Arthritis
- Elbow
- Foot/Ankle
- Fracture Care
- Hand
- Hip
- Knee
- Osteoporosis
- Shoulder
- Sports Medicine
Common Orthopedic Procedures
- Anterior Cruciate Ligament Repair
- Arthroscopic Surgery
- Fracture Repairs
- Joint Replacements
- Rotator Cuff Repair
- Tendon Repair
- Ulna Nerve Transposition

Robotic Joint Replacement Surgery

AVALA is one of 12 hospitals in the world with three Stryker Mako Robots and Technology. Our physicians are part of an elite training group specializing in this technology providing patients with robotic-assisted total hip, total knee, and partial knee replacements.

Benefits of Robotic Joint Surgery
- Faster Recovery Times
- Improves Screw and Pedicle Placement Accuracy
- Less Radiation Exposure
- Personalized Patient Surgery Plan
- Reduces Surgery Time
Why Robotic Joint Surgery?

Every patient is unique and can experience joint pain from arthritis for different reasons. Pain from osteoarthritis and joint degeneration can be constant or come and go each day. Different movements can also affect pain differently.

It is common for patients to try medication and other conservative treatments to treat hip or knee pain. If you haven’t experienced adequate relief with those treatment options, you may be a candidate for robotic joint replacement surgery, which may provide you with relief from your joint pain.
How Robotic Joint Surgery Works

Each patient will take a preoperative CT scan at AVALA Imaging Center. This CT scan will allow the physician to make a personalized surgical plan for each patient based on their anatomy. The preoperative CT scan allows the physician to visualize a patient’s anatomy in real-time during the robotic surgery.

During surgery, the robotic arm guides the physician based on the patient’s personalized surgical plan, to accurately place implants.

Hand Surgery

At AVALA Hospital, our hand physicians have extensive training in all aspects of the hand, including nerves, tendons, bones, and blood vessels. This elite group of hand physicians also specialize in severe cuts or trauma caused from accidents that occur at home or work environments. Our goal is to eliminate the pain and discomfort caused by injury or disease.

Most hand surgeries are completed as outpatient procedures at AVALA, meaning patients return home the same day as their procedure. Some procedures can also be completed at your physician’s clinic.

Conditions Treated
Below is a list of hand conditions treated by AVALA Hand Physicians.
- Animal Bites
- Arthritis
- Burns
- Carpal Tunnel
- Crush Injuries
- Cysts
- De Quervain’s Tenosynovitis
- Dupuytren’s Contracture
- Finger Dislocations & Fractures
- Ganglion Cysts
- Hand Fractures, Sprains, Tendonitis
- Infection/Inflammation
- Lacerations
- Ligament Injuries
- Mallet Finger/Jersey Finger
- Nerve Injuries
- Osteoarthritis
- Osteoporosis
- Paralytic Deformities
- Tenosynovitis
- Trigger Finger
- Tumors
- Wrist Fractures, Sprains, & Tendonitis

OrthoCare Walk-in Clinic
Orthopedic Urgent Care: Mon-Fri | 10am – 4:30pm

AVALA OrthoCare is an Orthopedic Urgent Care facility where no appointment is necessary! Our board-certified orthopedic surgeons will treat all bone, joint, sprains, strains, and work or recreational injuries. We have onsite x-ray and physical/hand therapy services. Skip the long and costly emergency room trips and visit AVALA OrthoCare instead! We accept patients 4 years and older.

Benefits of OrthoCare
- No more waiting at the emergency room or general urgent care
- No need to make an appointment
- No need for a referral letter to see an orthopedic specialists
Although most broken bones require just a cast or splint, you should seek immediate treatment to ensure that your bone heals properly and that there are no torn ligaments. If after your visit to an ER or urgent care center your injury requires further treatment, you will have to make an additional appointment to see an orthopedic doctor.
OrthoCare Services
With AVALA OrthoCare , you can be seen by one of our board-certified orthopedic specialists on a walk-in, no appointment basis, and receive the best care for your bone, joint or sports related concussion injuries all in one day. Our fast-track Access offers you:
- See a board-certified orthopedic specialists without an appointment: One of our board-certified orthopedic specialist will determine the best treatment options for your fracture or concussion injury.
- Prompt bone and joint exams, diagnosis, and treatment: Utilizing our state of the art equipment, such as our x-ray technology, our physicians can provide a pinpoint diagnosis and provide you with an individualized treatment plan.
- Concussion Evaluation: Our trained clinicians use neurocognitive assessment tools and services, such as ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) to scientifically validate concussions and to determine a recovery time frame for your safe return to work or play.
- Same day return to work assessments: In a timely and cost effective manner, we treat injured employees and return them back to work productivity. We offer a full range of services, from providing a work assessment at your initial visit and proper medical evaluation to suggesting safe work practices to prevent further injuries.
- Same day access to physical and hand therapists: Our physical therapists make it their goal to provide quality care and patient satisfaction.
Our dedicated team of orthopedic specialists, physical & hand therapists, and imaging specialists are focused on treating the full range of orthopedic and sports medicine injuries on a walk-in basis.

Frequently Asked Questions

Learn more about Stryker Mako robotic-assisted surgery at AVALA Hospital.

BEFORE SURGERY
- Am I too old for a hip or knee replacement?
  - While age is an important factor in your health, age alone is usually not a reason to not have knee replacement surgery. Your doctor will be more interested in your overall health and will consider a variety of things such as blood test results, your physical strength, bone density, diet/lifestyle, etc. to determine whether knee replacement is right for you.
- What kinds of test will I need before surgery?
  - Your doctor wants to make sure you’re healthy and prepared for surgery and recovery. You will likely need a physical checkup, routine blood work, and a urine test. If you’re over 50, or have a heart or respiratory issue, you may also need an EKG and a chest X-ray. Your doctor will recommend specific tests based on your specific diagnosis and medical condition.
  - If you are having a robotic-assisted total joint replacement, you will also need a CT scan taken at the AVALA Imaging Center.
  - All inpatients will be given a COVID-19 test prior to surgery.
- Should I attend physical therapy before surgery?
  - Your doctor might also ask you to get some physical therapy before surgery. Casually referred to as “prehab,” physical therapy before surgery is an increasingly common practice because studies show that patients who strengthen relevant muscles and joints before a surgical procedure will have a better recovery afterward.
- Should I attend the total joint class offered by the hospital?
  - Your case manager, who assists you before, during, and after your surgery, will schedule you to attend a pre-operative class so you and your family members learn more about what to expect and how to support you. By attending class, you and your case manager will be better equipped to plan for your surgery and recovery experience. Contact the hospital for further details about the pre-operative class.
  - Due to COVID-19 all pre-operative classes are virtual. Your case manager will send you a link to access a pre-recorded informational class.
SURGERY & HOSPITAL STAY
- When do I arrive at AVALA for my surgery?
  - AVALA will call you the day before your surgery to provide your time of arrival.
- What should I bring to AVALA the day of my surgery?
  - Driver’s license, insurance card, home medications in original bottles, facemask, loose fitting comfy clothes (pajamas, shorts, t-shirt), non-skid shoes (tennis shoes), CPAP (if applicable).
- How long will my surgery last?
  - Surgery generally lasts 1 to 2 hours.
- How long will I be in the recovery room before being taken to my inpatient room?
  - Typically, 1 hour, if anesthesia criteria has been met and a room is available.
- After surgery, will the surgeon talk to my caregiver or me about how my surgery went?
  - Typically, your doctor or one of the assisting surgeons will call to talk with your family as soon as you have been taken into the recovery room. If your family misses the surgeons call, they should contact the surgeon’s office. Your doctor’s office will arrange a time for your surgeon to discuss your surgery with your family.
- Will I experience pain after surgery?
  - Yes, pain is normal after surgery. Your pain may be different from the pain you are experiencing now. A block is given by anesthesia to help with post-operative pain. It is especially important to take pain medication 30 to 45 minutes prior to a physical therapy exercise session so that you can achieve your goals more comfortably.
- What equipment do I need after surgery?
  - Required: Rolling walker with ONLY 2 wheels in the front.
  - Recommended: Bedside commode to place over toilet to aid in the restroom.
  - Hip Replacement: Hip Kit, which consist of sock aid, reacher, shoehorn, and handled sponge.
- How long do I stay at AVALA after surgery?
  - The average length of stay in the hospital is 1 to 2 days. You and your caregiver will be staying in a private patient room with en suite bathrooms, private chef with in-room dining service, sound machines, silk sleep mask, non-slip socks, custom clothing tote bag, and 65-inch flat screen TV.
- Can my caregiver spend the night at AVALA?
  - Yes, our inpatient rooms have accommodations for your caregiver to stay with you at the hospital.
- When do I start physical therapy after my surgery?
  - A physical therapist will meet with you in your AVALA patient room to discuss your exercise plan and begin therapy a few hours post-surgery.
DISCHARGE & RECOVERY
- When will I be discharged from AVALA after surgery?
  - It depends on you, your recovery process, and your doctor’s recommendation. Most people go home within one to two days after surgery. You will discharge after your therapy sessions.
- What happens after I am discharged from AVALA?
  - You will go home with home health for 2 weeks or go straight to outpatient physical therapy pending your recovery progress.
- Do I need assistance at home?
  - Yes, you will be able to care for yourself but will need assistance with household and driving duties.
- What if I do not have a caregiver?
  - It is very important to discuss your options with your surgeon and/or AVALA case manager.
- Should I go home or to a rehab facility after leaving the hospital?
  - It is recommended that someone assist you full time for the first 48-72 hours after discharge. After that, you will still need assistance part time for a minimum of one to two weeks. Your case manager will arrange for continued physical therapy either at home or at an outpatient facility. If you live alone or may need extra assistance getting out of bed or standing from a chair (or if you home has lots of stairs and no bathroom on the first floor, for example), your case manager may recommend that you spend a few days in a rehab facility. Talk with your case manager to decide the best plan for you. Rehab depends on several factors (progress with PT, bed availability at facility, and insurance approval).
- How long do I go to Physical Therapy after surgery?
  - You will attend physical therapy for 4 to 8 weeks, everyone heals at different rates, and your recovery time may be shorter or longer.
- After surgery, how soon can I get back to daily activities?
  - Most people who undergo knee replacement surgery and participate in a physical therapy regimen prescribed by their doctor, return to their day-to-day activities, such as driving, in four to six weeks. However, everyone is different. Your doctor will help determine a plan best suited for your recovery and your lifestyle.
- When can I return to work after surgery?
  - Everyone is different, but most people do not return to work until after their six-week post-op checkup. Talk with your doctor for recommendations based on your job duties, your surgery, and your recovery.
- When can I drive after surgery?
  - Average time to begin driving after surgery is 4 to 6 weeks.
- When can I walk up and down stairs?
  - Although everyone is different, you will practice walking up and down stairs in physical therapy at AVALA before you discharge if you have stairs in your home. If your doctor allows, you can climb stairs once or twice a day at home during your recovery.
- Will I have pain after I leave the hospital?
  - Most people who have had a total joint replacement need a short course of medication to manage their pain. You may only need the medication at night or before physical therapy. Talk with your doctor about what to expect.
- When do I see my surgeon again?
  - You should connect with your physician’s office to schedule your post-op appointment. Post-op appointments, after a total joint replacement is typically 2 weeks, 6 weeks, 3 months and 1 year.

Clinic Locations: Covington, Hammond

Timothy Devraj, MD

Clinic Location: Covington

Orthopedic Surgery

Robotic Joint Replacement Surgery

Hand Surgery

OrthoCare Walk-in Clinic
Orthopedic Urgent Care: Mon-Fri | 10am – 4:30pm

Frequently Asked Questions