However, there is a new approach to joint replacement that, for many patients, allows them to leave the hospital the same day of surgery.

To find out more, we spoke with Sumon Nandi, MD, associate professor of orthopaedics and chief of adult reconstruction at the University of Maryland.

Why did you become an orthopaedic surgeon?
In medical school, I was really moved by how important mobility was to an individual’s quality of life and how it is often a part of one’s identity. The orthopaedic surgeons I had the privilege of working with could restore patients to a state of pain-free mobility with a single surgery, which made me want to help patients this way. It is inspiring to see them walking around after surgery when they were previously restricted to use of a walker or wheelchair.

What is your patient care philosophy?
I care for patients as I would hope another physician would care for my own family. An orthopaedic surgeon should be your partner in your joint replacement journey. I try to give honest advice as it relates to an individual patient’s health considerations, and discuss how we might achieve an optimal outcome.

Who should consider a joint replacement?
Total joint replacements of the hip or knee are used for several reasons: patients have arthritis resulting in all of the cushion (cartilage) in the joint wearing away; they’ve tried everything short of surgery (physical therapy, joint injections, anti-inflammatory medications, braces, and assistive devices like a cane/walker) with no relief; and/or their pain prevents them from enjoying desired activities.

How can patients avoid needing this surgery?
Total joint replacements are performed for arthritis, and there is a genetic component to the development of the condition that is not avoidable. Thus, even normal activities may ultimately result in arthritis in many people. At what age arthritis occurs varies—some patients make it into their 90s without significant arthritis, while others may need a joint replacement at the age of 50.

Are you ever too old or too young for a joint replacement?
Research shows knee replacement outcomes are best when a patient is at least 50. There is no such minimum age defined for hip replacement surgery. A total joint replacement surgeon will carefully discuss the degree of arthritis observed on x-rays and the benefits of proceeding or delaying surgery based on a patient’s age.

Describe for us the recovery process.
To achieve the outcome you want, it is critical to discuss your expectations for recovery after surgery and how your surgeon envisions your rehabilitation. We expect all patients to be up and walking the day of surgery. Those eligible for rapid recovery joint replacement can return home the same day. Patients with pre-existing conditions that require monitoring are discharged the morning after surgery. I see my patients back in the office for follow-up two weeks after a knee replacement and six weeks after a hip replacement.

What’s your best advice for a successful replacement?
First, find an orthopaedic surgeon who specializes in hip and knee replacements. Patients should also stop smoking and have any chronic medical problems, like high blood pressure or diabetes, well-controlled. This will help minimize infection risk. Do your best to follow instructions regarding care of your wound and activity after the procedure. Communicate with your surgeon about any questions you have after surgery so they can help guide you to your best possible outcome.

Anything else people should know?
I am exceptionally proud of the care provided by University of Maryland’s joint replacement team. If you think surgery might be for you, I am confident you will find our physicians committed to safety, quality, and an overall outstanding patient experience. I feel fortunate to work with them every day.

To schedule an in-person or virtual telemedicine appointment with Dr. Nandi, call 410-448-6400. He practices in Columbia, Downtown Baltimore and Hunt Valley.

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You might know that there are systems in place that provide a safety net for people living with disabilities. But you might not know that the most vulnerable individuals only qualify for that safety net if they have less than $2,000 in total assets. You read that right. If at any point a person receiving certain disability benefits has more than two grand to their name, they’re cut off. No more assistance. No more safety net. Just uncertainty, frustration, and fear.

First Maryland Disability Trust, Inc. (FMDT) is a nonprofit that was formed by a group of disability and elder law attorneys in 2005 whose mission is to improve the quality of life, dignity, and independence of Marylanders of all ages living with disabilities. They knew that public benefits alone could never meet all the needs of an individual with disabilities. The average Supplemental Security Insurance (SSI) payment in 2022 is only $841 per month. Try covering basic bills on $900, much less the additional costs that might be associated with managing a disability.

Different trusts suit different needs, but the core concept is the same—rather than spending down income and assets to meet public program requirements, a trust can help an individual protect their assets while preserving their eligibility for benefits. A first-party disability trust is funded by an individual’s own assets, and is often used when a person with a disability comes into a windfall such as an inheritance or a court settlement. A third-party trust is a supplemental needs trust created by family or friends of an individual with disabilities, and can be funded by any source except the individual themselves. FMDT even offers pooled trusts, which improve access to benefits and create more efficient trustee services.

Funds in an individual beneficiary’s account can cover all sorts of expenses that are essential to maintaining a certain quality of life but that would quickly exceed a tight budget. This is everything from clothing to home improvement, travel accommodations to cable TV, even healthcare that isn’t covered by public or private insurance—the list goes on. With significant expertise and years of experience, FMDT seeks to empower people living with disabilities to live life to the fullest.

FMDT is open to any individual, regardless of age or disability, and can help you plan for your own needs or those of a loved one, now and into the future. Participants must be individuals with disabilities as defined by the Social Security Administration, and they must be willing to place their assets in trust for their lifetime.

The nonprofit accepts new beneficiaries referred by attorneys, state and local courts, advocacy groups, and more—even this magazine can count as a referral! FMDT does advise all clients to meet first with a special needs attorney, as they don’t offer legal services. But don’t hesitate to ask FMDT to connect you with one of their trusted, experienced partners. After nearly two decades, they know who to call. In fact, in addition to referring potential clients to attorneys, FMDT is on-hand to assist attorneys in all areas of practice.

Bringing a dedicated personal touch to their trust management services, FMDT partners with legal experts, financial planners, and disability advocates to create comprehensive plans that support the well-being of the whole individual. So while the benefits of a basic safety net may or may not be enough to get by, let FMDT help you reclaim control of your assets—and your life. Go to www.firstmdtrust.org/ to get started.

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