Dr. John W. Staeheli, M.D.
List of specialities
The most gratifying part of my work is when a patient tells me how their hip replacement has “changed their life!” Hearing that is a special reward. A northwest native Dr. Staeheli graduated from Gonzaga University and attended medical school at Creighton University. After an internship in the US Navy, he was accepted to Mayo Clinic for Orthopedic Residency. Upon completion he returned to the Navy teaching orthopedic residents at Portsmouth Naval Hospital and was Associate Professor at Eastern VA Medical School. He directed the Total Joint Service for 3 years and was co-director of the Trauma Service. After the Navy, Dr. Staeheli has worked in Spokane and was Team Physician for the Gonzaga Bulldogs until moving to the Tri-Cities with his family in 1994. His interests are Joint replacement, trauma, sports medicine & foot and ankle surgery.
He is an avid skier, reader and not often enough fly fisherman. He and his wife have 3 grown children; two are serving in the US Navy (one as an orthopedic surgeon). He does volunteer work with SIGN and works in the Dominican Republic every January with a team of volunteers.
Ten Years in Total Knee Replacement
What a difference time makes! We can look back 10 years on our Total Knee Replacements and compare them to now and try to project into the future.
Ten years ago the average hospital stay was over 5 days. Now it is 3 days. That is a good thing for lowering costs because the number of knee replacements has more than doubled over 10 years and will double again in the next 10.
We used to have people pre-donate blood or consider transfusions for TKA. Now we have Bloodless Surgery Programs and eliminate the need, expense, risk and this has had a positive outcome for everyone.
Our ability to be more precise with alignment of TKA has improved significantly using a variety of techniques. Better alignment should improve longevity but we need another 10 years to know for sure.
There have been many changes over 10 years that include better pre-op education and preparation of the patient. Improved anesthesia techniques and medications. Blood loss that used to be 2-3 units are now less than 1 unit. Pain and nausea are managed much better with multi modal techniques. Hospital and OR protocols have decreased the risk of infection, thrombosis, pneumonia and other problems.
Early mobilizing – getting up and moving on day 1 reduces complications and gets people out of the hospital.
There are many social agencies that can help with discharge planning so people can go home or be discharged from the hospital sooner.
Early physical therapy improves motion and helps prevent the stiffness that some people get after a Total Knee.
There will be further improvements in the next 10 years to make a good operation better, more efficient and predictable. We may even see biological advances that will prevent or retard knee arthritis and eliminate the need for surgery for many people.
** Blood loss is minimized by several techniques. We use intra-operationally including tourniquet use, special thermal cautery tools to seal bleeding surfaces (aquamantup) Thrombin agents that help coagulate local bleeding and injectable medications that constrict bleeding vessels.