General FAQs

Answers organized by stage of care. Call 212-606-1065 (NYC) or 203-705-2113 (CT) if you don't find what you need.

Office Visits & Appointments

  • Call our office or submit an appointment request through this website. A team member will ask a few questions to confirm that Dr. McLawhorn is the right specialist for your needs.

  • Insurance card(s) and referral letter (if required), government-issued photo ID, prior surgical/medical records and operative reports, prior imaging on disc or in hard copy plus radiology reports, and your current medications and allergy list.

  • If you don't have current imaging, X-rays will be taken first — please arrive 15 minutes early. A nurse will take your vitals. Shorts are provided for the lower extremity exam. Dr. McLawhorn schedules 30 minutes for first visits: thorough history, physical exam, imaging review, and care plan discussion.

  • Whenever possible, Dr. McLawhorn prefers that patients obtain X-rays at HSS, even if imaging was recently performed elsewhere. HSS radiographs include specialized calibration markers and views used for joint replacement planning.

    If X-rays are needed, they will be obtained before your appointment with Dr. McLawhorn. Please arrive early for registration and radiology, if scheduled. A nurse will obtain your vital signs, and shorts will be provided for the examination.

    Dr. McLawhorn will review your history, perform an examination, evaluate imaging, and discuss a personalized treatment plan.

Preparing For Surgery

  • HSS is consistently ranked the #1 orthopedic hospital in the world. More joint replacements are performed at HSS than at any other hospital globally. Higher volume is associated with better outcomes. The infection rate for primary total joint replacement at HSS is among the lowest anywhere.

  • We schedule a full pre-surgical testing day: Blood work, EKG, any required imaging, and a medical evaluation with an internist, who also manages your hospital stay. You will attend a pre-surgical joint class to prepare for surgery, your hospital stay, and recovery.

    • Baby aspirin (81 mg): May be continued

    • Higher-dose aspirin and NSAIDs: Stop 7 days before

    • Plavix: Hold 7 days before

    • Coumadin: Hold 7 days before; INR must be below 1.2

    • Lovenox: Hold 24 hours before

    • Novel anticoagulants (Pradaxa, Xarelto): Timing determined by your HSS internist

    • All non-essential dietary supplements: Hold at least 7 days before

  • Dr. McLawhorn strongly recommends a one-on-one preoperative physical therapy session at HSS prior to surgery. This visit helps patients understand the recovery process, learn postoperative exercises, review assistive devices, and prepare for a smoother recovery. This appointment will be scheduled on the same day as pre-surgical testing.

    A longer trial of preoperative physical therapy is also frequently required by insurance companies as part of the surgical authorization process. In some cases, documentation that physical therapy was completed — or that symptoms were too severe for therapy to be effective — may be necessary to obtain approval for surgery.

  • No. With modern techniques including tranexamic acid (which significantly reduces blood loss), pre-surgical blood donation is rarely necessary. Directed donation from family members is also discouraged.

Surgery & Hospital Stays

  • Almost all patients receive neuraxial (spinal or epidural) anesthesia — consistently better outcomes than general anesthesia. You will also receive IV sedation so you are comfortably asleep but breathing on your own without a breathing tube. Nerve blocks and local infiltration are added for additional pain control.

  • Yes. Dr. McLawhorn personally performs all of his surgeries. As HSS is a teaching institution, orthopedic residents or fellows may assist and may participate in post-surgical inpatient care.

  • More than 90% of patients undergoing primary hip or knee replacement are candidates for same-day discharge and return home on the day of surgery. Patients undergoing revision surgery, complex primary joint replacement, or those with certain medical conditions may require an overnight stay or longer hospitalization.

  • The vast majority of patients go directly home. Dr. McLawhorn strongly encourages home recovery — his own research shows better outcomes (lower blood clot risk, lower readmission rates) for patients recovering at home versus rehabilitation facilities.

Recovery & Life After Surgery

  • HSS provides procedure-specific rehabilitation guides:

  • Yes. Dr. McLawhorn recommends antibiotics before any dental procedure — including routine cleanings — for at least the first 2 years after joint replacement. For more invasive procedures, he recommends antibiotics for life. If not allergic to Penicillin: 2g Amoxicillin one hour before. If allergic to Penicillin: 600mg Clindamycin one hour before.

  • Flying is generally considered safe beginning approximately 6 weeks after surgery. If air travel is necessary during the first 6 weeks after surgery, additional blood clot prevention is typically recommended, often with a prescription blood thinner such as Xarelto® taken on the days of travel.

    Between 6 weeks and 3 months after surgery, Dr. McLawhorn generally recommends taking a baby aspirin (81 mg) before air travel. For longer flights—including cross-country travel or international flights to Europe, Asia, or other distant destinations—stronger blood clot prevention may be recommended during this period.

    During flights, patients should wear compression stockings, walk the cabin periodically, stay well hydrated, and avoid excessive alcohol and caffeine intake.

    After 3 months, most patients can travel without special blood clot precautions or additional anticoagulation.

  • Call: 212-606-1065 (NYC) or 203-705-2113 (CT), or email: McLawhornOffice@hss.edu

  • Complete a HIPAA release form and fax or mail it to the office. Allow 5–10 business days. Imaging must be requested separately through the HSS Radiology Records Room: 212-606-1135.

Trusted Resources

Ready to discuss your options? Call 212-606-1065 (NYC) or 203-705-2113 (CT).

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