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Appointments
(720) 516-4087
(303) 694-3333
Highlands Ranch
Inverness
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How do I make an appointment?Call (720) 516-4090 to see us at our Highlands Ranch location, or (303) 694-3333 to see us at our Inverness (Steadman Hawkins) location. It's always a good idea to check with your insurance to see if you need a referral to see us.
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Do I need a referral to make an appointment?This depends on your insurance. Some insurances require a referral while others do not. Most surgical specialists recommend a referral to ensure that you are seeing the correct specialist.
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Should I see a Physician Assistant or Dr. Koonce?You are welcome to book an appointment with any of our providers. It's generally faster to get in with one of our Physician Assistants (Jordyn Roddy, PA-C or Allan Schmelzel, PA-C) than it is to see Dr. Koonce. Our PAs are experts in hip and knee pain and can diagnose your problems, provide injections, refer for other services, and even schedule you for surgery. Dr. Koonce sees every patient scheduled for surgery before the surgery date at a preoperative appointment.
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What can I expect at my first appointment?We evaluate every patient individually for past medical history, past treatments for hip or knee pain, imaging (x-rays, MRI, etc), and develop an individualized plan for each patient. We give recommendations based on available information but ultimately you make the decision on your care and pathway forward.
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What conditions do you see in your clinic?We see adult patients (age 18 and older) for all types of hip and knee pain. Our primary area of expertise is joint pain due to all types of injuries and arthritis, and if we don't treat your condition, we will refer you to a specialist that we trust who does.
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What don't you see in your clinic?Orthopedic surgery has become quite specialized, so we limit our practice to hip and knee conditions. We believe that by limiting our scope of practice, we can provide a higher level of expertise for the conditions we treat. We do not see patients for back pain, neck pain, or pain in other joints such as shoulder, elbow, wrist, hand, foot, and ankle. We have partners in the University of Colorado system that are experts in these other conditions and we are happy to guide you to the best clinics!
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What should I bring to my appointment?For your initial consultation please bring: A referral letter from another physician (if required by your insurance) Insurance card Driver's license or valid ID X-rays, MRI, CT scans, or any other relevant imaging for the joint(s) being evaluated. A CD with the images is best so we can upload them into our system. We also like to have the radiologist's report (usually a paper document) that describes the findings on the images. Your list of medications If you have had a prior hip or knee replacement and you would like that joint evaluated for a problem, it's helpful if you bring your operative report from the prior surgery. This is the surgeon's written description of how the surgery was done and what implants were used.
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What insurances do you take?We take most insurance and we also accept direct payments from patients for services. We can verify when we make your appointment whether we accept your insurance.
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What type of hip and knee replacement implants do you use?Dr. Koonce has used hip and knee products from all of the major manufacturers in the United States. He prefers Depuy-Synthes products as they have consistent data showing quality outcomes in registry studies and in his practice. It is important to note that scientific studies have not proven a benefit of one hip or knee replacement manufacturer over the others. We believe we use the best available, highest performing implants on the market. The implants are sized to each patient individually during the surgery.
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Do you do the direct anterior approach for hip replacements (incision in the front)?Dr. Koonce and his team are experts in the minimally-invasive direct-anterior approach for hip replacements. This is truly a minimally invasive approach because we go in between muscles and not through them. Compared to when we used to do this through other approaches, we have found that patients have less pain, a faster recovery, and a far lower dislocation rate. We do 100% of our primary and revision hip replacements through this approach. We teach other surgeons how to do this approach and have done more than 1500 hip replacements using these techniques.
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Do you do minimally invasive knee replacements?Our goal with knee replacements is to give you the best outcome and fastest recovery. We make the smallest incision possible to do the surgery right. Our incision is shorter than most surgeons, and we use a special closure technique to minimize your scar. The idea of "minimally invasive" surgery for knee replacements is a bit of a marketing tactic. Most knee replacements are done though an incision in the front of the knee. There is a minimum incision size to do the surgery right and get the implants in the correct position. In fact, some studies have shown that when surgeons try to do the surgery through an incision that is too small, outcomes are actually worse. All of this being said, our patients regularly comment that our incisions are smaller and look nicer than others they have seen in the community.
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How long does it take to get in for surgery?Since joint replacement is major surgery that requires insurance authorization, medical optimization, patient education, and operating room reservation, it normally takes at least 2 weeks to get in for surgery. Our goal is to get you in for surgery as soon as you would like to do it. We do our best to work around your schedule. Our wait time may be longer than 2 weeks depending on the number of patients on our surgery list.
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After we decide on surgery, what tasks do I need to complete?After we have chosen a surgery date, there are some tasks every patient needs to complete. We will get authorization for surgery through your insurance. We will ask you to: Read through our educational materials Take an online joint replacement class (HipSkool or KneeSkool) Every patient gets a preoperative medical evaluation at our hospital. There is no need to do this through your PCP unless we specifically request it. We will help you arrange this appointment. We see everyone back before surgery for a preoperative orthopedic appointment in our clinic where we review final details and sign a consent form. For some patients, we may have you check in with a specialist such as a cardiologist to make sure surgery is safe for you. We will guide you though this process and give you a list of dates and times for your preoperative appointments.
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Will I need physical therapy after knee replacement surgery?Physical therapy after knee replacement surgery is a requirement. Two variables that affect outcomes are range of motion (flexibility of the knee) and strength in the muscles around the knee. Our physical therapists know how to coach you through achieving the best range of motion and strength. In addition, they can help with things like soft tissue release, massage, icing, elevation, and monitoring your progress. The physical therapist is there to guide you and measure your progress, but most of your therapy exercises are done at home in between therapy appointments.
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Will I need physical therapy after hip replacement surgery?We love our physical therapists and very much respect their role in treating musculoskeletal conditions. Therapy can be helpful for many patients both before and after surgery. Our experience and the available scientific evidence suggest that most patients don't need physical therapy after hip replacements. Only about 20% of our patients see a therapist after hip replacement. This is different from knee replacements where physical therapy is required after surgery. We suggest no therapy for 6 weeks after surgery as your primary therapy during this time is walking. At your 6-week appointment, we are happy to provide a referral for physical therapy if either you or our surgical team feel it would be of benefit. Examples of patients who benefit from therapy are those with significant weakness, difficulties walking, a significant limp before surgery, those needing gait training, or patients who simply feel the coaching of a therapist would benefit them.
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Ho much time will I need off work?This is a difficult question to answer because every patient is different. Patients perceive pain and the stress of surgery differently, and it often depends on age, how physical your job duties are, overall health status, and motivation to return to work. Some of our patients want to get back to work quickly, while others have the benefit of sick leave and prefer to take recovery more gradually. Generally, we recommend taking 2-6 weeks off work (average 4 weeks) for recovery. Hip replacements recover slightly faster than knee replacements. We are happy to fill out paperwork for your employer if you need to take time off work. Much of this is dictated by you as it's your body and your job we are talking about.
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What sports and activities can I expect to do after joint replacement surgery?We expect that you will return to most activities after joint replacement surgery. Examples of activities our patients regularly participate in include walking, hiking, backpacking, biking, swimming, skiing, snowboarding, golf, tennis, pickle-ball, and swimming. Hip and knee replacements can be life-changing surgeries, but they are artificial joints, so they will have a few limitations. We generally recommend against impact sports or sports where you need to stop and cut quickly. You may not be able to participate in activities such as jogging, jumping, basketball, soccer, and lacrosse. While some of our patients still participate in lighter impact sports, there are limited research studies on whether this will affect the longevity of your joint, so we recommend against the sports with repetitive impact.
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