Two key members of the joint replacement team


Christine Thompson, RN, (left) and Dhara Soni, PA-C
Christine Thompson, RN, (left) and Dhara Soni, PA-C, help patients navigate their joint replacement surgery journeys.


While the focus of Greenwich Hospital’s Total Joint Replacement Program is often on the skilled orthopedic surgeons who replace patients’ worn or damaged hips and knees with prosthetic ones, it takes a team to accomplish these procedures.

Dhara Soni, PA-C, is the clinical manager for the hospital’s surgical physician assistant (PA) program. She is one of nine PAs who collaborate with surgeons – before, during and after every operation – primarily in orthopedics, but also in other specialties, including general surgery, neurosurgery, bariatrics, vascular, thoracic, urology and plastic surgery. “Our role extends from admitting patients to first-assisting in the operating room and postoperative management in the hospital,” Soni explained.

In the operating room, surgical PAs help position patients on the operating table, then work alongside the anesthesiologists, nurse technicians and surgeons throughout the procedure. Postoperatively, physician assistants monitor patients’ progress, review test results, order medications, and assess for any postoperative complications. They collaborate with consulting physicians for comprehensive care, help nurses with wound care and pain management regimens, and coordinate with physical therapists and social work for discharge planning. Maintaining a breadth of knowledge about multiple surgical specialties is challenging, Soni said, “but it keeps our skills sharp in many different techniques, including robotics and laparoscopy.”

Even before patients arrive at Greenwich Hospital for joint replacement surgery, Christine Thompson, RN, is already playing her part as the program’s nurse navigator. Thompson is a certified orthopedic nurse who is responsible for guiding each patient through the entire process. “I get in touch prior to surgery to review their medical history and make sure they know what to expect when they come to the hospital,” said Thompson.

She also conducts weekly webinars that provide preoperative education on joint replacement, and meets individually with patients when they are admitted to answer any questions and review details for discharge. “Explaining things to patients can alleviate their anxieties associated with surgery,” Thompson said.

“Once they are home, I call within 48 hours to ask how they’re getting around, and to talk about wound care and medications,” Thompson added. She follows up again after three weeks, three months and one year. “That’s when I reevaluate their quality of life since the surgery, including their physical improvements and emotional state.”

While the joint replacement team appreciates her efforts, Thompson said educating patients is the favorite part of her job. “They often thank me for taking the time to clarify everything, and that never gets old.”