NWOC August 2020 Update

I am happy to report that despite the COVID-19 pandemic, Proliance Surgeons have returned to work. We are close to achieving 90% of our pre-pandemic work volumes. Proliance Surgeons and our clinics have been diligent in following the federal and state mandates to protect patients, staff, and healthcare workers. We have practiced social distancing in our clinics, along with mask and appropriate gloves for exams. Several clinics and physicians have used telemedicine, when appropriate, for clinic or postoperative follow ups to limit patient exposure in the clinic. We continue to test all surgical patients in advance of their procedure. Patients must have a negative COVID-19 test within 72 hours of their scheduled elective surgery.

Many patients have chosen the outpatient surgical setting for procedures. This includes total knee, total hip, and arthroscopic sport medicine procedures. To date, I am happy to report that there are no COVID-19 exposures in my office or through the outpatient ambulatory surgery center at Seattle Orthopedic Center. We continue to strive to serve the orthopedic needs of our community, while maintaining everyone’s safety and health as our #1 priority. Many patients have been relieved to have their orthopedic surgical procedures performed, since our reopening in mid-May of this year. Our clinic plans to continue clinic and surgical services weekly, and do not anticipate any further shutdowns at this point in time. We look forward to serving you and your family’s orthopedic needs this summer and fall. Our clinic enjoys personalizing your orthopedic care and developing a relationship during the pre and postoperative rehabilitation period. You will always see Dr. Clark during your clinic visits while under our care.

We look forward to seeing you in our clinic in the near future. Please feel free to contact us by phone or e-mail to schedule an appointment. Stay safe and healthy during these extraordinary times. Call 206-526-8444 for an appointment, or schedule online. Have a great summer in the Pacific Northwest!

Herbert R. Clark, M.D.

NWOC March 2020 Update

March 12, 2020

Dear Patients and Colleagues:

The COVID-19 pandemic continues to dominate healthcare news. It is important to follow the healthcare guidelines set out by the CDC to limit the spread of the virus especially here in Seattle, which is the epicenter of the corona virus. My web page has a link to the Proliance and CDC guidelines for your education.

On a different note, I would like to encourage patients of all ages to enjoy good joint health this spring. There are many factors that contribute to joint health and preserving articular cartilage. These include, but are not limited to weight reduction to an appropriate BMI, eating a healthy low-inflammatory diet, and low-impact cardio exercises that maintain our fitness without wearing out our joints at an early age. There are many vitamins, supplements, and herbal remedies claiming to promote joint health. I encourage all of my patients to thoroughly research, through reputable web sites, any supplements, vitamins, or herbal remedies which they are considering taking. Many of these medications are not controlled by the FDA and contain additives in varying quantities that patients may chose to avoid taking.

Orthopedically, we treat patients at the early stages of osteoarthritis (loss of articular cartilage in the joints) with activity modifications, anti-inflammatory medications, physical therapy, and an anti-inflammatory diet. Injections for osteoarthritis include cortisone, viscosupplementation (hyaluronic acid), platelet rich plasma (PRP). Stem cell injections continue to be heavily marketed to the consumer; to date, I am unaware of any level 1 studies that show stem cells regrow articular cartilage in our joints. The more advanced osteoarthritis is in our joints, the less successful conservative management or injections work. When pain of an arthritic joint has taken over a patient’s quality of life, then it is time for them to consider joint arthroplasty surgery.

I again encourage all of us in the greater Seattle area to be vigilant during this time of the corona virus pandemic. Hand washing, social distancing, and limited community exposure are essential in containing the spread of this virus. I look forward to seeing you for your orthopedic needs in my office and I am happy to discuss your joint health and tailor a treatment protocol specific to your situation and orthopedic needs. Please continue to enjoy the incredible outdoor opportunities offered in the great Northwest.
Stay healthy, active, and engaged with your family and friends this spring.

Herbert R. Clark, M.D.

Important Announcement

Health and safety of our patients and staffs remain our first priority at all time.

As the national emergency has been declared over coronavirus (COVID-19), we will be providing a limited care service to urgent and emergent (“non-elective”) encounters only, from Tuesday March 17th 2020, through Friday, March 27 (with further review planned at that time).

For existing appointments, we are mandated to postpone all non-urgent, non-emergent clinical visits over the same period of time.

Thank you for your understanding.


Updated (March 10, 2020):

Information source: Proliance Surgeons

The CDC has shared these resources and recommendations for healthcare facilities as this COVID-19 virus progresses through our communities.

Original message (March 2, 2020):

Proliance Surgeons is taking the spread of COVID-19 very seriously. We are monitoring the situation, staying in touch with our local Public Health officials, and updating our processes and protocols accordingly.

It is important to know that 80% of COVID-19 cases are mild or without symptoms. Like the seasonal flu, COVID-19 infection is more severe in patients with chronic underlying health conditions and the elderly. For the most updated information about COVID-19, visit the CDC’s Share the Facts, Stop the Fear page.

We will update this page as we learn more to provide you updated resources on COVID-19.

In order to help us protect you, our staff and other patients, please call us to reschedule your appointment, if you have any of the following symptoms:

  • a fever over 100F
  • dry cough
  • new onset of shortness of breath
  • or feel sick

We appreciate your patience during this time.


We are providing these links to up-to-date resources for your convenience.

» CDC Coronavirus

» CDC Fact Sheets

» Washington Department of Health

» Snohomish Health District

» King County Department of Health

A new Washington call center can answer questions about the Novel Coronavirus (2019-nCoV), how it spreads and what to do if you have symptoms. Call 1-800-525-0127 and press #.

The public can help:
  1. Do not go to the emergency room unless essential. Emergency rooms need to be able to serve those with the most critical needs. If you have symptoms like cough, fever, or other respiratory problems, contact your regular doctor first.
  2. Stay home when sick.
  3. Practice excellent personal hygiene habits, including handwashing, coughing into tissue or elbow, avoid touching eyes, nose, or mouth.
  4. Stay away from people who are ill, especially if you are 60 and older or have underlying health conditions such as diabetes, heart disease, lung disease, or a weakened immune system.
  5. Stay informed. Information is changing frequently. Check and subscribe to Public Health’s website (www.kingcounty.gov/COVID) or blog (www.publichealthinsider.com).

Total Knee Arthroplasty Surgery

Total knee arthroplasty (TKA) is a common procedure for end stage arthritis. Over 600,000 total knee replacements are performed annually in the United States. The main reason patients choose knee replacement surgery is pain and dysmobility, which limits patients’ activities of daily living. When patients have failed conservative medical management, and are choosing to be inactive to avoid knee pain, then total knee arthroplasty surgery becomes a definitive treatment choice.

As surgeons, we have the ability to do total knee replacements or partial knee replacements. Patients with isolated arthritis to one compartment may be candidates for hemiarthroplasty. Partial knee replacements can be performed on the medial joint compartment, the lateral joint compartment, or the patellofemoral joint. The type of surgery and implant selection will be tailored to your needs and thoroughly discussed at your appointment through our office.

There are many vendors which make total knee implants. Commonly, the implants are metal and polyethylene. The most common knee implants are mainly cobalt-chrome with polyethylene tibial trays and patellar domes. For patients with nickel allergies, or metal ion sensitivity to cobalt or chrome, we have the option to use implants made out of titanium or oxonium. Again, these issues will be discussed and reviewed through your clinic appointment and prior to your actual surgical procedure.

Total Knee Replacement Rehabilitation

Total knee arthroplasty surgery involves extensive rehabilitation to strengthen your quadriceps muscle. Most patients feel that total knee replacement rehabilitation is tougher than total hip arthroplasty rehabilitation. Once patients have gained their range of motion and their surgical pain has cleared, they have a better quality of life and are able to resume activities that they had previously given up, due to their arthritic knee pain. As a surgeon, it is very rewarding to watch patients get their life back! Most patients have a higher level of function and are able to resume activities that they had previously discontinued due to their knee pain.

There are risks associated with knee replacement surgery and these will be thoroughly discussed preoperatively with patients and their family. Patients are also encouraged in preoperative fitness and health, which will expedite their postoperative rehabilitation and recovery. Orthopedic literature suggests that a BMI less than 35 reduces the risk involved with total knee arthroplasty surgery. Be careful what you read on the internet prior to your surgery.

Individualized Treatment

I look forward to seeing you as a patient in the future. I will individualize your treatment and total knee arthroplasty surgery. I will also be involved with your postoperative rehabilitation and coordinate your health care with your primary care physician. It is my belief that collaboration between health care providers is best when patients are undergoing major joint replacement surgery.

Finally, you will have direct access to my office and staff to answer all of your questions and address all of your orthopedic needs during the perioperative period. Again, we look forward to serving you and hope that you will contact our office by phone or through our web page to make an appointment.

Herbert R. Clark, M.D.

Wishing Everyone a Happy New Year

Newsletter January 2020

The staff at Northwest Orthopedic Clinic/Proliance Surgeons, would like to wish everyone a happy new year. We trust that you had an enjoyable holiday season with your family’s. Many of you have new healthcare plans and we are hopeful that you will continue to seek orthopedic care through our office. As you are aware, Proliance Surgeons is contracted with most carriers throughout the Puget Sound Region. As a patient, you have the right to seek orthopedic care through our office and not an institution where you have been referred by you primary care physicians. If you have any questions concerning our ability to treat you, please feel free to contact our office for assistance in addressing this issue.

January and February are excellent months for adults needing reconstructive surgery. They are able to have surgery and complete their rehabilitation prior to their scheduled spring and summer family events and travel. Sports injuries continue throughout the winter with basketball, ice hockey, indoor soccer, and skiing. Again, we have emergency appointments available every Monday, Wednesday, and Friday for acute injuries that need immediate attention and x-ray. Again, you can schedule an appointment by calling the office or online through our website.

We look forward to serving all of you in 2020. We enjoy our personal service to you with immediate access to physician care through Dr. Clark. We are also happy to provide a second or third opinion on complex orthopedic issues or indications for revision surgery. These are often complicated issues and a second opinion can be reassuring to most patients. Finally, as a reminder, we do multiple sports injuries that require nonsurgical treatment. This includes bracing, physical therapy rehabilitation, biologic injections with platelet rich plasma, and a safe return to athletic play once orthopedically and medically stable for competition. These will all be discussed and tailored to your needs after being evaluated at our office.

Again, happy new year to all of our patients and friends. We appreciate the relationships that we have developed over the last 33 years of my practice. We look forward to serving you in 2020 and encourage you to make an appointment at your earliest convenience.

Herbert R. Clark, M.D.


NWOC December Update

Wishing Everyone a Wonderful Holiday Season

All of the staff at Northwest Orthopaedic Clinic, a division of Proliance Surgeons, wishes everyone a wonderful holiday season this December. We hope that all of you are able to spend time with your family and friends during this special season.

We continue to work throughout the month of December. Many patients choose to have elective surgery due to their time off from work and having met their deductibles and out-of-pocket max on their insurance policies. We are usually able to accommodate patient’s needs and schedules and encourage everyone desiring surgery before year end to make appointments at your earliest convenience.

Sports Injuries during Winter

Sports injuries can continue throughout the winter months. As football season draws to a close, we start to see basketball, snow skiing and snowboard, and volleyball injuries. Again, our clinic has emergency openings every Monday, Wednesday and Friday to work in acute injuries that need immediate attention and x-ray. We are able to facilitate orthopedic care and rehabilitation with early return to sports activities. You may contact our office directly or schedule online at your convenience.

Best wishes to all of our patients for a great holiday season and new year. We also wish all of our referring physicians and colleagues a wonderful holiday season and happy new year. We look forward to serving your orthopedic needs this month and in to 2020 and appreciate the many relationships that we have developed over the last 33 years of my practice.


Herbert R. Clark, M.D.

Fall Follow Up In The Northwest

As previously noted, orthopedic surgeons are extremely busy in the fall. Soccer, football, and the start of basketball are all common sports where student athletes unfortunately have injuries that need orthopedic management. My office has open clinic appointments weekly to see urgent orthopedic injuries on Monday, Wednesday or Friday. Simply visit my website or call the office for a timely appointment. This avoids call centers and lengthy waiting times to be seen and evaluated by an orthopedic surgeon.

In addition, the fall season is busy for those patients that have met their deductible and out-of-pocket maximum on their insurance plans. Having elective surgery for total joint replacement is an ideal time and a financial benefit to the patient. Please be seen early to allow all for insurance clearance and scheduling, and pre operative lab test.

The fall also brings open enrolment for insurance plans. Make sure that your insurance plans include the providers that you want to access. Further, it is important to know that you may seek orthopedic care through my office even if your primary care physician refers you to an institutional practice, which historically can be difficult to access in a timely fashion. Proliance Surgeons is contracted with most major insurance carriers in the greater Seattle area which allows you to seek care through my office at your convenience.

Finally, I would like to again emphasize the quick access to my office for timely appointments, treatment and management. I am also able to facilitate timely surgery before the end of the year if that is appropriate for your situation. You may contact the office or schedule an online appointment at any time. Please let us know how we can best serve you and your orthopedic needs into the future.

Herbert R. Clark, M.D.

Fall in the Northwest

Fall has arrived in the Northwest. The days are shorter and the temperature is cooler. Universities and schools are in full session. Athletic programs are in full-swing, ski season is only a month away, and “Turkey Bowl” football training never happens.

Orthopedic sports injuries are common at this time of year. I see many student-athletes with injuries, many of which are nonsurgical management. Treatment and rehabilitation for sports injuries will be coordinated through my office at all times. Surgical management will be decided on an individual basis.

Many baby boomers and seniors also take advantage, at this time of year, to have joint replacement surgery. It is an ideal time to surgically deal with end-stage arthritis and undergo joint replacement surgery and rehabilitation in anticipation of a nonpainful joint and new lease on life. Many patients known as “snow birds” will elect to have their surgery in Seattle and then head south for the winter, where they will continue their rehabilitation process in warmer weather.

My office and staff are happy to make a timely appointment by phone, or through the internet, which fits your family and work schedule. We are dedicated to customizing your orthopedic treatment to your specific needs and communicating these treatment plans to your primary care physician. We look forward to serving you, your family and friends in the future with orthopedic needs as the healthcare environment around us continue to change yearly. My staff and I want to wish all of you a safe and healthy fall season in the beautiful Northwest.

Herbert R. Clark, M.D.