Preparing for Surgery

Now that you have made the decision to have your joint replaced, your surgeon’s office staff will schedule your appointment for pre-admission testing (PAT) as well as your surgery date.

pre-admission testing 

1. Eat and take your medications as you normally would do. You do not need to fast for the tests.

2. Bring to the hospital a list of all your medications, including dosage and instructions; a list of your physicians’ names and phone numbers; a copy of any documents with instructions on who will assist us in your healthcare decisions.

3. Park in the hospital visitor’s parking lot. Valet parking is available at a nominal rate.

4. We look forward to your arrival at the Admitting Desk on the first floor.  Have your insurance card and photo ID available. 

5. The nurse will complete an interview and insure that all the tests ordered by your surgeon are performed. Testing may include blood work, urine, x-rays and an EKG. 

6. You will also meet privately with an anesthesiologist and a case manager. 

7. The PAT visit takes approximately 3 hours.

before the day of surgery

1. Arrangements can be made with the Home Care department to visit your home for an evaluation and to make suggestions to support your rehabilitation. 

2. Ten days before surgery stop all anti-inflammatory medications such as Aspirin, Motrin, Naproxen, Vitamin E, Herbal Supplements, etc. These medications may cause increased bleeding. If you are on Coumadin, Plavix or other blood thinning medications you will need special instructions from your physician for stopping the medication. The physician will instruct you on what to do with your other medications.

3. If you are feeling sick anytime before your surgery or on the day of your surgery, call your surgeon. He or she will tell you what to do. 

the night before surgery

1. Do not eat or drink anything after midnight. The only exception is to take medications with a small sip of water, as instructed by the anesthesiologist or nurse. Do not chew gum, mints, or candy. 

the day of surgery

1. Please arrive to the Admitting Department on time. We will place an identification bracelet on your arm and show you to your room. 

2. The nursing staff will prepare you for the Operating Room (change into hospital gown, start an intravenous (IV) line, etc).

2. You will then be brought to the Holding Area of the Operating Room. Here we will start your antibiotics. You may also get special catheters inserted to help with pain control.

3. The anesthesiologist, Operating Room nurse and your surgeon will all see you in the Holding Area before you go into the room for your surgery.

4. After surgery you will go the Post Anesthesia Care Unit (PACU), where you will be closely monitored for one – two hours. While you are recovering, your physician will talk with your family. During your time in the Recovery Room, pain control will be established, your vital signs will be monitored and an x-ray may be taken of your new joint. You may have an oxygen tube in your nose when you wake up. You will still have the IV line. You may have a catheter in your bladder to drain your urine.  

5. After your stay in the PACU, you will be taken to your room in the Orthopedic unit. Family members or friends may visit. During this time you will be receiving pain medication through your IV and/or a pain pump. As soon as possible, start your exercises. You will be allowed a clear liquid diet initially.  If you tolerate this diet well, you may advance to more solid foods for supper. 

6. You may have a Patient Controlled Analgesia (PCA) pump. This pump delivers a dose of pain medication when you press the button. 

7. The physical therapist and case manager may visit you later in the day.  

8. If you had a total knee replacement you may be placed on a continuous passive motion (CPM) machine to start exercising your leg.

post surgery to discharge

1. Recovery is different for every person. Goals to mark your progress and help you and your family know what to expect will be posted in your room. 

2. The nursing staff will orient you to the unit. Please don’t hesitate to ask questions or use your call bell to get help. We are here for you! 

3. Your registered nurse and case manager will assess your needs on an ongoing basis and adjust your care accordingly.

4. Medication will be available to help control your pain. This is especially helpful when taken about 30-45 minutes before your physical therapy.  

5. The physical therapist will work with you every day. Refer to the handout describing your exercises.

6. Your case manager will talk with you and stay informed about your progress, in order to arrange appropriate discharge.

7. Expect to be discharged 2-3 days after surgery. Most patients go directly home. Arrangements can be made if a stay at a rehabilitation facility is needed.

the night following surgery

1. You will be encouraged to sit up on the side of the bed. Your nurse or physical therapist will help you.

2. Please do not attempt to walk or sit in a chair without help from the nursing staff or physical therapist! This is very important.

how to minimize complications

1. Deep Vein Thromboses (DVT’s) are blood clots that can form in your legs. Exercise and ambulation are the most important things you can do to help minimize the chance of getting DVT’s. Other ways are with medications (blood thinners such as Coumadin and Lovenox) and compression devices placed on your legs.

2. Leg and ankle swelling can be reduced by elevating the operative leg, avoiding sitting for more than 30-45 minutes at a time and performing your ankle exercises.

3. The risk of pneumonia can be minimized by doing breathing exercise with your incentive spirometer. 

4. Infection can be reduced by keeping the dressing clean and dry. Call your doctor if you have a fever greater than 101º or if the incision becomes swollen, red, or exhibits changes in the color, amount or odor of the drainage.

5. If you had a total hip replacement, dislocation of the new joint can be minimized by following specific hip precautions (Your physical therapist will instruct you with regards to hip precautions. Also, refer to the Exercises handout).

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