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Questions

We know you have many questions about your surgery, hospital stay, and recovery. All of these questions will be answered in your Total Joint Replacement Education Class, but here are the most frequently asked questions and answers to help you understand your experience

Should I exercise before my joint replacement?

Yes, if you are able. Contact your surgeon with specific questions about exercise and to receive a special sheet to guide you through a personal exercise program.

What should I pack?

You will wear your own clothing starting the day after surgery, so pack loose-fitting garments (shirt, underwear, pants with an elastic waist). Bring flat, sturdy shoes with a closed back, like sneakers, loafers, or sandals with a strap. If you use a CPAP or BiPAP machine, bring it with you.

What are the major risks to joint surgery?

Most surgeries go well without any issues, but infection and blood clots are two possible complications. Your care team will share exercises, medications, and other treatments with you that help prevent these complications.

What are Advance Medical Directives?

Advance Directives are a means of communicating the patient’s wishes regarding health care to all caregivers. If a patient has a Living Will or has appointed a Health Care Proxy, and is no longer able to express his or her wishes to the physician, family, or hospital staff, the hospital is committed to honoring the wishes of the patient as they are documented at the time the patient was able to make that determination. It is Highland Hospital’s policy to place patients’ wishes and individual considerations at the forefront of their care, and to respect and uphold those wishes. Please bring copies of your Advance Directives with you to your presurgical screening appointment, so they can become a part of your medical record. If you would like more information about completing a Living Will and/or appointing a Health Care Proxy, contact your primary care physician.

Types of advance directives are:

Living Will: Written instructions that explain your wishes for health care if you have a terminal condition or irreversible coma and are unable to communicate.

Health Care Proxy: This document names a person (your agent) to make medical decisions for you, if you become unable to do so.   

Health Care Instructions: This states your specific choices regarding the use of life-sustaining equipment, hydration and nutrition, and the use of pain medications.

 

Is my home ready for a safe home discharge?

Weeks before your surgery, get your home ready!

  • Clear clutter out of living areas.
  • Remove throw rugs.
  • Put nightlights in your hallways and bathrooms.
  • Determine if you need to move a bed downstairs.
  • If your mattress is on the floor, place it in a frame.
  • Check stairway railings to be sure they are secure and stable.
  • Stock up on healthy foods, and make and freeze meals to have handy for easy preparation.
  • Catch up on laundry and housekeeping.

Who will be performing the surgery?

Your orthopaedic surgeon will perform the surgery. Residents, physician assistants, and nurse practitioners assist during the surgery.

How long does the surgery last?

Your time in the operating room is about 3 hours, but the actual elapsed time from operating room to the post-anesthesia care unit (PACU), where you will recover from anesthesia, is usually about 4 hours. After you are taken to the operating room, your companions will be directed to the main lobby where they will receive updates.

Will the surgery be painful?

Recovering from any surgery will involve discomfort and pain, and managing that pain begins with you. We rely on a close partnership between you and your nurse; tell your nurse about your pain, rating it from 1-10. Do not wait until your pain reaches a level of 7, or it will take too long to get relief.

What type of anesthesia will be used?

Before surgery, your anesthesiologist will administer your anesthesia to control your pain and keep you comfortable during surgery. The exact type of anesthesia you will receive will depend on the type of surgery you are having, your overall health, and other risk factors. In every case, you will have the opportunity to talk with your anesthesiologist the day of your surgery.

Will I have any side effects from anesthesia?

Your anesthesiologist will discuss the risks and benefits associated with the different anesthetic options, as well as any side effects. Nausea or vomiting may be related to anesthesia or the type of surgical procedures. Medications to treat nausea and vomiting will be given if needed.

What will happen before my surgery?

In addition to meeting your your anesthesiologist, your surgical nurse will start Intravenous (IV) fluids and give you any needed presurgical medications. Monitoring devices, such as a blood pressure cuff, EKG, and others will be attached for your safety.

Where will my family or friends wait during my surgery?

Your companions will wait in the main lobby of the hospital. Our digital Surgical Information Board, located to the left of the pharmacy, provides real-time updates on each patient’s status. Your companions will also receive a pager from the Information Desk, so they can be alerted to check at the desk for updates.

When will my pain go away?

You can expect to have some pain for several weeks. However, post-surgical pain is different from the deep, aching pain most people experience before surgery. Your new or repaired joint should eventually relieve the pain and stiffness you’ve had prior to surgery.

Where will I go after discharge from the hospital?

Research shows that joint replacement patients who recover at home get better faster and with fewer complications. The vast majority of our patients will go directly home with home care services 1-2 days after surgery.

Some patients, however, need more care, and a skilled nursing facility (a nursing home that provides rehab services) may be recommended. Your insurance plan will dictate whether a skilled nursing facility is an option for you. Even if your insurance company states that you have coverage for skilled nursing facility, that does not mean you will necessarily qualify for it.

Will I need any special medication after surgery?

Your surgeon will determine the medications necessary to assist in your recovery and will prescribe them prior to your discharge. In some cases, these include blood thinners to prevent blood clots. 

As a convenience, your discharge prescriptions will be filled at the Highland Pharmacy, located immediately off the main lobby. Leaving the hospital with your medicine is not only easier than stopping on the way home, but it also helps ensure you do not miss any doses. Your co-pays and price will be the same as at your home pharmacy and we can easily send any refills there.

Will I need help at home?

Yes. Family and friends will need to be available to help for the first week following your surgery. Your home care coordinator will arrange for a nurse and physical therapist to come to your house as needed.

What if I live alone?

Plan to have your surgery when family members or friends will be available to help for the first week after surgery.

What equipment will I need at home?

If you have hip or knee replacement surgery, you will need a standard walker, cane, or crutche and may want to consider a raised toilet seat. A tub bench and grab bars in the tub or shower are helpful too. Your occupational therapist may also recommend a reaching tool, a sock aid, a long-handled shoehorn, elastic shoelaces, and a long-handled sponge or back brush.

Will I need physical and occupational therapy at home?

You will need both. Your home care coordinator will arrange for a physical therapist to provide therapy. An occupational therapist will assess your ability to manage your daily living activities and guide you through hygiene, dressing, and homemaking skills.

How will I get to my follow up medical appointment and to outpatient physical therapy if needed?

You may not drive after joint replacement surgery until cleared by your surgeon. Arrange for a friend or family member to provide transportation.

When can I go back to work after joint replacement?

You may go back to work when approved by your surgeon—usually 6 weeks for non-physical work and 12 weeks for more strenuous jobs.

When can I have sexual intercourse?

You can usually resume sexual intercourse after 3 to 6 weeks. Your occupational therapist can discuss it with you upon request.

What activities may I participate in after recovery?

You should discuss specific activities with your surgeon, but you are encouraged to participate in low impact activities such as walking, dancing, golfing, hiking, swimming, bicycling, or gardening as soon as you feel able.

Will I notice anything different about my joint?

Yes. You may have a small area of numbness to the outside of the scar. The joint may feel stiff with movement. With total knee replacement, there may be a slight swelling and warmth for a year. A "clicking" sound or sensation is a common finding and represents normal mechanical contact of the plastic and metal components in your knee prosthesis.

How often will I need to be seen by my surgeon following the surgery?

Your first post-operative office visit will be:

  • Total hip replacement: 4 to 6 weeks after your surgery
  • Total knee replacement: 2 to 6 weeks after your surgery

The frequency of follow-up visits will depend on your progress. Many patients are seen at 6 weeks, 12 weeks, and then yearly or as directed.