While in the pre-operative area, you will change into a hospital gown and have the opportunity to use the bathroom.
An antibacterial skin preparation may be applied prior to surgery to reduce the risk of infection. An intravenous catheter, a thin tube, will be placed in a vein to deliver fluids into the body.
The orthopedic surgeon and anesthesiologist will meet with you and review your medical history prior to surgery. You will receive medication to prepare you for surgery prior to be being taken to the operating room.
Your family members may stay with you in the pre-operative area until the time of your surgery. They should then wait in the surgical waiting area to speak with the orthopedic surgeon or his/her designee after the surgery is complete. A volunteer will direct them to the surgical unit.
Depending upon the difficulty of your case, surgery can take anywhere from one to three hours, with an additional one to three hours in the recovery room.
In the recovery room, your vital signs will be monitored, you will receive medications to control your pain and nausea, and may have X-rays taken of your new joint.
You will be transferred to the surgical unit, where the nursing team will begin providing care and your family will be allowed into your room.
After knee or hip replacement surgery, you will likely spend two or three days in the hospital.
Moving and Walking After Surgery
Your nurses will encourage you to move and walk following surgery.
However, please do not get up by yourself until instructed to do so, and follow staff instructions on how to get in and out of bed safely. Use your assistive devices, such as a walker or cane, to aid in your mobility. These devices will be provided for you during your stay in the hospital.
Equipment needed for home will be coordinated by your discharge planner before you leave the hospital.
It is important to get adequate rest during your recovery. To optimize your recovery, we recommend that only one or two close family members visit you the day of surgery. Visitors with a cold or fever are best to stay home.
Please check with the hospital regarding any changes to these regulations.
Some pain is expected after surgery. We will work with you to help set a reasonable pain goal and manage pain in the best way so you can fully participate in therapy.
Your pain will lessen every day.
Pain medications are ordered to relieve your pain. Your orthopedic surgeon, the physician assistant or nurse practitioner will select the type and route of administration (oral, intravenous, skin patch) based on your medical needs. A pain specialist may be asked to see you if you are having complex pain management issues. It is best to take your pain medication on a regular basis and avoid long periods without pain medication.
Do not take medications that were not given to you by your nurse.
Report increases in pain, light-headedness and nausea to your nurse.
Constipation is a common side effect of pain medications. You may have medications ordered to help relieve your constipation. Adequate fluids and fiber can also help relieve constipation.
Nausea can also occur after surgery, please let your nurse know if you feel nauseous. Medications can be given to relieve your nausea.
Medications you were taking at home are usually ordered for you during your hospital stay unless there is a medical reason to discontinue them for a short time. Never take any medication during your hospital stay unless the nurse dispenses it to you. If you have questions or concerns about the medications you are receiving, please discuss them with your nurse.
Cryo therapy is the application of ice to the surgical site to decrease the amount of swelling and therefore decrease pain. You will be encouraged to use cryo therapy during your recovery.
The exercises that you learn in physical therapy will help decrease swelling and strengthen muscles, thereby decreasing your pain. Physical therapy may be done in your room or in the physical therapy gym usually twice per day. Participation in physical therapy is essential for your recovery.
Preventing Blood Clots/ Deep Vein Thrombosis (DVT)
Surgery, limited mobility, advanced age and/or previous blood clotting abnormalities may put you at risk of developing blood clots. Preventative techniques to reduce this risk may include blood thinning medications and the use of foot pumps designed to assist with circulation.
Beginning physical therapy as soon as you are able and following your recommended leg exercises will also help to promote blood flow.
Food and Fluids
During the initial hours after surgery, you may not have much of an appetite, but it is important to begin taking fluids as tolerated. Gradually increasing fluids and food will increase your strength.
You will have fluids going through your IV at first. The IV will be stopped when you are eating and drinking well.
You will likely start with a liquid diet. You can order your meals by telephone approximately one hour before your desired meal time. Remember to allow enough time for you to enjoy your meal before going to physical therapy.
While you are in the hospital, your care will be provided by a variety of medical professionals.
- Your orthopedic surgeon, who will perform your surgery and direct your care after surgery
- Physician assistants and nurse practitioners, who work with your orthopedic surgeon to manage your care during your hospital stay
- An anesthesiologist, who is responsible for your anesthesia before, during, and immediately after surgery
- Your medical doctor or a hospitalist, who manages your routine medical needs during your hospital stay
- A physiatrist, a doctor of physical medicine, who develops your rehab program
- Your orthopedic clinical advisor, a certified orthopedic nurse who will talk to you about your health and safety needs before and after surgery
- Registered nurses, who provide your bedside care following your surgery
- Nursing attendants who assist you with personal hygiene needs, help you to move using assistive devices, and ensure your comfort
- A physical therapist, who works with you to regain muscle strength, range of motion and balance after your surgery.
- An occupational therapist, who will teach you how to bathe and dress yourself during your recovery
- A respiratory therapist, who will instruct you on the use of an incentive spirometer to improve your breathing (after surgery, nearly every patient receives a spirometer; you will use this several times a day)
- Care managers/discharge planners, who will plan your discharge from the hospital and answer questions about insurance coverage for services and equipment
- A pharmacist, who can assist you with understanding how and when to take your medications
- Registered dietitians, who will advise you on what meals to order at the hospital and will work with you on meal plans
This team is provided to you upon your admission to the hospital. It is not necessary to make separate arrangements.