Preparing For Joint-Replacement Surgery

Taking The Necessary Steps

doctor examining patient leg

This information is a brief overview of the joint-replacement surgery experience. It does not replace any instructions provided by your physician. You should discuss this information with your physician.

Four weeks before surgery

You may find it helpful to learn about your joint anatomy and joint-replacement surgery.

Three weeks before surgery

Ask family and friends for support. They can help you with activities such as driving and moving items in your home for safety. The Arthritis Foundation has a support network that can provide emotional support. You can contact your local chapter or go to the Arthritis Foundation Website (www.arthritis.org) for more information.

Prepare your home for your return from the hospital:

Bath – Put a nonskid mat in your bathtub. Consider an elevated toilet seat. It may reduce stress on your hips and knees as you sit and stand. A bathtub seat (bench) allows you to sit while bathing for increased safety and comfort. Place a shelf in the shower at chest height to reduce bending to retrieve items. A long-handled bath sponge may be used to reach lower legs. Women can purchase razor extenders to shave their legs.
Floors – Check the safety of your home to prevent falls or tripping. Remove rugs. Move long electrical and telephone cords against the wall.
Furniture – You may want to prepare a bed on the main level of your home to reduce the need to climb stairs. Have an elevated chair or high seated chair with arms in every room, if possible.
Kitchen – Make and freeze meals, or stock up on frozen dinners to simplify meal preparation. You should plan on making enough meals for at least one week. Put frequently used items like canned foods and cleaning supplies in easy-to-reach cabinets. Avoid very low or very high shelves that would require kneeling or using a footstool.

Two weeks before surgery

Your physician may not want you to take any aspirin or nonsteroidal anti-inflammatory medicines such as Advil, Ibuprofen, and Motrin for the 10 days before surgery. If you take heart medicines, your physician will tell you how to take those medicines. Tylenol or medicines with acetaminophen may be allowed. Ask your physician.
Purchase or borrow the special equipment your physician recommends. This may include an elevated commode and small devices such as a grabber. Items are available at Heritage Medical Equipment and Supplies’ two locations, and other sources. Practice using the items at home.

Ten days before surgery

Call supermarkets and pharmacies to see if they provide delivery service and if they charge a fee. Shop for items you may need when you return from the hospital or arrange for home delivery.
Go to a joint-replacement surgery class at Great River Medical Center. The class time will be scheduled for you by our staff.
If you are taking heart medicines, your physician will tell you how to take them before surgery. Tylenol or medicines with acetaminophen may be allowed. Ask your physician.
Make a list of all of the medicine you take, the doses and how often. Bring this to your pre-admission visit to the hospital.
Pre-admit to the hospital three to nine days before your surgery. Ask your surgeon if an appointment is necessary. Your insurance will be verified and, depending on your surgeon’s instructions, you may have laboratory work, X-rays, and an EKG. Plan at least two and one-half hours to complete the visit. You may receive a breathing exerciser. A nurse will review written directions for the exerciser. If you have receipts from the blood you or your family has donated, give them to the nurse in the Preadmission area. Anesthesia staff may discuss anesthesia with you.
Manage your finances. You may want to balance your checkbook, pay bills, make arrangements to board pets and stop the delivery of your newspaper. If you are going to a rehabilitation facility after being discharged from the hospital, you can request that mail be held at the post office until you return home.

Week of surgery

A list of items you may want to pack for your hospital stay is below. Your physician may have additional information about preparing for your hospital stay.

Breathing exerciser, if you have received one.You probably will need this right after surgery. Check with your physician.
Clothing – Robe, undergarments, slippers or flat rubber-soled shoes for walking, and loose-fitting clothes for your trip home
Medicines – Bring all medicines you are taking. Also, write down your medication information and give it to hospital staff. Include the name, dose and how often you take each medicine. Please tell your physician and nursing staff if you have any medication allergies.
Money – Bring only enough money for items such as newspapers and magazines.Leave your checkbook, credit cards, jewelry, keys and other items of value at home.
Personal grooming items – Comb or brush, contact lenses, deodorant, electric razor, eyeglasses, lotion, shampoo, toothbrush, and toothpaste

Night before surgery

You may want to read an overview of your procedure. Eating or drinking (not even water) after midnight may not be allowed. Ask your surgeon. Your anesthesiologist may prescribe a medicine for you to take the evening before surgery.

Day of surgery

Report to the hospital at least two hours before your scheduled surgery. Nurses will complete your surgery preparation and likely will review your care following surgery. Leave your personal belongings in the car until after surgery. Your family can bring them to your room after it has been assigned. This will happen when you are in surgery or recovery.

Ask your physician how you may feel after surgery. You may be nauseated, dizzy, weak, loss of appetite, and have constipation. You probably will experience pain, but patients usually feel better a few days after surgery. Your pain will be managed through your IV or by pills.

Your first meal after surgery likely will be ice chips and clear liquids. You will progress to solid foods as tolerated. Check with your physician about your first meal.

A catheter may have been placed in your bladder during surgery. It usually is removed when you can get out of bed to use the bedside commode or restroom. As you recover, walking to the restroom will build your strength and prepare you for discharge home.

Feeding yourself and washing your face and upper body will be among the first self-care tasks you do. Eventually, you will be able to bathe yourself with a little help around your surgery area.

Your bandage will probably be changed once or twice a day.

You typically are allowed to have visitors after you have been moved from the recovery room and into your own room. If you prefer not to have visitors, please tell the nurse.

Your surgeon will visit you and your physical therapist will begin post-operative exercises.

Hospital discharge

You will be discharged from the hospital when your physician feels the time is right. This typically is five days after surgery. You will need to make arrangements for someone to drive you home from the hospital. Your therapist will review how to get in and out of a car.

Depending on your situation, your physician may recommend that you be transferred to a rehabilitation facility after you are discharged from the hospital. You may be there a few days so you can begin physical therapy and your health can be monitored.

When you return home:

Get pain medicine. Your surgeon probably will give you a prescription for pain medicine. You likely will need less each day, but you may need to continue it at night for a while. Check with your physician. Do not drink alcoholic beverages while you are taking pain medicine.

Follow your surgeon’s instructions. Discuss with your surgeon before hospital discharge:

Constipation is a common problem for patients after surgery. It usually is caused by limited activity and pain medicines. Discuss your diet with your physician. It should include fresh fruits and vegetables, and eight full glasses of liquid each day unless your physician tells you otherwise.
Diet – A well-balanced diet will help your body heal.
Housecleaning. Your physician will tell you when it is okay to mop, sweep and vacuum. Use long-handled feather dusters for dusting high and low items.
Resting. You probably will tire more easily than usual. You may want to plan a rest period of 30 to 60 minutes mid-morning and mid-afternoon.
Sitting. It is safer and easier to get in and out of chairs using both arms. To increase your comfort, use a cushion or pillow to raise your body while seated. Avoid low or overstuffed furniture.
Vehicles – You may ride in a car, but you must follow your physician’s instructions for how to get in and out of the vehicle. You can raise the height of the car seat with pillows to protect your hips and knees. Your physician will tell you when you can drive – typically four to six weeks after surgery. Make sure you can break the car without discomfort before you attempt to drive in traffic. If you have a car with manual transmission, talk with your physician about driving limitations.
Walking aids. If you will be using a walker or crutches to assist with walking, ask your physician how much weight you may put on your operated joint.
Wound care. Some swelling around the incision is normal.You will find it more comfortable to wear loose clothing to avoid pressure on the incision. When you are discharged, your bandage may be removed and replaced with a smaller bandage. Change the bandage as recommended by your physician, usually once a day. Call your physician if you notice any signs of infection.

One week after surgery

Post-operative appointment. If you don’t already have a post-operative appointment, call your surgeon’s office a day or two after you arrive home to make an appointment. It usually is two weeks after your surgery.
Visitors. You may want to wait a few days after you are home from the hospital or rehabilitation facility before welcoming visitors. This will allow you to rest and become comfortable in your home setting.

Two Weeks After Surgery

Wear loose-fitting clothing to your post-operative appointment. Your surgeon will examine the surgery area checking for signs of infection. Your stitches or staples likely will be removed. Your range of motion will be checked, and you will review your physical therapy instructions. You likely will return for follow-up appointments at three months, six months and one year after your surgery, and yearly thereafter.