Joint Replacement: What To Expect

Doctor’s Evaluation

Your orthopedic surgeon will talk with you about your symptoms, medical history and recommended course of treatment.

Physically Prepare for Surgery

Preparing for joint replacement begins weeks before the actual surgery. In some cases, beginning the process a few months in advance may provide an added benefit. Ways you may be advised to prepare include:

• Exercising under your doctor’s supervision
• Stopping smoking
• Watching your weight
• Meeting with a physical therapist for a pre-surgical therapy and exercise program

Appointment Scheduling

Our office will assist you with setting up your necessary pre-surgery appointments or guide you accordingly. These dates may include:

• Surgery date
• Pre-admission testing
• Physical exam with primary care physician within 30 days of your operation date

Home Safety Evaluation

A physical therapist will visit your home to help ensure that it is safe. Please follow their recommendations and suggestions to maximize home safety.

Preparing Your Home

Preparing for surgery includes preparing your home. It is important for an easier and safer recovery process. Preparing your home before surgery makes less work for your family while you are in the hospital and also makes your discharge smoother.

Storage: Avoid Reaching

• Store all food and other supplies between your waist and shoulder level.
• Remove items from top shelves and place at counter level.
• Do not use step stools or reach for objects on your tiptoes.
• Stock up on frozen food and canned goods.

Rearrange: Easy Access

• If you normally sleep on the second level, try to go upstairs only once per day if your surgeon says it is OK.
• Prepare a room on the first floor with all your needed supplies.
• Place the phone within reach.
• Attach a bag or lightweight basket to your walker to carry light items.

Arrange: Help

• Make arrangements, if possible, for someone to stay with you, especially at night for the first 2 weeks.
• Ask a friend or family member if they will be able to buy groceries, run errands for you or drive you to your appointments.
• Request help from others with cooking, bathing and exercises.

Clean Up: Remove Rugs & Clutter

• Remove any throw rugs so that walking will be safer during your recovery.
• Look around the room for electrical cords, footstools, pets and other obstacles that may be a safety hazard after surgery.
• Rearrange your furniture to allow a clear path for your walker.
• Make sure your pets are in a secure place while you are walking to avoid injury.

Surgery

The orthopedic surgeon and specialized team at Exeter Hospital will perform your surgery. The actual surgery last approximately 60-90 minutes.

Our caring nurses will prepare you for your procedure, assist the physician in the pre-operative areas, and provide specialized care following the surgery. As a patient, you can expect to spend a minimum of three days in the hospital following surgery.

In-Hospital Therapy

A therapist will work with you two times a day during your hospital stay, but you must perform exercise on your own between therapists visits. Your goals for discharge from the hospital are as follows:

• Getting safely in and out of bed without assistance.
• Getting safely in and out of a chair without assistance.
• Knowing your precautions so you will continue to protect your new joint after you leave the hospital.
• Performing your exercises as instructed by your therapist to increase strength and independence.
• Walk a functional distance using a walker or crutches.
• Performing stairs (if indicated).

Hospital Discharge

Your doctor will decide if you will be able to return directly home after discharge from the hospital, or if you would benefit from the care at a skilled rehabilitation facility (short-term stay) before returning home. Age, overall barriers, physical barriers at home and insurance coverage may determine discharge destination. Your orthopedic case manager will help you make that transition as well.

Discharge Checklist

Do:

• Use a walker or crutches to assist with walking.
• Continue normal walking activities at home.
• Use a pillow between your legs in bed.
• Continue your therapy exercises.
• Get help to put on your shoes and socks, or use the aids described in physical therapy.
• Use an elevated toilet as instructed.
• Take your medication as directed.
• Keep your return appointment with your doctor.

Do Not:

• Do not overdo your activities.
• Do not bend your hip more than 90 degrees.
• Do not sit in low or overstuffed chairs.
• Do not bend over.
• Do not cross your knees.
• Do not sit in the bathtub. Take showers or sponge baths.
• Do not drive until approved by your doctor.

Adaptive Equipment

Because every patient recovers differently, your surgeon will prescribe equipment that is best for your individual recovery. Some of this equipment is optional, and insurance coverage varies. Your case manager will help you to understand your insurance coverage and order the prescribed equipment for you as indicated.

• Walking aids: to help steady your gait and provide support
• Elevated toilet seat: to use on your toilet at home to reduce stress on your hips and knees
• Set cushion: to use on a chair to elevate the seat to the appropriate height
• Bath seat: extends over the side of the tub to help you bathe safely and maintain precautions
• Long handled bath sponge: to assist you in washing and to avoid bending; you can wrap a towel around the sponge to help with drying off
• Dressing stick: to assist you in dressing yourself when you cannot bend; combination of hook-pusher on one end helps you pull on slacks or skirts, or remove socks
• Sock aid: to help you put on your socks
• Long handled shoehorn: to help you put on your shoes
• Elastic shoelaces: rubber/rayon laces provide firm support yet stretch to allow your feet to slip in or out of the shoes without having to untie and retie them