Welcome, Thank you for choosing Saint Joseph s Hospital Health Center for your joint replacement surgery Updated August 2015
This class is designed to give you some basic, important information about joint replacement surgery We will cover what to expect before, during, and after your surgery You will be given a booklet in Pre-Admission Testing The booklet contains detailed information about hip & knee surgery, your care and recovery
To answer any questions you may have about your upcoming joint replacement surgery To inform you of what to expect so you are comfortable with your surgery & your stay at Saint Joseph s Hospital To be discharged within 2-4 days
Golf? Walking? Playing with your children &/or grandchildren? Gardening? Vacationing with your family? We will work with you to help you to achieve the goals that you set for yourself
When a joint becomes painful with every step, when people can no longer get up out of a chair, when they can t prepare food for themselves or handle their daily tasks, they need to understand that the opportunity exists to return them to a higher level of functioning. -- Dr. John Parker, Orthopedic Surgeon
Allow for movement between bones Each bony surface of the joint is lined with cartilage Cartilage provides smooth friction free movement, nutrition to the joint, & provides shock absorption
Ball (femur) & socket (acetabulum) joint Moves in three directions Socket not lined completely with cartilage
Hinge joint-largest joint in the body The thigh bone (femur) & the shin bone (tibia) meet to form the knee joint The knee cap (patella) covers and protects the knee joint Cartilage covers the end of the knee bones & cushions the knee for smooth, easy movement
OSTEOARTHRITIS Slow developing joint pain Stiffness, bony enlargement One or both sides affected Usual onset is middle age RHEUMATOID ARTHRITIS Symptoms come and go Affects all ages Chronic systemic inflammatory disease Rheumatoid arthritis usually affects joints symmetrically (on both sides equally), may initially begin in a couple of joints only, and most frequently attacks the wrists, hands, elbows, shoulders, knees and ankles
Non-surgical Care Medication Injections Activity modification Physical therapy Minor Surgery Arthroscopy Surgical Care Cut section view of knee joint Decreased joint space Rough bone Worn cartilage Joint replacement surgery Arthritic hip joint
There are over 1.1 million procedures done each year in the United States Knee & Hip joint replacement surgeries are two of the most common surgeries performed in the United States With the rise in the number of baby boomers reaching retirement & increasing demands on athletes, the number of total joint replacement surgeries is expected to increase each year
Surgeon Physician Assistants Anesthesia Care Provider Nurses Registered Nurses Licensed Practical Nurses Physical Medicine & Rehab Physical Therapists Physical Therapy Assistants Occupational Therapists Case Manager/Discharge Planner Pharmacist
Also playing a vital role in your recovery is YOU & your coach
A coach can be your spouse, a friend, a family member, a neighbor or anyone that can be a support to you as you recover from your joint replacement surgery Your coach will help you with Activities of daily living (if needed) Transportation to follow-up appointments Preparing your home Run any necessary errands that you may need help with
Inside your home and outside Good lighting No trip hazards Clear pathways- i.e. plans for leaf, snow removal Handrails Frequently used items within reach More information can be found in the booklet
A phone call from the hospital about your expected arrival time (please arrive on time) This will occur the business day before surgery after 5 pm If you have not received a call by 7 pm, please call 448-5520
You will be NPO after MN which means no food or drink after midnight Morning medications will be taken with just a sip of water, enough to get the medication down Limit belongings and leave all valuables at home. Your family will be responsible for carrying your personal items, a credit card will be needed for the TV You are expected to arrive on time, do not wait for the valet with your family. Go right to the registration desk.
Nurses will review your medical/surgical history Medications will be reviewed An IV will be inserted You will receive multiple pre-op medications that include medications for pain, nausea, and antibiotics You will be transferred to the block room prior to the OR An anesthesiologist will insert your spinal for surgery You may have a urinary catheter inserted Most patients do not
You will receive a spinal for your joint replacement You will be in a comfortable twilight state while in the OR, you may be able to hear what is happening around you You will not feel any pain during your joint replacement surgery Research has shown that this type of anesthesia results in less complications and shorter hospital stays Please refer to your surgeon for any questions that you may have regarding anesthesia
Arrive in Post Anesthesia Care Unit (PACU), you will be there for approximately 1 2 hours Arrive to floor, be greeted by your nurses You will have a private room as soon as one becomes available
Frequent vital signs and assessments Clear liquid diet, advanced to regular food as you can tolerate Physical Therapy (PT) Evaluation if able Nurses use cell phones tied into the call bell system to meet your needs more efficiently
Located on the wall across from your bed A way to keep you connected with your care Names of your nurses, unit manager When you received your last dose of pain medicine When you are due for your next dose Your phone number in your room
The physician assistants (PAs) and residents that see you post-operatively are an extension of your surgeon, they work together closely to take care of you
We use oral medications for pain control This may be adjusted based on your specific needs Asking one hour before PT is an option If you have spasms, can t sleep, uncontrolled pain: Ask your nurse! There are more therapies/orders that can be used We also use cold therapy/ice packs on your surgical site to help with pain management Mobility and other therapies can help (music, imagery, etc) as well
Case manager/discharge planner will be in to see you and assess your discharge needs Group PT will start this day Any drains and catheters are removed by your nurse or PA You will order your meals when you would like them You can ask for pain medicines when you need them Use your call bell and wait for your nurse before getting out bed! Call Don t Fall!
Group Therapy Following your therapy evaluation, you will start to attend two group sessions per day You can get dressed in comfortable, non-restrictive clothing every morning You will be wheeled to therapy in a comfortable chair Any assistive devices you may need, you will bring to therapy (Walker, cane, etc.) Get Moving PT will be an important part of your recovery that you will go to twice every day During your PT group therapy, you will be doing exercises laying down, sitting and standing You will learn to walk with an assisted device (walker, cane or crutches) You will practice getting in and out of a chair, laying down, getting into a car and going up and down stairs
Teach you strategies to: Perform self care tasks (dressing, bathing and toileting) Use adaptive equipment as needed for self care tasks Function safely in your home Address barriers to movement precautions
Examples of equipment that you may need OT will help you determine what you need Hip Kit Raised Toilet Seat Commode (From left) Long shoe horn, dressing stick, sock-aide, long sponge, reacher Tub Transfer Bench Shower Chair
Your surgeon will put your new joint in but, you are the one who has to move it
PT will continue twice per day You are encouraged to dress in comfortable clothes You will continue to be monitored and assessed If you are going home after discharge, you will be invited to a Discharge Tea to review information to prepare you for home You may be discharged this day, depending on your progress and physician/pt recommendations
You may heal better in your own home Some people are able to begin outpatient physical therapy after hospitalization Others may begin home physical therapy and visiting nursing if needed Please watch this video on discharge planning.
While we encourage people to return home when they are able, Rehab may be needed for those who need a higher level of assistance Rules and Criteria to be accepted to rehab continuously change, please talk to the case manager/discharge planner while you are here
In the morning, your PA will see you and assess if you are able to be discharged You will attend a morning group PT class if it does not affect your desired discharge time Discharge time varies, most often before 12 noon Patients are discharged through our main entrance We do our best to coordinate a timely discharge
Continue PT and exercise regimen Increase activity based on your tolerance Use assistive device until no longer needed Keep follow up appointment Driving only with doctor approval Resuming sexual activity Knee Replacement- As soon as you feel able to Hip Replacement- 4 to 6 weeks, though could be sooner Ask your doctor, PT or nurse for additional information Your PAT booklet has more information
If you have diabetes we may monitor your blood glucose while you are in the hospital more frequently than you do at home and we may give you insulin while you are here If you currently take insulin at home, we may give you a different insulin while you are in the hospital
We wash our hands frequently We clean our equipment & workstations frequently Each room has a dedicated walker so that equipment is not shared between patients How can you help
Do not shave the surgical site prior to surgery Wash your hands before meals and after using the bathroom. Wash your hands often! It s just as important for family members to wash their hands often, too! Wash with the chlorhexidine soap per your packet that you receive in Pre-Admission Testing (PAT) See your dentist on a regular basis
Foot pumps & ted stockings Prevent post-op blood clots Wear the foot pumps when you are in bed or in the chair Various anti-coagulation medications Incentive Spirometry and deep-breathing Prevent pneumonia after surgery, do 10 times every hour while awake Antibiotics
Pain medications can cause constipation We will start you on a bowel regime postoperatively with various stool softeners Good hydration; we start you on clear liquids first & advance you to solid foods as tolerated Return to activity get moving!
Again, we want to thank you for choosing SJHHC for your joint replacement needs Do not hesitate to ask our knowledgeable team of nurses and physicians any questions that you may have as you recover from your surgery
Cathy Hayden, RN, CNS Ph. 315-423-4941 Catherine.hayden@sjhsyr.org or Call 315-448-5410 Please verify your viewing of this education