Print Handheld Contrast

Your Surgery

 

Preparing for Surgery and Discharge

With joint replacement surgery, the surgery itself is just one component of the whole process. In order for your surgery to be successful, there are things that you can and should do to be adequately prepared.

It is important to discuss with your family and friends your decision to have surgery and how they may be of assistance to you before, during and after surgery. Some things to consider are:

Living Arrangements

Driving and Transportation

Equipment

Homemaking

Safety Proofing your Home

 

Topˆ

 

Pre-Admission Clinic

Once your date for surgery has been set, you will have an appointment at the hospital prior to surgery in the Pre-Admission Clinic. The purpose of the Pre-Admission Clinic visit is to help you prepare for your surgery. Here we will talk to you about what will happen to you while you are in hospital and what you are to expect when you return home.

The Pre-Admission Clinic visit is your opportunity to discuss any questions or concerns that you may have about your surgery, hospitalization and discharge home.

For more information about the Pre-Admission Clinic, please visit What to expect in your Adult Pre-Admission Clinic appointment.

 

Topˆ

 

Day before surgery

The day before surgery, there are activities you must make sure you complete:

• You must call your surgeon’s office between 2:30 and 4pm to confirm your time of surgery
• You must remove finger and toenail polish
• You must not eat anything after midnight the night before or the morning of your surgery
• You must not chew gum, candy or smoke after midnight the night before or the morning of your surgery
• You must bathe or shower the night before and the morning of the surgery

When you wash, both the night before and the morning of the surgery, you must also wash with the special cleansing sponge given to you in the Pre-Admission Clinic visit. You should:

Hip Surgery	Knee Surgery
Use the sponge to wash from your waist to your knee on the leg having surgery Rub the sponge over the skin until it becomes foamy and rinse away with water.	Use the sponge to wash from the middle of your thigh to your ankle on the leg having surgery Rub the sponge over the skin until it becomes foamy and rinse away with water.

If you are feeling unwell, or there are any changes to your health in anyway, you must immediately contact your surgeon’s office.

What to bring to hospital

In a small overnight case or bag, pack:

• One set of clothes to go home in
• A bath robe
• One or two night clothes (if you prefer over using a hospital gown)
• Slippers or sandals that are easy to slip on and have a closed heel
• My Guide to Total Joint Arthroplasty
• Personal items such as toothbrush and paste, razor, comb, deodorant, lotion, tissues and feminine hygiene products

You should also bring in crutches if you have them so the physiotherapist can size them correctly and teach you how to use them. Please do not bring in any walkers or canes.

 

Topˆ

 

Day of surgery

On the day of your surgery you:

• Will arrive at the hospital at least 2 – 2 ½ hours before the time of surgery
• Report to the Pre-Admission Clinic area.
• Be directed to the Surgical Preparation area where you will wait and be prepped for your surgery.

For more information, please visit What to expect on the day of your surgery.

 

Topˆ

 

Pain Management

The goal of pain management after surgery is to provide best possible pain control and improve rehabilitation. Your ability to do activities necessary for a full recovery improves outcomes for you. Early activity prevents scar tissue formation in joint surgery and helps to reduce the risk of problems that can occur if you stay in bed too long. Walking and coughing reduce your risks of developing blood clots in your legs and chest infection.

We cannot promise that you will have no pain. Every attempt will be made to keep you as comfortable as possible. Please remember that it is better to treat pain early than to delay treatment until it is severe. So if you have pain, let your nurse or doctor know.

For more information, please visit:

Anesthesia and You

Managing Your Pain

 

Topˆ

 

Preventing Blood Clots

For the first few days after surgery, you will not be getting up as often as you were prior to surgery. As a result, you are at a higher risk of developing blood clots. To prevent this, you will be given a medication once a day to thin your blood called Fragmin® (dalteparin). This medication is:

• Given to you using a small needle in your stomach
• Your nurse will give you this medication and begin teaching you to give the injections yourself starting on the first day after surgery
• You will need to continue this medication at home, for a total of 10 to 14 days after surgery

Your surgeon may choose to shorten or lengthen the duration of this therapy based on other risk factors.

Please note that Fragmin® (dalteparin) is not a paid benefit under the Ontario Drug Benefit Program for preventing blood clots. This affects you if you are senior citizen (age > 65) and/or receive:

• Social assistance
• Trillium program
• Home care drug card

Alternative drug plans (ie. benefits through employer) may cover this drug.

If you already take a medication for blood thinning such as Coumadin® (warfarin), you will resume this drug after surgery. The day after surgery you will be put on a combination of Fragmin® and Coumadin® initially because the Coumadin® will take a few days to start working again.

 

Topˆ

 

After Surgery

The typical length of stay in hospital after joint replacement surgery is 3-4 days. During your stay in hospital, a nurse, physiotherapist and occupational therapist will work with you to make sure you are ready to return safely home. Sometimes family members are asked to come in so they can be shown how to assist you in the activities you need to do to return home.

Each day, your nurse will assist and review:

• Bathing and toileting yourself

• Teach you how to manage your incision, pain medication and blood thinner injections

• Things to watch for when you return home
  

A physiotherapist will see you each day you are in hospital to:

• Teach you to get in and out of bed

• Review with you the use of ice to help minimize swelling after surgery

• Review with you the exercises you will be responsible for when you leave the hospital

• Assist you with your walking and teach you how to properly use the walker and/or crutches you will use when you return home

• If you have stairs to manage at home, the physiotherapist will instruct you on the correct technique to go up and down safely at home.

After hip surgery, an occupational therapist will see you a day or two after to:

• Review with you your hip movement restrictions

• Equipment needs

• Review with you how to manage your activities of daily living ie. Dressing, Bathing, Homemaking, Safety Proofing your home

Once you have completed all the activities needed for you to return home and your surgeon is satisfied with the overall outcome of your surgery, you will be discharged home with:

• A prescription for pain medication
• An appointment to see your surgeon again in 6 weeks
• A referral to see a physiotherapist in your community

 

Topˆ