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Preparing for Total Knee or Hip Replacement Surgery
By Daniel Casciato


Preparation is the key to a smooth surgical experience when facing total knee or hip replacement surgery. Often these procedures are scheduled in a way that helps you have the lead time you need to learn about the surgical procedure, to prepare for a successful experience, and to be well positioned for a smooth recovery. Let’s take a closer look at how physician-owned Advanced Surgical Hospital, the area’s only seven-time recipient of the Press Ganey Guardian of Excellence – Patient Experience, prepares its patients for joint replacement surgery.

Preparing for Surgery
Every patient who is having either a total knee or hip replacement will visit the Welcome Center at Advanced Surgical Hospital approximately two weeks before surgery. At that time, they will meet with anesthesia, nursing, physical therapy, and social services, according to Dr. John Evans, DPT, Director of Rehabilitation at Advanced Surgical Hospital.

  • The Anesthesia team will screen each patient to assess whether he or she meets criteria to undergo surgery.
  • The Nursing team will go over the patient’s medical history and medications and will instruct the patient on a “to-do list” before surgery.
  • The Physical Therapy and Social Services teams will review the patient’s home setup to determine what type of durable medical equipment the patient has or will need as well as educate the patient on transitioning home after surgery and the rehabilitative process.

All four of these disciplines will answer any questions the patient may have. On the day of surgery, patients will meet with registration staff, nursing staff, anesthesia, and the surgical team.

Dr. Evans recommends each patient have plans in place for discharge from the hospital. We want you to be able to safely go home with a family member or caregiver because home is generally the best place to recuperate.

“People prepare for all sorts of things in life such as sporting events, vacations, and weddings but most do not prepare for surgery,” says Evans. “Surgery is a major event so you should do everything you can to be as thoroughly prepared as possible.”

Doing a pre-surgery exercise regimen (Prehabilitation or “prehab”) is also very beneficial.

“Ideally, prehab should begin six weeks before surgery to allow enough time to improve mobility, strength, and cardiovascular conditioning,” says Evans, who has led Rehabilitation Services at Advanced Surgical Hospital to become the 2019 recipient of the Best of the Best in Business. “The healthier and more functional you are before surgery, the quicker and easier your recovery will be after surgery.”

Weight loss and proper nutrition are critical as well. Your body will need the appropriate nutrients after surgery to heal properly. Eating a healthy diet lowers inflammation, speeds up the healing process, and provides energy and strength needed for recovery.

“For every pound of body weight you lose, you reduce the load on your knees by four pounds,” says Dr. Tony Wano, D.C., of Wano Chiropractic. “Unhealthy fats found in processed foods can increase inflammation and pain. Excessive weight can put you at risk for certain side effects and complications in surgery.”

Since joint replacement surgery is an elective procedure, it is wise to make sure your house is in order before surgery day arrives, which includes nutrition, exercise, secure home environment, family and caregiver support.

One thing everyone should avoid before any surgery is alcohol and tobacco, warns Dr. Joseph Stracci, D.O., of Advanced Surgical Hospital.

“Avoid aspirin, over the counter medication, vitamins, and supplements at least one week before surgery,” he says. “Some of these can thin your blood.”

What to Expect During Recovery
Patients can expect to usually spend two nights in the hospital followed by discharge to home. Once home, patients will usually be seen once by a nurse and several times by a home health physical therapist. At the patient’s first office follow-up with his or her orthopedic surgeon, outpatient physical therapy will be ordered. Most patients will attend outpatient physical therapy two to three times a week for six to eight weeks on average.

“Healing time after having a total joint replacement will vary between patients but you can expect at least a three-month timeframe,” says Dr. Stracci.

To help prevent and control pain, Iovera can be taken before surgery. Iovera is a non-opioid cryoanalgesia for nerve pain that is usually done at least one week before surgery. Iovera delivers injected doses of cold temperature to targeted sensory nerves that stops the transmission of pain signals for a period of time. Pain relief usually lasts for approximately 90 days.

“Anesthesia is the main concern patients have before surgery,” says Dr. Stracci.

Patients think they will have general anesthesia—however, Advanced Surgical Hospital uses nerve blocks and IV sedation. People also worry about whether or not they will be sick after surgery from the anesthesia and/or pain medication. Lastly, people worry about pain.

On the day of surgery, the anesthesia team at Advanced Surgical Hospital will administer long lasting nerve blocks. Oral pain medication is also used to manage pain during and after your inpatient stay. Physical therapy and early mobility are also methods that help to reduce pain, swelling, and stiffness.

Together, the surgical and anesthesia teams at Advanced Surgical Hospital will evaluate, monitor and supervise your care before, during and after surgery to assist with your safety and a successful outcome.

Dr. Evans points out that Advanced Surgical Hospital has received many recognitions, throughout its 10 year history, for its patient care processes and outcomes which “underscores the value of a joint replacement program that focuses on helping patients be well prepared and highly engaged in their recovery process,” he says.

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For more information, visit ashospital.net
Advanced Surgical Hospital complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. (TTY: 711)

Advanced Surgical Hospital cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. (TTY: 711)
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-888-808-9008 ID 67115549 (TTY: 711)

Advanced Surgical Hospital 遵守適用的聯邦民權法律規定,不因種族、膚色、民族血統、年齡、殘障或性別而歧視任何人。注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電1-888-808-9008 ID 67115549 (TTY: 711)



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