Total Joint Replacement Patient Education

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Total Joint Replacement Patient Education
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Welcome to Centerpoint Medical Center
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Our Goal Is To

• Provide you with valuable information on what to
  expect before, during and after surgery
• Give you an opportunity to meet fellow
• patients that will be having surgery the same
  day
• Familiarize you to our HMI unit and Staff
• Decrease your anxiety level

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• The Total Joint Center

• Designed specifically for jointreplacement
  patients
• Continuum of Care approach
• Extensive clinical expertise with a compassionate
  caring treatmentphilosophy
• Known for its quality of care

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Knee Anatomy

• Femur (thigh bone)
• Tibia (shin bone)
• Patella (knee cap)
• Ligaments
• Connect bone to bone
• Tendons
• Connect muscle to bone
• Articular cartilage
• Teflon-like coating on the ends
• of the bones. Also lines the
• back of the patella
• Meniscus
• Cartilage pads

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Knee Anatomy

• Joint capsule
• Tough ligament-like
• material which
• surrounds the joint like
• a balloon
• Synovial lining
• Lining of the joint
• capsule. Creates
• synovial fluid which
• lubricates the joint.

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Hip Anatomy

• Pelvis
• Socket
• Femur
• Head (Ball)
• Neck
• Articular
• Cartilage

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Hip Joint Anatomy

• Joint capsule
• Tough ligament-like
• material which
• surrounds the joint like
• a balloon
• Synovial lining
• Lining of the joint
• capsule. Creates
• synovial fluid which
• lubricates the joint.

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Hip Joint Anatomy
Position of the hip sometimes causes pain to be
deferred down the leg and deep in the buttocks
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Arthritis

• Over 100 different kinds of arthritis
• Osteoarthritis
• Most common
• Degenerative joint disease, affects the
  cartilage
• lining at the ends of bones
• Rheumatoid Arthritis
• Disease of the tissue that lines the inside of
• joints (synovium)
• Causes the lining to thicken and break down
• bone and cartilage
• Joint becomes inflamed, stiff and deformed

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Osteoarthritis

• Cartilage becomes worn, no longer
• allowing smooth movement inside the joint
• Painful grinding sensation as the joint
• works
• Pain, stiffness, and loss of function are
• common

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Total Knee Replacement

• Removal of the damaged cartilage and bone
• to position the new metal and plastic joint
• surfaces to restore alignment and function
• of your knee

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Total Hip Replacement

• Ball is replaced,
• socket is
• resurfaced
• Rough cartilage
• and bone spurs
• are removed
• Metal and plastic
• are used to
• restore the
• smooth surfaces

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Expectations after Surgery

• Return Home in 4
• days
• and
• get back into an
• active lifestyle
• in 6 to 12 weeks!

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Surgery Event Calendar

• 1. Pre-Operative Education Class
• 2. Pre-Operative Doctors Appointment
• Discuss risks/complications
• Sign consents
• Medical evaluation by your primary
• care physician or specialist
• 3. Pre-Surgical Testing Appointment

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Pre-Surgical Testing

• Pre-admission screening
• Visit last 1 to 2 hours
• Medical tests will be obtained (blood test,
• urine sample, EKG, possibly a chest X-ray)
• Please bring the following with you
• All your medications or an updated list with
• dosages
• List of physicians you see on a regular basis
• List of allergies/medical/surgical history

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Preparing for Surgery

• Nutrition
• Eat balanced meals to maintain or lose weight
• Follow physician prescribed diet
• If you are diabetic, continue to check blood
  sugar
• Physical Therapy
• Perform exercises regularly to increase muscle
• strength
• Stop Smoking/Tobacco Use
• Anesthesia risks
• Post Operative Respiratory Complications
• Delays wound healing
• Fresh Start Smoking Cessation Classes offered

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Preparing Your Home

• Remove all throw rugs out of your path
• Widen pathways so that you may get
• your walker through
• Remove or tape down any cords or wires
• Move things you might need to areas
• where you can reach them
• Prepare nutritious meals in the freezer to
• simplify cooking

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Day Before Your Surgery

• Do not shave legs the day before or
• day of surgery
• Shower with antibacterial soap the
• night before and the morning of
• surgery
• Do not eat or drink after midnight,
• including water, chewing gum or
• candy

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What To Bring With You

• All your medications that you take or an updated
  list with dosages
• Loose, comfortable clothes, enough for 4 days
• Flat supportive walking shoes that are non-slip
• Personal toiletries
• Eyeglasses instead of contact lenses
• Dentures
• Telephone numbers of people you want to call

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Things To Leave At Home

• DO NOT bring
• Large amounts of money
• Credit cards
• Valuables, jewelry

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Day Of Surgery

• Take any morning medications that
• you were instructed to take
• Arrive at the hospital 2-3 hours before
• your scheduled surgery time
• Park in the front parking lot
• Enter through the main entrance
• Report to the surgery desk

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Day Of Surgery

• The staff will prepare you for surgery
• You will change into a hospital gown
• A name band will be verified and applied
• An IV will be started
• Your medical/surgical history will be reviewed
• Your medications will be reviewed and recorded
  (your family will be asked to take them home with
  them that day)
• Instructions will be given to you and your
  family

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Day of Surgery

• You will be transported in your bed to
• the holding area by operating room
• personnel
• Your family will be directed to the
• surgical waiting area
• Both areas are located on
• the 1st floor

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Pre-Holding Area

• Meet your surgical team
• Pre-Op Holding Nurse reviews your
• medical/surgical history
• Surgeon, with your assistance,
• marks the operative leg
• Anesthesiologist will speak to you about
• anesthesia options
• Prophylactic antibiotic will be administered
• Relaxing medication will be
• administered

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Operating Room

• Anesthesia administered
• Foley catheter inserted while you are
• sleeping
• Your surgery will last approximately
• 1 to 3 hours
• The OR nurse will notify your
• family/friends when surgery
• has started and ended

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Post Anesthesia Care Unit (PACU)

• You will receive immediate, careful monitoring
• while you recover from anesthesia
• You will awaken with
• oxygen in your nose,
• blood pressure cuff on your arm,
• pulse on your finger
• catheter in your bladder
• surgical dressing and surgical drain (knee)
• Vital signs monitored frequently
• Receptionist will let your family know when you
• are transferred to the 4th floor

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Recovering From Surgery

• Once you arrive to the 4th floor you will
• encounter various conditions and activities
• Vital Signs
• Incentive spirometry
• Foot pumps
• Surgical dressing and hemovac
• IV fluids
• Blood tests, blood transfusions
• CPM
• Cold therapy

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Pain Management

• In order for you to have your pain treated
  effectively,
• it is important to
• Request pain relief when you begin to feel any
• discomfort
• You will be asked to rate your pain on a scale
  of
• 0 (no pain) to 10 (most severe pain). Help the
• doctor and nurses assess your pain and report
• whether the pain relief measures were effective
• If you have been taking prescribing pain
• medication please let your doctor and nurse know
• what works best for you

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Preventing Complications

• Blood clots
• Blood thinners (Lovenox and /or Coumadin)
• Stockings/Foot pumps
• Mobility
• Pneumonia
• Incentive spirometry, coughing deep breathing
• Mobility
• Infection
• Prophylactic antibiotics for 24 hours
• Hand gel sanitizers

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Preventing Complications

• Constipation
• Daily stool softeners
• Laxative as needed
• Increase fluid intake
• Nausea
• Diet will be progressed as tolerated
• Medication as needed
• Swelling
• Cold therapy

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Rehabilitations Begins

• You will be evaluated by a physical
• and occupational therapist on the
• morning after surgery
• Physical therapists will instruct
• you on transferring, walking with a
• walker, strengthening exercises,
• stair climbing, and review
• precautions
• Occupational therapists will
• instruct you on transfers, self care
• activities and use of adaptive
• equipment
• Our goal is to help your reach your
• maximum level of independence
• before you are discharged

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Discharge Planning

• A Case Manager and/or Social Worker
• will
• Visit with you the day after surgery
• Assist in the transition from hospital to your
  discharge destination
• Assist with insurance questions
• Make arrangements for medical equipment home
  delivery

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Discharge Destination

• Most patients are discharged to home on Day 4
• Your discharge destination will be determined by
• Your condition at discharge
• Your insurance coverage
• If you are not ready to return home at
• time discharge, alternative options will be
• discussed with your discharge planner

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Discharge Destination

• Option 1 Home with Outpatient
• Rehabilitation
• Option 2 Home with Home Health
• Therapy
• Option 3 Short Term Inpatient
• Rehabilitation

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Care After Discharge

• If going home, arrange to have someone available
  to help you
• Case management will arrange continued physical
  therapy (home health therapy or out-patient
  rehab)
• Medical equipment, if needed, will be
• delivered to your home
• First post-operative visit is usually
• 10-14- days (staples removed)
• Follow discharge guidelines

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Things to Remember

• Self Motivation is the key to
• successful surgery !
• Do your physical therapy exercises
• Items to bring to hospital
• Comfortable, loose clothing and good shoes
• Toiletries, lip balm, hard candy
• Medications for Review
• Listing of all of your doctors

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• Thank You
• for
• choosing
• HMI
• for your
• Total Joint Replacement
• www.centerpointmedical.com click on Human Motion
  Institute