Preparing for total joint replacement begins weeks before the actual surgery. In general, you may be told to:
- Donate blood –While some total joint procedures do not require blood transfusion, you may need blood before or after surgery. You may use donor blood or plan ahead to make an autologous donation of your own. You may also have a family member or friend with the same blood type as you designate a donation specifically for you.
- Exercise under your doctor’s supervision – It’s important to be in the best possible overall health to promote the best possible surgical experience. Increasing upper body strength is important to help you maneuver a walker or crutches after surgery. Strengthening the lower body to increase leg strength before surgery can reduce recovery time.
- Have a general physical examination – You should be evaluated by your primary care physician to assess overall health and identify any medical conditions that could interfere with surgery or recovery.
- Have a dental examination – Although infections after joint replacement are not common, an infection can occur if bacteria enter the bloodstream. Therefore, dental procedures such as extractions and periodontal work should be completed before joint replacement surgery.
- Review medications – Your orthopaedic surgeon can tell you which over-the-counter, prescription medications and herbal supplements should not be taken before surgery.
- Stop smoking – Breaking the habit is particularly important before major surgery to reduce the risk of post-operative lung problems and improve healing.
- Lose weight – For patients who are overweight, losing weight helps reduce stress on a new joint.
- Arrange a pre-operative visit – It’s important to meet with healthcare professionals at the hospital before surgery to discuss your personal hospital care plan, including anesthesia, preventing complications, pain control and diet. Bring a written list of past surgeries and medications and dosages you normally take at home.
- Get laboratory Tests – Your surgeon may prescribe blood tests, urine tests, an EKG or cardiogram, and chest X-ray to confirm you are fit for surgery. These tests should be performed within 14 days of the scheduled surgery in order to be acceptable.
- Complete forms – You will need to fill out a consent form for your surgeon confirming that you agree to have the operation and that you know the risks involved, as well as hospital forms about your past history, medications, previous operations, insurance and billing information.
- Prepare meals – You may want to prepare meals in advance and freeze them so they’re ready when you return.
- Confer with physical therapist – The physical therapist will record a baseline of information, including measurements of current pain levels, functional abilities, the presence of swelling, and available movement and strength. You will also practice post-operative exercises using either a walker or crutches.
- Plan for post-surgery rehabilitative care – Total joint replacement recipients may need help at home for the first few weeks, including assistance bathing, dressing, preparing meals and with transportation. If you can’t arrange for someone to help you at home, you may need to stay in a rehabilitation or skilled nursing facility. A medical social worker can assist with arrangements. Home therapy visits should end when you can safely leave the house and outpatient physical therapy should begin.
- Fast the night before – No eating or drinking after midnight before surgery; however, you may brush your teeth or have a few sips of water if you need to take medicines. Discuss the need to take medications such as insulin, heart or blood pressure pills with your doctor or nurse to make sure you don’t miss them.
- Bathe surgical area with antiseptic solution – Use antiseptic scrub brushes supplied by your health team the night before and morning of to reduce the risk of infection. Tell the nurse if you are allergic to iodine or soap. If possible, shampoo your hair. You must remove all nail polish and make-up. Do not shave your legs within 3-4 days of surgery.
Getting Your House Ready
Some common things in your home may now be dangerous. To prevent falls, you should remove or watch out for:
- Long phone or electrical cords that lie across the floor
- Loose rugs or carpet
- Furniture you might trip over in stairs and hallways
- Stacks of books, piles of magazines,mail, etc.
- Pets that run in your path
- Water spills on bare floors
- Bare bathroom tile or slippery floors
- Ice or mildew on outdoor steps
It would also help to:
- Arrange the most frequently used kitchen utensils and food on shelves and counters that can be reached easily.
- Have a chair or stool handy in the kitchen to sit in while preparing and cooking food.
- Leave most frequently used dishes in the dish rack, and most frequently used foods in the most accessible cabinets.
- Have a rolling cart to take food from the refrigerator to the counter, and from the counter to the table.
- Have a walker bag or apron with pockets to carry small items such as glasses, books, silverware, etc.
- Attach a cup holder to your walker to carry drinks in covered cups.
- Arrange for someone to care for or feed your pets.
Packing Your Bags
Make sure to take these things with you to the hospital:
- Exercise shoes with closed-in heel and non-slip soles
- Knee length robe or cover-up for walking in the halls
- Grooming items such as shampoo, toothpaste, deodorant, etc.
- A list of medications you are currently taking at home, including the name, strength and how often you take each medication
- Papers from the blood bank if you have donated your own blood
- A list of allergies (to food, clothing,medicine, etc.) and how you react to each one
- Any education materials you received in pre-admission classes
- A copy of your Living Will and Health Care Power-of-Attorney, if you have either one. Hospital personnel are required by law to ask for these when you are admitted. They will make a copy for your medical record and return the original.
- A copy of your insurance card
- A walker if you already have one, and a list of other adaptive equipment you may have at home with your name on all equipment you take to the hospital
- Glasses, hearing aid, and any other items you use every day
- Short gowns, pajamas, underwear, socks/stockings and one set of street clothes to wear home
- Leave jewelry, credit cards, keys and checkbooks home. Bring only enough money for items such as a newspaper,magazine, etc.
Hip Safety Precautions
Once you have a new hip, you will need to follow some safety rules. This will help you heal faster and keep your new hip from dislocating. One of these rules is to always sit with your knees lower than your hips. So before surgery, check around your house to see if you need to adapt anything by sitting:
- On the side of your bed
- In your favorite chair
- On the sofa
- On the toilet
- In the seat of your car
If your knees are not lower than your hips in any of those situations, you will need to change the height by making accommodations such as propping up with pillows or buying a raised toilet seat.