The physician recommends surgery for my joint issue. Now what?
Once our physicians have determined that an operation is required, our staff will work with you to obtain insurance authorization for the procedure, help make any necessary referrals for medical or cardiology clearance for surgery, and will also help in scheduling your procedure.

I’ve had the same family doctor for years. Can he do my preoperative evaluation?
We do prefer that you be examined by one of the internal medicine physicians that we recommend. We have found this to facilitate the surgical experience, as physicians we refer are very familiar with our processes and are readily available following your procedure. We understand that you may have some apprehension about seeing a new doctor; please note, the internal medicine physicians we work with are very knowledgeable and provide comprehensive, quality health care.

Can I have a big dinner the night before the surgery?
Although it is tempting to plan an extravagant meal before checking into the hospital, it is never a good idea to eat a huge meal prior receiving general anesthetic — even if you eat many hours prior to surgery. Your large meal will not be fully digested and will remain in your bowel longer than it should, which may cause a postoperative problem. Our recommendation is to enjoy light meals, low in residue, between 24 and 48 hours prior to your hospitalization, to insure normal bowel function after surgery.

How long does a joint replacement surgery take?
A primary (first time) total hip or knee replacement generally takes between sixty and ninety minutes in the operating room. This is followed by a minimum one hour stay in the recovery room. A revision hip or knee surgical procedure will generally take longer, as the procedure is more complex. For other types of orthopedic surgery, your physician will be able to provide a more accurate estimate once your X-rays are complete.

Why do I need a physical before surgery?
Prior to surgery, you may need to complete a medical history review and physical examination with an internal medicine physician to ensure that you can tolerate general anesthetic. Your physical exam will be scheduled for you within a week of your surgery date, as part of our scheduling process. If you are coming in from out of town for your surgery, you will be seen by the internal medicine physician who is staffed at the hospital where you are being admitted.

On the day of surgery, what should I bring to the hospital?
On the day of surgery, please bring a toothbrush; hair comb; small amount of cash (ten or twenty dollars); pajamas, nightgown and/or robe; swimsuit (should you require aquatic therapy); sturdy slippers with a closed heel (Velcro closures are especially good); your insurance information; and a good book.

Please leave your valuables and medications at home. The hospital will not allow you to take your own medicines once you are admitted. However, please do bring a complete list of your medications (including strength and dosages) to be sure you are getting all the medicines you need during your hospitalization.

If you still have any equipment from a previous joint replacement surgical procedure, such as a knee immobilizer, crutches or walker, please bring the equipment to the hospital with you to avoid having to pay for these similar items again. Please label any equipment you provide with your name.

Can I donate my own blood?
We encourage it! When we schedule your surgery, we will provide you with details about how to donate blood. This provides you with plenty of time to get enough blood donated prior to your hospital admission.

Are infections a concern with total joint replacement surgery, and will infections interfere with my plans for surgery?
Yes! Any current infection, such as an infected toenail, draining sinus, bladder infection or dental abscess may impact your surgery. We prefer to not operate on anyone with a current infection, as this can increase the risk of infecting the new joint. Any recent infection must be well controlled prior to elective surgery of major proportion. Please report any infection symptoms to us as soon as you suspect a problem so that we can treat you promptly and help you return to good health for surgery.

How long will I stay in the hospital?
An average hospital stay for a joint replacement procedure, such as a hip or knee replacement, is between three and four days — but may vary depending upon the type of surgical procedure. Your discharge date will be determined by your progress in physical therapy. When you are able to get in and out of bed without help, you can go home. A few procedures, such as certain hand surgeries, do not require a hospital stay.

When will I get out of bed for the first time?
In most cases, you will be able to get out of bed the day after surgery. Note, this may vary depending upon the type of surgical procedure you have.

Will I need crutches after surgery?
You will need a walking aid, such as a walking cane, crutches or a walker, for a minimum of six weeks following surgery. The walking aid lessens the amount of pressure placed on a newly replaced joint, thus enabling your new joint to heal.

When will I be able to return to work?
As a general rule, you should plan on a minimum of six weeks recovery time away from work. Thereafter, your return to work will depend on the level of activity your job requires of you, as well as your physical therapy and recovery progress. You may investigate the possibility of returning to work on a part-time basis in order to facilitate the transition back to work.

Will I need physical therapy after I leave the hospital?
For hip replacement surgery, physical therapy may not be necessary after you are discharged from the hospital. For knee replacement surgery, we recommend approximately four weeks of physical therapy after hospital discharge. For serious hand injuries and complex hand surgery, you may need specialized therapy by a certified upper extremity physical therapist. We are happy to provide you with referrals to physical therapists that we recommend. For other types of orthopedic surgery, your surgeon can outline specific physical therapy needs.

Can I conduct my physical therapy at home?
Physical therapy programs vary by insurance plan coverage. If your insurance provider allows in-home therapy, we are happy to provide you with an in-home therapy prescription. If your insurance provider does not allow in-home therapy, you will need to visit a physical therapy facility. Our staff is happy to help you evaluate your insurance coverage before you leave the hospital.

I live alone. Will I be able to take care of myself at home after surgery?
For the first week following surgery, we advise that you make arrangements for someone to assist you. If this is not possible, we are happy to assist you in contacting social services or home care services, which provide in-home nurse services several times per week.

Will I be seen by my physician for postoperative office visits?
If your postoperative progress is satisfactory, you may see one of the physicians’ fellows for your follow-up visit. The fellows are orthopedic surgeons and work closely with our physicians. After your follow-up visit, the fellow will confer with the physician regarding your progress to ensure consistent care.

I am coming in from out of town for my surgery. Will I need a follow-up visit with my physician?
The normal postoperative program includes follow-up visits at six weeks, twelve weeks, six months, one year and annually thereafter. If at all possible, your physician would prefer to meet with you up to six weeks following your procedure. If you are not having any problems, you do have the option to send X-rays for each of the follow-up intervals. We will then contact you via phone once your physician has reviewed the X-rays and determined your progress.

Will I be able to board an airplane and fly immediately after my hospital discharge?
Yes, many of our patients fly home following surgery. You should be comfortable with your activity restrictions by the time you leave the hospital. Prior to discharge, you will learn how to effectively get in and out of a car with your new joint. If necessary, resources are available to help you in making transportation arrangements (to/from the airport, airplane reservations, etc.).

When making your travel reservations, we advise that you notify the airline personnel of your recent surgery so that they can provide any special assistance you may need when boarding and deplaning the aircraft. If you have had knee surgery, it is also helpful to reserve a bulkhead seat to allow maximum extension of your operated leg. If you have a long flight ahead of you, plan on getting up and walking up/down the aisle ways periodically to decrease stiffness. Also be sure you have adequate pain medication with you (we will prescribe pain medication prior to your hospital discharge).

Will my new metal joint set off the metal detectors in airport security?
It is likely that most U.S. security systems are sensitive enough to pick up the metal in your new joint. To facilitate your travel, we will provide you with a card that verifies the presence of a prosthetic joint. If you have travel plans, please request this verification card from your physician’s nurse.