2024 03 PHC Hip Knee Guidebook

Your Guide
to Hip & Knee

Replacement Surgery
Table of Contents
Services We Provide........................................................................................... 4
Getting Back on Your Feet................................................................................. 5
Why Joint Replacement May be Needed................................................ 5
Goals of Surgery...................................................................................... 5
About Hip Replacement..................................................................................... 6
Understanding How the Hip Joint Works................................................ 6
Understanding the Mechanics of an Artificial Hip Joint......................... 7
Fixation..................................................................................................... 7
Approach.................................................................................................. 7
About Knee Replacement.................................................................................. 8
Understanding How the Knee Joint Works............................................. 8
Understanding the Mechanics of an Artificial Knee Joint...................... 9
Fixation..................................................................................................... 9
Your Piedmont Care Team............................................................................... 10
Preparing for Surgery
Leading Up to Surgery Checklists.......................................................... 11
Benefits of Joint School.......................................................................... 11
Joint School Topics.................................................................................12
Discharge Plans.......................................................................................12
Medications and Supplements...............................................................13
Health Care Decisions............................................................................13
Prehabilitation (Prehab) – BEFORE Your Joint Surgery..........................14
Goals of Prehab.......................................................................................14
Pre-Operative Exercises..........................................................................16
Recommended Durable Medical Equipment (DME)..............................19
Home Safety Preparation......................................................................20
Pre-Op Checklist.....................................................................................21
Surgery
Day of Surgery....................................................................................... 22
Important Information........................................................................... 22
At the Hospital....................................................................................... 22
Anesthesia.............................................................................................. 23
Recovery
Following Surgery.................................................................................. 24
Understanding Pain............................................................................... 25
Recovery at Home................................................................................. 26
Caring for Yourself at Home.................................................................. 28
Moving Forward..................................................................................... 29
Frequently Asked Questions...........................................................................30
Convenient Locations...................................................................................... 32
Services We Provide
Welcome to Piedmont! You’ve come to the right place for your joint replacement surgery. We’re
committed to providing you with exceptional health care every step of the way.
We believe the more you know about what to expect before, during, and after your joint replacement
surgery, the more you’ll be able to join us in making your surgery and recovery a success.
We hope you take advantage of everything we have to offer and become an expert in your health and
care in preparation for your surgery.
Our services include:
• Orthopedic navigators (at select locations)

o Our navigators are your advocate. They teach Joint School, assist with pre-operative preparation,
provide support throughout treatment, answer questions and address concerns.
• Online Joint School

o https://www.piedmont.org/orthopedic/total-joint/total-joint-replacement
• Online physician talks

o https://www.piedmont.org/orthopedic/total-joint/total-joint-replacement
• Online physical therapy demonstrations
o piedmont.org/orthopedic/orthopedic-patient-education
o piedmont.org/media/file/Knee-Replacement-Excercises.pdf
o piedmont.org/media/file/Hip-Replacement-Excercises.pdf
• Online and/or printed guidebook for hips and knees
o Guidebooks are available online and at some Piedmont hospital locations

o piedmont.org/media/file/Hip-Knee-Guidebook.pdf
• Piedmont My Chart (https://www.piedmont.org/patient-tools/mychart)

It’s easy to sign up, easy to use, and it helps you:
o Connect with your doctor
o See your test results
o Manage all your appointments
o Request medication refills
o Check in before you walk in
Thank you for choosing Piedmont. We look forward to taking

excellent care of you every step of the way.
4 •4 piedmont.org/orthopedics
Getting Back on Your Feet
Recent improvements in materials and techniques have made total joint replacement a common and
highly successful surgery. Most hip and knee replacement surgeries take between 1-2 hours. In most
cases, patients are walking with a walker or cane within hours of surgery and begin physical therapy the
day of surgery. A joint implant’s longevity will vary in every patient based on factors such as age, weight,
activity level and medical conditions. An implant is a medical device subject to wear that may lead to
mechanical failure. There is no guarantee that your implant will last for any specified length of time, but
in general, it should last about 20 years. More joint replacements are now done as outpatient procedures
with discharge to home the same day as surgery. In rare cases patients may be required to stay in the
hospital for 1-2 days.
Why Joint Replacement May Be Needed

An injury, disease or normal aging can cause
articular cartilage to become thin, rough or worn.
When it does, the bones begin to rub together.
This results in a slow wearing away of the bone
surface, which can cause pain and stiffness.
The most common cause of joint disease includes:
• Osteoarthritis occurs as the cartilage thins due to

wear and tear that destroys the cartilage. This is
the most common form of arthritis.
• Rheumatoid Arthritis may affect many parts of the

body including the synovial membrane in joints.
The diseased membrane makes large amounts of
fluid, which thins the cartilage and causes the joint to swell. We strive to enable patients
to walk the day of surgery
• Traumatic Arthritis may occur at any age. This type of and resume normal activity
arthritis is from an injury to the joint, which damages the in 6 to 12 weeks.
cartilage.
• Avascular Necrosis is the death of the bone due to a lack

of blood supply.
Goals of Surgery
• Relieve pain (the main reason for most people)
• Improve joint motion
• Correct deformity
• Restore independence
• Return to an active lifestyle
5
About Hip Replacement
Understanding How the Hip Joint Works
The hip joint is a ball-and-socket joint. The ball (femoral head) is attached to the top of the femur
(thigh bone). The acetabulum (socket) is curved and is part of the pelvis (hip bone). The ball rotates
in the socket and allows you to move your leg in all directions.
A smooth substance called cartilage acts as a cushion between the ball and socket. A thin
membrane (synovial membrane), containing synovial fluid, surrounds the joint and lubricates
the cartilage. The cartilage allows the ball to glide easily inside the socket, as well as provides a
smooth surface on your bones to make movement easy and painless.
Normal Hip Joint Arthritic Hip Joint
pelvis
(hipbone)
acetabulum
(socket)
femoral head
(ball) worn
cartilage
femur
(thighbone)
With an arthritic hip, the cartilage wears out. The bones rub together and become rough, resulting
in inflammation and pain. Therefore, you have decreased range of motion and difficulty walking.
6 • piedmont.org/orthopedics
Understanding the Mechanics of an Artificial Hip Joint
With hip replacement, the weight-bearing surfaces of the hip joint are replaced with man-made materials
called a prosthetic implant or hip prosthesis. The prosthesis consists of four components: acetabular
component (socket), acetabular liner, femoral head (ball), and femoral stem. Once the components are
aligned, movement that is more natural and less painful is restored.
• Acetabular component (socket): the metal cup fits into the resurfaced socket of the pelvis/ hipbone. It
is usually made of metal but can also be made of plastic.
• Acetabular liner: the liner fits into the cup and allows the femoral head (ball) to glide easier. The liner
can be made of a high-quality plastic (polyethylene) or ceramic.
• Femoral head (ball): the ball will fit directly into the plastic or ceramic lined socket and attach to the
femoral stem. The ball can be made of either metal or ceramic or a combination of materials.
• Femoral stem: the stem inserts inside the femur. The stem is metal and made with either titanium,
cobalt-chromium alloys, or a titanium and cobalt mixed metal.
Acetabular
liner
Fixation
Both the acetabular component and femoral stem are attached with either cement or press-fit
(cementless). When cemented in place, a fast drying cement attaches the prosthesis to your actual
bone. When press-fit is used, the specially textured implant allows your bone to grow into the prosthesis
and secure it into place.
Approach
There are two surgical approaches for hip replacement: anterior and posterior.
The difference is how the surgeon opens the body to reach the hip joint.
• Anterior – incision is made in the front of the leg
• Posterior – incision is made on the side of the hip toward the back of the body
Talk to your surgeon about what materials, fixation and approach

is best for you.
7
About Knee Replacement
Understanding How the Knee Joint Works
The knee is the largest joint in the body. It is made of the femur (thigh bone), tibia (shinbone),
and the patella (kneecap). When you bend or straighten your knee, the end of the femur rolls against the
end of the tibia, and the patella glides in front of the femur.
A smooth substance called cartilage acts as a cushion between the thigh bone and shinbone.
A thin membrane (synovial membrane), containing synovial fluid, surrounds the joint and lubricates the
cartilage. The cartilage provides a smooth surface on your bones to make movement easy and painless.
Normal Knee Joint Arthritic Knee Joint
femur
(thighbone)
patella
(knee cap)
cartilage
synovial worn
membrane cartilage
meniscus
tibia (shinbone)
With an arthritic knee, the cartilage wears out. The bones rub together and become rough, resulting in
inflammation and pain. Therefore, you have decreased range of motion and difficulty walking.
Understanding the Mechanics of an Artificial Knee Joint
With knee replacement, the weight-bearing surfaces of the knee joint are replaced with manmade
materials that make up the implant/prosthesis. The prosthesis consists of four components:
femoral component, 2 tibial components, and patellar component. The metal parts of the implant are
made from titanium or cobalt/chromium-based alloys. In order to ensure a smooth, gliding motion, and
to avoid friction, metal surfaces always move against plastic.
• Femoral Component: is made of metal that curves up around the end of the femur (thighbone). It has
a central groove to allow the patella (kneecap) to move up and down smoothly as the knee joint bends
and straightens.
• Tibial Component: is made up of two parts: (1) a flat metal platform or tray that secures to the top of
the tibia (larger of the two bones in lower leg) and (2) a plastic (polyethylene) liner or spacer that snaps
onto the top of the tray.
• Patellar Component: is a dome-shaped “button” piece of plastic (polyethylene) that replicates the
surface of the kneecap.
Fixation
All components are attached with either cement or press-fit (cementless). When cemented in place, a
fast drying cement attaches the prosthesis into your actual bone. When press-fit is used, the specially
textured implant allows your bone to grow onto the prosthesis and secure it into place.
Talk to your surgeon about the details of your surgery.
9
Your Piedmont Care Team
Orthopedic Surgeon – performs the surgery and oversees your treatment.
Advanced Practice Professional (APP) – health care professionals (physician assistant [PA] or nurse
practitioner [NP]) licensed to examine, diagnose, and treat patients in collaboration with their physician
partners.
Anesthesiologist – physicians who ensure your safety and comfort during surgery.
Anesthetist – advanced practice nurses or anesthesia assistants who administer anesthesia medications.
Hospitalist/Inpatient Medical Service (IMS) – physicians who manage other health conditions not
related to the surgery such as diabetes or high blood pressure while you are in the hospital.
Hospital Pharmacist – monitors medications for correct use, side effects, and potential drug interactions.
Registered Nurse or Licensed Practical Nurse (RN, LPN) – nurses who monitor you for complications
and coordinate your care.
Patient Care Technician (PCT) – assists your nurse in providing daily care.
Physical Therapist (PT) – evaluate you and develop a plan to help you recover safely. They teach you
exercises to regain muscle strength and how to use aids such as walkers and canes.
Physical Therapy Assistant (PTA) – assists your therapists in providing daily therapy sessions.
Occupational Therapist (OT) – teach you easier ways to do daily activities such as bathing and dressing
as you heal.
Case Manager – nurses or

social workers who assist with
preparation for your discharge
home from the hospital. They
coordinate services such as home
health or outpatient therapy and
equipment.
Orthopedic Navigator/
Coordinators – navigators who
answer questions and address
concerns throughout your entire
care.
Preparing for Surgery
As Soon as a Decision for Surgery is Made
q Register for Joint School
q Quit smoking
q Diabetic patients - work with your primary care provider to lower/control your Hemoglobin A1c
q Make a discharge plan
q Designate a coach and include them in your calendar of events
q Start prehabilitation (Prehab)
q Walk at least 30 minutes daily to build up stamina
q Start daily strengthening exercises
q Start accumulating the necessary durable medical equipment (DME)
Four to Six Weeks Before Surgery

q Attend Joint School
q Within 30 days of your surgery, complete your medical clearance with your primary care physician
One to Two Weeks Before Surgery

q Go to pre-operative visit with surgeon if necessary
q Complete pre-admission testing with hospital nurse
q Stop medications/supplements that cause internal bleeding
q Increase protein in your daily diet
q Start a stool softener if prone to constipation or sensitive to narcotics
q Begin deep breathing exercises to improve your lung function, if you received an incentive
spirometer (IS), begin using that as well
q Start preparing your home for recovery
q Complete pre-registration process with hospital business office
Benefits of Joint School

This comprehensive, interactive, web-based class will prepare you and your caregiver(s) for a successful
surgery and recovery. Patients who attend Joint School at Piedmont prior to their surgery are 25% less
likely to be readmitted within 30 days and have a 50% reduction in their complication rate.
To register for a class please visit https://classes.inquicker.com/?ClientID=12422.
11
Joint School Topics
• Understanding your procedure • How to care for yourself at home
• What to expect before & after surgery • Role of the coach/caregiver
• Physical/occupational therapy • Discharge planning
• Pain management
Designate a family member

or friend to be your coach
During your joint replacement

experience, the involvement of a
friend or relative participating as
your “coach” is very important. Your
coach should be with you from
pre-admission testing, through
your stay in the hospital, and after
your discharge to home. They are
encouraged to attend Joint School,
give support during your therapy
sessions, and keep you focused on
healing. They will ensure that you
continue your exercises when you
return home, and that your home
remains safe during your recovery.
Discharge Plans
Most of our patients are discharged on the day of surgery, though some may be discharged 1-2 days
afterward based on medical necessity. Believe it or not, discharge planning started the moment you
decided to have surgery. One of the benefits of having elective surgery (a surgery scheduled in advance
because it does not involve a medical emergency) is being able to select a date that is convenient for
you and your support system. Preparing a plan for discharge is very important for your recovery. You
should plan to recover at home (people tend to eat, sleep, move around more and heal better at home)
with assistance from friends or family members after leaving the hospital. It is critical that you identify
someone to be your “Coach” who will be available to drive you home from the hospital and stay with you
for the first 24 hours, and then be readily available to you for an additional 10-14 days.
Have your transportation arranged. You will receive discharge instructions concerning medications,
activity, and care of your surgical incision.
You will be discharged from the hospital when:

• Your medical condition is stable
• Your pain is tolerable with oral pain medication
• Your discharge arrangements are complete
• You successfully meet therapy goals
Medications and Supplements
• Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) need to stop at least 7-10 days before surgery. Over-
the-counter NSAIDS are medications such as Ibuprofen (Advil, Motrin), Naproxen (Aleve), Aspirin (if
your Aspirin is prescribed by a cardiologist or neurologist, talk to them before stopping). Prescription
NSAIDS are medications such as Celebrex, Meloxicam/Mobic, Diclofenac/Voltaren, lndomethacin/
lndocin, and Nabumetone/Relafen.
• Herbal supplements need to stop at least 2 weeks before surgery. The following supplements
can increase the risk of bleeding (list is not exhaustive): Omega 3 fatty acids/fish oil, Vitamin E,
Chondroitin, Glucosamine, Turmeric, Capsaicin, Cumin, Valerian, Garlic, Ginkgo, Ginseng, Licorice,
Ginger, St. John’s Wort, Ephedra, Goldenseal, Feverfew, Saw Palmetto, and Kava-Kava.
• Prescription Anticoagulation/Blood Thinner Drugs: such as Coumadin, Xarelto, Eliquis, Pradaxa,
Plavix, and physician ordered Aspirin, will need to be held according to your prescribing physician’s
directions.
• Follow instructions provided by your surgeon’s office and/or the hospital on when to stop GLP-1 agonist
used for weight loss and diabetes management (ex: Trulicity, Ozempic, Wegovy, etc.).
Health Care Decisions

Advance Medical Directives are printed instructions that communicate your healthcare wishes if you are
unable to communicate them for yourself. This document may be called an Advance Directive, Healthcare
Power of Attorney or Living Will. The Georgia Advance Directive combines these into one document.
The Healthcare Power of Attorney (also known as Healthcare Agent or medical decision maker) allows
you to designate someone to make healthcare decisions for you if you are unable to make them yourself.
Some of the decisions you may allow your healthcare agent to make include medical interventions,
organ donation, and autopsy.
The Living Will portion communicates your healthcare wishes if you have a terminal condition or are in
an irreversible coma AND unable to speak for yourself. Some of the healthcare instructions included are
related to life sustaining equipment, medications, hydration and nutrition.
You may complete an Advance Directive on your own. An attorney or notary is NOT required in the state
of Georgia. If you have an Advanced Medical Directive, bring a copy of the document with you to the
hospital. A Registration Clerk will scan it into your electronic medical record.
13
Prehabilitation (Prehab) – BEFORE Your Joint Surgery
Many patients with arthritis of the hip or knee avoid using their painful leg. Muscles become weaker,
making recovery slower and more difficult. To speed your recovery up, it is important to get in the
best physical shape possible for your surgery. The aim is to prevent going into surgery weak and
deconditioned.
Goals of Prehab
Improve fitness level: Increases overall stamina and improves the rate of healing and recovery.
• Start walking a minimum of 30 minutes daily

• Other conditioning programs are water aerobics, swimming, stationary cycling, and Tai Chi
Improve muscle strength: Builds strength and flexibility by preparing the muscles for an increased
workload during the months of recovery.
• Begin isometric exercise (Exercises are on pages 16-18)
• Perform 5-10 repetitions of each exercise 2 times a day
• Can be performed at home without exercise equipment
Improve nutrition: The nutrients from food provide us with the strength, energy and ability to heal.
People who are well nourished are less likely to develop infection and heal faster. Protein aids the body in
repairing damaged tissues.
• Eat foods high in protein: meats, poultry, seafood, eggs, peas, nuts, soy, seeds, dairy products
• Start drinking high protein supplements 5 days before and 30 days after surgery
Protein loses occur during surgery from tissue breakdown and blood
loss. Increased protein intake helps prevent muscle loss and promote
wound healing. Protein is vital to combat the effects of the surgical
stress response, promote immune heath, and reduce the risk of
muscle catabolism.
Weight Regular Daily Protein Requirement After Surgery Daily Protein Requirement
150 pounds 54 grams 82 grams
Increase protein by 30gm/day at least 1 week before and 30 days after surgery.
Food Measure Grams of Protein
Black beans, canned 1 cup 15 g
Peanuts 1 cup 39 g
Seeds, sunflower 1 cup 27 g
Soybean 1 cup 33 g
Cheese, mozzarella or cheddar 1 cup (diced) 28 g
Beef 3 oz. 26 g
Turkey breast 3 oz. 26 g
Pork chop 4 oz. 24 g
Fish (tilapia, grouper) 1 filet 23 g
Fish (tuna) 3 oz. 23 g
Raw tofu 1/2 cup 10 g
Chicken 4 oz. 22 g
Pork sausage 3 oz. 14 g
Cottage cheese 4 oz. 13 g
Milk 1 cup 10 g
Lowfat yogurt 6 oz. 9g
Egg 1 large 6g
Commercial Name Serving Size Amount of Protein

Premier Protein 11 fl. oz. 30 grams
Ensure Max Protein 11 fl. oz. 30 grams
Ensure Clear 8 fl. oz. 8 grams
Orgain Organic Nutritional Shake 11 fl. oz. 16 grams
Isopure Protein Drink 20 fl. oz. 40 grams
Kate Farms (vegan) 11 fl. oz. 16 grams
Fairlife High Protein 11.5 fl. oz. 30 grams
Boost Max Protein 11 fl. oz. 30 grams
Protein20 Protein Infused Water 16.9 fl. oz. 15 grams
These products may not be appropriate for individuals with diabetes. Please consult
with your surgeon if you have diabetes prior to purchasing protein supplements.
15
Pre-Operative Exercises
Total Knee and Hip Replacement Exercises Video demonstrations are available
Below are descriptions of exercises recommended online at piedmont.org/orthopedics
before, during, and after your surgery. There are twelve under Patient Education
(12) exercises for both hip and knee replacements,
three (3) additional exercises specifically for knee
replacements, and two (2) additional exercises specifically for hip replacements. Each exercise has
a video demonstration on our website piedmont.org/orthopedic/orthopedic-patient-education
performed by a Piedmont physical therapist. Practice the exercises along with the videos to make sure
you are doing them correctly. You can also download the PDF of the exercises and print a 1-2 page copy
to put by the bed or your favorite chair for easy reference.
Perform the exercises slowly. Start with 5-10 repetitions of each exercise twice a day on both legs. Increase
the number of repetitions each week - make 20 repetitions your goal. Expect to be sore at the beginning.
STOP any exercise that causes extreme pain.
1. Ankle Pumps 2. Quad Sets 3. Gluteal Sets

Gently point toes up towards Slowly tighten thigh muscles of Squeeze the buttocks together
your nose and down towards legs, pushing knees down into as tightly as possible. Hold for
the surface. Do both ankles at the surface. Hold for 5 count. 5 count.
the same time or alternate feet.
Coach’s note: Look and feel Coach’s note: Patient can
Coach’s note: Perform for the muscle above the place hands on right and
throughout the day, 10 per knee to contract. As strength left gluteal (buttocks) area
hour while awake. improves, the heel should and feel for equal muscle
come slightly off the surface. contractions.
4. Abduction and Adduction 5. Heel Slides 6. Short Arc Quads

Slide leg out to the side. Keep Bend knee and pull heel Place a large rolled towel
kneecap and toes pointing towards buttocks. If needed, (about 8” diameter) under the
toward ceiling. Gently bring assist by pulling with a bed leg. Straighten knee and leg.
leg back to pillow. May do sheet placed under the foot for Hold straight for 5 count.
both legs at the same time. increased knee bend.
Coach’s note: Work for full
extension (straightening) of
the knee. Assist with hand
under heel, encouraging
lifting the foot from the hand.
7. Knee Extension - Long Arc 8. Standing Heel Raises 9. Standing Knee Flexion
Quads
Hold on to a walker or chair. Holding on to a walker or
Slowly straighten operated leg Rise up on toes slowly for 5 chair, bend the knee, lifting
and try to hold it for 5 count. count. Come back to foot flat foot toward buttocks. Hold for
on the floor. 2 count.
Coach’s note: Encourage
patient to completely Coach’s note: When lifting up, Coach’s note: The tendency is
straighten knee. do not lean backward. for the hip to come forward as
the knee is bent. Encourage a
straight line from the shoulder
to knee.
Additional Exercises Specifically for Hip Replacement
10. Standing Rocks 11. Standing Partial Squats

Holding onto the walker or Holding onto the walker or
chair, place your surgical leg chair, slowly squat by bending
behind you. Rock weight back your knees and slightly
and forth over the surgical leg pushing your buttocks out (act
keeping the knee straight. Do like you are about to sit down).
NOT lift the heel. Keep both feet on the floor.
Coach’s note: The tendency Coach’s note: Encourage

is for the knee on the surgical erect posture with eyes
leg to bend. Encourage a forward. Do not bend at the
straight knee on that leg and waist.
equal weight bearing through
both legs.
17
Additional Exercises Specifically for Knee Replacement
12. Straight Leg Raises 13. Extension Stretch 14. Sitting Knee Flexion
Bend good knee, securing heel Prop foot of operated leg up Keeping feet on floor, slide
on surface. Keep affected leg as on a chair. Put a roll under your foot of operated leg backward,
straight as possible and tighten ankle. Sit back and try to relax. bending knee. Hold for 5 count.
muscles on top of thigh. Slowly You may apply ice at the same
lift straight leg 10 inches from time. Stretch for 5 minutes. Coach’s note: Each time bend
the surface and hold for 2 to the point of pain and then
count. Lower it slowly, keeping Coach’s note: When sitting just a little more. Slide foot
the muscle tight. for any length of time, prop underneath chair, keeping
your foot as shown. Do not hips on chair.
Coach’s note: Make sure the sit with your knee bent more
straight leg is maintained and than 2 hours at a time without
the knee does not bend with changing positions.
the lift. Go slowly. If needed,
put hand under foot as in #6.
Support for Using a Walker or Cane

These exercises help build upper body strength. You will need to rely more on your arms to help move
yourself around (using a walker/cane, getting up from a chair or bed) after surgery. Be sure to exercise both
arms. Add 1-5 pounds of weight. There is no need to purchase special equipment. Therapy recommends
using a can of soup or bags of rice or beans as weights.
Biceps Curls Triceps Curls Seated Press-Ups

• Sit up straight in a chair. Keep • Sit, leaning forward from the • Sit in a sturdy chair with
your elbow close to your waist. armrests.
body and your wrist straight.
• Bend your elbow, so that your • With palms flat on the
• Bend your arm, moving your forearm is parallel to the floor. armrests, press down to lift
hand up to your shoulder. Then straighten your elbow your buttocks from the chair.
Then slowly lower your arm. as you extend your arm Hold for a few seconds.
behind you.
• Bend your elbows to slowly
ease back down.
Recommended Durable Medical Equipment (DME)
There is equipment that therapy recommends you use for 2-4 weeks after surgery. Some items are
required and some are optional. Start accumulating the equipment you will need prior to surgery so
you can have everything in place when you return home. A good place to start locating equipment is in
friends or relatives attics/basements; other great places are GoodWill, Salvation Army, and thrift stores.
Equipment is also available at specialized DME stores, pharmacies, and on websites like Amazon.
Rolling Walker Cane Elevated Toilet Seat

Required Optional (Usually graduate to Optional (Can also be used in
a cane after walker) the shower as a shower chair)
Tub Transfer Bench Handheld Shower Hip Kit

and Grab Bars
Optional (Expect to sit to Required for posterior hips;
shower at first) Optional Optional for anterior hips
and knees
19
Home Safety Preparation
Begin preparing your home to maintain your independence and increase your safety after surgery.
Minimize Tripping and Falling Hazards:

• Install railings on both inside and outside stairs
• Remove plants and other items from both inside and outside stairs
• Remove slick mildew or ice from outdoor steps
• Remove throw rugs, electrical cords and clutter from pathways
• Ensure the inside of your home is well lit
• Use night lights, particularly on the way to the bathroom
• Ask a friend or family member to care for your pets
Furniture:
• Chairs or recliners versus sofas or couches are easier to sit down on and rise from after surgery
• Chairs should have a firm back and arm rests
• Ideal surface height is two inches above knees
• Add an extra firm cushion to low chairs
• Add another mattress or place the bedframe on blocks for low beds
• If your bedroom is upstairs, a second walker is convenient
• Temporarily rearrange furniture to make larger passageways while using a walker
Bathroom Safety:
• You will be sitting to shower for the first 2-4 weeks after surgery
• Obtain a shower chair for walk-in showers or transfer tub bench for bathtubs
Or
• Temporarily remove sliding glass doors from bathtubs to use bench
• Install grab bars in or near your shower or bath (towel racks do not prevent falls)
• Be sure that your shower or tub has a non-slip coating or mat
• Install a hand-held shower attachment for easier bathing
• Temporarily move frequently use items to waist height to prevent reaching and squatting
Kitchen Safety & Food Preparation:

• Stock up on prepared and canned food and other staples
• Buy frozen meals or prepare your own and freeze
• Reorganize cabinets/pantry/refrigerator so frequently used items are easy to reach
• Put a high stool in the kitchen to sit on while doing counter top activities
Pre-Op Checklist
Items to Purchase Before Surgery
q 6-8 oz. bottle of Chlorhexidine Gluconate or CHG (Hibiclens) soap (if not provided at PAT visit)
q 35 bottles of protein supplement (Ensure/Boost/Premier/ Etc.)
q One 20 oz. and one 36 oz. bottle of Gatorade/Powerade/sports drink (zero sugar version if diabetic),
any color is okay
q Rolling walker with two wheels on front (if you don’t have one)
q Bedside commode to place over your toilet to add extra height (NOT required, but very helpful)
Two Days Before Surgery
q Drink at least 8 glasses of water per day

q Bathe/shower with special CHG (Hibiclens) soap
q Pack hospital bag
q Stop shaving your legs
Night Before Surgery
q Follow pre-admission testing instructions

q Bathe/shower with special CHG (Hibiclens) soap
q Drink 36 oz. high-carbohydrate sports drink before bed (zero sugar version if diabetic)
q Gather items to bring on the day of surgery
What to Pack in Your Hospital Bag
q Personal hygiene items (toothbrush, deodorant, battery-operated razor, etc.)

q A list of all the medicine you take including the name of the medication, dosage, instructions, and
reason for taking the medication
q A list of any allergies you have (to food, clothing, medicine, etc.) and how you react to each one
q Loose-fitting clothes (shorts, T-shirts)
q Flat shoes or tennis shoes with enclosed heels and non-slip soles
q CPAP machine (if needed for
sleep disorder)
q Contacts, glasses, hearing aids,
etc. with cases
q Personal electronic devices
(i.e. cellphone) and chargers
q Rolling walker (we can adjust it
for you)
21
Surgery
Day of Surgery
q Bathe/shower with special CHG (Hibiclens) soap before going to the hospital
q Continue drinking clear liquids until 3 hours before surgery
q Consume 20 oz. sports drink (zero sugar version if diabetic), if you are unable to drink all 20 oz. stop
when you feel full *Make sure you are finished drinking it 3 hours before your surgery
q STOP drinking water and clear liquids 3 hours before your surgery
q Follow hospital provided fasting instructions
q Take only the medications instructed by pre-admission testing
What is a clear liquid?
A clear liquid is anything you can see through, such as:

• water
• ginger ale
• tea
• chicken broth
• Sprite
• Gatorade
• apple juice
• popsicles
• Jello
• black coffee (sweetener is ok, but NO creamer)
Important Information
q Arrival times are usually 2 hours before surgery to allow enough time to prepare you for surgery
q Wear loose-fitting clothes and flat shoes or tennis shoes with enclosed heels and non-slip soles
q Do NOT wear makeup, lotion, finger and toenail polish or jewelry
q Leave personal belongings in the car until after surgery
q Check in with the registration clerk at sign-in and provide:
• Advance Directive if completed and witnessed
• Patient Financial Responsibility if required (co-payment or deductible)
• Insurance card, photo ID or driver’s license
At the Hospital
q Apply nasal swab provided by pre-op staff to kill any MRSA bacteria in your nose
q Comply with pre-op warming protocols to maintain your body temperature and help reduce the risk
of getting an infection
Anesthesia
The Operating Room and Post Anesthesia Care Unit (PACU) at the hospital are staffed by board certified
and board eligible anesthesiologists. You will meet with the anesthesiologist prior to surgery to
discuss the risks and benefits associated with each anesthetic option, as well as complications or side
effects that can occur. They will consider your surgical procedure, your medical history, and current
medications and allergies to determine which type of anesthesia is best for you. This time will allow
you the opportunity to ask questions and give you the information you need to make decisions about
receiving regional nerve blocks.
Types of Anesthesia
• General anesthesia - produces temporary unconsciousness and unresponsiveness for the entire body
using medication through your IV
• You will be completely asleep throughout your surgery with an airway device to help you breathe
• Possible adverse risks include, but are not limited to: postoperative delirium or cognitive dysfunction,
malignant hyperthermia, breathing problems after surgery, post-operative drowsiness, nausea/
vomiting, and minor sore throat
• Spinal anesthesia - involves the injection of a local anesthetic in the lower back to provide numbness,
loss of pain, and loss of sensation from the waist down
• Lasts for the length of your procedure and up to a few hours after
• You will be provided sedation medicine during the surgery so you take a nap but breathe on your own
• Possible adverse risks include, but are not limited to: headache, urinary retention, mild bruising
where needle was placed, and in very rare cases nerve damage
• Regional nerve block (spinal blocks and leg blocks) - involves a numbing injection near the nerve to
provide numbness, loss of pain, and loss of sensation to a particular area of the body
• May last up to 24 hours, a change in pain level will occur when the block wears off
• Beneficial for pain control during/after procedure, reduces need for narcotics, increases ease of
participation in PT, and early recovery after surgery
• Possible adverse risks include, but are not limited to: itching and/or pain at the injection site, and in
very rare cases nerve damage
Day of Surgery Timeline

Orthopedic Unit
Registration Pre-Op Area Surgery PACU/ Recovery Phase II Recovery If Applicable
Arrive 2 hours 2 hours 1.5 - 2 hours 1 - 2 hours < 1 hour <24 - 48 hours
before surgery
Arrive to the Change into hospital Anesthesia Monitor and stabilize Monitor vital signs, Monitor vital signs,
registra�on desk gown administered vital signs dressing and dressing and incision
outlined in hospital Weighed for weight- Surgical procedure Manage pain & incision Advance diet 
speciﬁc resources based an�bio�cs takes place nausea Apply cold therapy resume regular diet
provided in PAT visit IV inserted Incision closed and Neuromuscular Par�cipate in Apply compression
Bring ID, insurance, An�bio�c and pre-op dressing applied assessment physical therapy devices to your legs
and Advanced medica�ons Transferred to Wake up from Review discharge to prevent blood
Direc�ve Betadine nasal recovery area anesthesia instruc�ons with clots
Sign forms an�sep�c swab Surgeon will update Perform incen�ve Coach/family Apply cold therapy
Staﬀ will escort you  Warming blanket your family/loved spirometry (IS) member Use incen�ve
to pre-op area to applied one when surgery is Apply cold therapy spirometer
prepare for surgery Hair removal with over Par�cipate in
clippers (if needed) physical therapy
Receive nerve block
(knee only)
The �me between arrival at the hospital and discharge home/ transfer to the orthopedic unit can be between 6-8 hours
2
23
Recovery
Call, Don’t Fall
If you need to get up for anything, call your care team using the nursing call system. While in the
hospital, do not rely on family or friends for assistance getting up. Our healthcare providers have been
properly trained to assist with your needs. After you go home, use your rolling walker and rely on your
coach for assistance.
Movement is Medicine
It is important for you to get out of bed, sit in a chair, and walk as soon as possible. While in the hospital
your nurse or physical therapist will help you move around safely. Moving as soon as possible after
surgery helps decrease your risk of complications, shortens your recovery time, reduce stiffness, and
helps you return to your pre-surgery baseline sooner.
Clean Your Hands

Cleaning your hands can prevent the spread of germs. Always clean your hands before caring for your
wound, and ask your provider/care team to do the same.
Ask visitors to clean their hands before and after visiting you, and do not let them touch your wounds or
dressing(s).
After surgery, you should

expect to be:
• Out of bed
• Dressed in your own clothes
(shorts/t-shirts are best)
• Sitting in a chair for meals
• Participating with physical and/or
occupational therapy
Understanding Pain
Recovery from any surgery involves pain and discomfort. Pain management begins with you. Pain control
following surgery is an important part of your care. The goal is to recognize and treat your pain quickly,
which allows you to participate in the therapy program. Pain can be chronic (lasting a long time) or acute
(lasting a short period of time) — and will change as you recover.
Zero pain is not realistic following surgery. The goal is to use multiple methods (oral medications, cold
therapy, frequent position changes, physical therapy, walking, etc.) to keep your pain at a tolerable level
that allows you to move and participate in therapy.
Using a number to rate your pain can help your care team understand and help manage your pain. “0”
means no pain and “10” means the worst pain possible. With good communication, your team can make
adjustments to make you more comfortable.
What to Expect After Surgery – Pain Management

What to Expect After Surgery - Pain Management
TYPES OF PAIN AFTER PERFORMING

EXERCISES
Incisional pain = soreness/discomfort

Treat with pain medication and ice pack
Swelling/ bruising= tightness around incision/ joint

Treat with R.I.C.E. (rest, ice, compress, elevate)
Rest
RATING YOUR PAIN Expected, realistic, reasonable pain, treat with oral medication, beginning
Facial
0-4 with Tylenol or Ibuprofen
Pain Rating
Grimace
Scale
Verbal
5-7 Tolerable, acceptable, allowable, often treated with oral pain medication
Descriptor
8-10
Activity No Pain Can be Interferers with Interferes with Interferes with Bedrest
Tolerance Ignored tasks/ sleep concentration basic needs required Non-tolerable pain/worst pain ever, often treated with IV medications
3
It is important to take your pain medication on a regular basis and let your surgeon’s office know if
your pain is not being managed effectively.
Tips for Managing Pain
q Keep a log of your pain medications and the time you take your medications at home
q Stay on schedule
q Do not add Tylenol (acetaminophen) if your prescription pain medication has acetaminophen in it
q Do not take multiple NSAIDs together (Mortin/Advil (ibuprofen), Aleve, prescription NSAIDs)
q Follow any instructions from your surgeon’s office
25
Recovery at Home
Common Post-Operative Complications and Preventive Measures
Although not all post-operative complications can be prevented, many can be avoided with your help.
It’s important to follow your doctor’s discharge instructions to include adequate exercise and proper
hygiene. This will decrease your odds of complications. These complications and preventative measures
will be looked for and followed in the hospital, but they should be done at home as well.
Blood Clots
(Legs – Deep Vein Thrombosus; Lungs – Pulmonary Emboli)
• Get up and move

• Do ankle pumps
• Drink plenty of fluids
• Take blood thinner medications as prescribed by your surgeon
You will be given a blood-thinner to avoid blood clots in your legs

and lungs. The length of time that you will take the blood-thinner will
be determined by your surgeon.
Contact your surgeon’s office immediately if you have signs of a blood clot - redness, warmth, swelling,
pain, and tenderness (NOT at your incision site).
CALL 911 if any of these signs are accompanied by difficulty breathing, anxiety, sharp chest pain, and
sweating.
Pneumonia
• Get up and move

• Use incentive spirometer and complete cough and deep breathing exercises
Ileus (bowels go to sleep)
• Get up and move

• Prevent constipation
Infection
• Keep your incision clean and dry

• Wash hands frequently, and before and after dressing changes
• Eat or drink enough daily protein
• Change clothes daily until your incision is healed
• Monitor your surgery site for changes and notify surgeon if needed
Remember:
Movement is Medicine
Knee Precautions
It is very important to follow precautions after knee replacement to ensure complete range of motion
after recovery. Precautions are aimed at making sure you can fully straighten your leg after it heals.
What toDo
• Do not place pillows or rolls under/behind your knee not
Expect place
After Surgerypillo
–K
knee when eleva
• If elevation or support is needed, place it under the heel
• Keep your knee out straight while lying down
surgery.
It is very important to follow precautions after knee replacement Place
to ensure complete range
of motion after recovery. Precautions are aimed at making sure you can fully straighten
pill
your leg after it heals.
• Do not place pillows or rolls under/behind your knee

leg/ ankles when e
• If elevation or support is needed, place it under the heel
• Keep your knee out straight while lying down
Do
kn
sur
8
Posterior Hip Precautions
leg
Not all hip replacements have precautions. Always follow your surgeons specific instructions. If your
surgeon used a posterior approach for your surgery, it is important to follow hip precautions to prevent
Not all hip replacements have precautions. Always follow your surgeons specific
dislocation.
instructions. If your surgeon used a posterior approach for your surgery it is important to
follow hip precautions to prevent dislocation.
Twisting your body or

NO T turning your leg inward8
NO L Leaning forward past 90o
Crossing legs (even at

NO C ankles)
27
Caring for Yourself at Home
• Change position and get up and walk frequently (every 45 minutes - 1 hour) to prevent stiffness and
swelling.
• Follow your surgeon’s instructions for incision and dressing care.
• Use cold therapy (ice cooler or packs provided by hospital) as needed either a couple of times a day or
continuously to reduce swelling and relieve pain. Do not put ice packs or cooling pads directly on your
skin. Use a towel or pillow case between you and the ice.
• Leg swelling is normal and will usually resolve gradually over several weeks. Prolonged sitting with
your foot in a down position tends to worsen the swelling. To prevent or reduce leg and ankle swelling,
elevate operative leg and perform ankle pumps.
• Do not place a pillow behind/under the knee after total knee replacement.
o Reminder- do not place a pillow behind/under the knee after total knee
• Prevent constipation by drinking plenty of water, eating fiber and taking stool softeners. Over the
replacement
counter laxatives, suppositories and/or enemas may be necessary.
• If pain prevents you from completing your daily exercises or participating in therapy, pain medication is
most effective when taken 30-60 minutes before the activity begins.
• You may chose not to take prescription narcotic/opioid pain medications. Talk to your surgeon about
alternatives.
• Try not to nap during the day so you will sleep at night.
I am doing well…
• Pain is controlled with medications
• Physical therapy is going well Continue your
• Incision is clean and dry, no signs of redness physical therapy
or unusual swelling
• Normal incision swelling and bruising
I feel worse…
• Pain not well controlled with medications
• Fever of 101o or greater Call your
• Physical Therapy not going well
• Drainage from or opening of incision
surgeon and tell
• Increase in swelling- can still bend hip, knee, them your
or ankle symptoms
• Dark redness or streaking on the operative leg
• Signs of a blood clot
• Fall WITHOUT injury or increased pain
I feel in danger…EMERGENCY Immediately call

• I had a fall WITH injury and increased pain your doctor and
• Short of breath seek emergency
• Chest pain care (go to
• Non-surgical reasons: sudden onset of emergency room
numbness/tingling, severe bleeding, serious or call 911)
injury
Precautions for Opioid Medications
• Take your medications exactly as prescribed and read all instructions that come with your medication.
• Taking more than the prescribed amount or using with alcohol, benzodiazepines or other drugs can
cause you to overdose or stop breathing.
• Opioids slow reaction time, cause drowsiness, and cloud judgement. It is unsafe for you to drive or
operate heavy machinery while taking.
• Opioids are at risk of being diverted by anyone with access to your home. They should be stored in a
safe and secure place such as a locked cabinet or safe.
• Unused opioids should be disposed of by either flushing down the toilet or turning in to a designated
take-back location.
• Be alert to side effects of some pain medications including sleepiness, dizziness, nausea, itching, and
constipation.
Opioids are powerful medications used to treat moderate to severe pain and should be taken for the
shortest period of time as possible. Using opioids may cause addiction. While addiction is more common
in people with a personal or family history of addiction, it can occur in anyone. If you are concerned
about addiction, or have a history of substance abuse with alcohol or any drug, talk with your surgeon.
Moving Forward
Guidelines for Your Long-Term Health and Safety
What to Do:
• Notify your dentist or other physician/surgeon in advance if you are having dental work or other
invasive procedures – cardiac cath, bladder exam, etc. Generally, prophylactic antibiotics are taken
prior to a procedure.
• Although risks are low for post-operative infections, the risk remains. A prosthetic joint could possibly
attract bacteria from an infection located in another part of your body. Call your primary care physician
promptly if you have any signs of infection–urinary tract infection, abscessed teeth, etc. Early
treatment is necessary.
• If you develop a fever of more than 101.0 degrees Fahrenheit or sustain an injury such as a deep cut or
wound, you should clean it as best you can, put a dressing or adhesive bandage on it, and notify your
physician. The closer the injury is to your prosthesis, the greater the concern. Occasionally, antibiotics
may be needed. Superficial scratches may be treated with topical antibiotic ointment. Notify your
physician if area is painful or reddened.
Take good care and keep moving!

29
Frequently Asked Questions
How long will I be at the hospital?
• Majority are only at the hospital 6-8 hours on the day of surgery
• Some stay overnight
• A few stay more than 1 night in the hospital
How long do I need help at home?

• Must have someone drive you home from the hospital and stay with you the first 24 hours after you are
discharged from the hospital
• Have support system to help as needed 10-14 days after surgery
o
You will need transportation to your surgeons office for your first post-op visit
o
You will need transportation to Outpatient Physical Therapy the first few weeks after surgery
When can I drive?

• Not until released by your surgeon
o
Typical time frame:
• Left leg surgery is 2-3 weeks after surgery
• Right leg surgery is 3-4 weeks after surgery
When can I bear weight on my surgical leg? When can I walk up and down stairs?
• You will be able to bear full weight on your leg the first time you get up after surgery
o
On rare occasions, your surgeon could change your weight bearing for a period of time
• You can safely use stairs the day of surgery
What activities will I be able to do after surgery?

• Walking about the house with your walker
• Provide your own personal hygiene care and toileting
• Light chores, such as washing dishes, fixing light meals, and laundry
How long will I be in pain?

• Pain is personal – some people will have more pain than others
• The day of surgery has the least amount of pain because of the numbing medications and anesthesia
given to you
• The day after surgery is more painful
o
The worse pain is typically the first 1-2 weeks after surgery
• Not everyone will get to zero (0) pain after healing
When will I get prescriptions for pain medications?

• Home pain medications are prescribed by your surgeon and filled at your local pharmacy
o
Some surgeons give pain prescriptions before surgery at the pre-op office visit (do not start taking
before surgery)
o
Others give pain prescriptions the day of surgery
Frequently Asked Questions
Will I be on blood thinners after surgery?
• Everyone is at high risk for blood clots after this surgery and will be prescribed a “blood thinner” by
their surgeon to take for 30 days after surgery
o
Most surgeons use Aspirin twice a day (starts the morning after surgery)
• Ask your surgeon what they are prescribing for you
Will I have issues with constipation after surgery?

• An expected side effect of narcotic pain medication is constipation
o
Home remedies:
• Walk around
• Increase fiber in your diet
• Stool softeners will not help after the fact but are helpful once bowels start moving
• Use over-the-counter laxatives, enemas, and/or suppositories – sometimes takes all of it before you
get results
• Miralax is the most popular laxative (tasteless powder you mix in any type of drink) – can use
2-3 times daily if needed
• Milk of Magnesia followed by warm prune juice is very effective
• Senokot or Dulcolax tablets are popular
• Fleet enemas
• Glycerin or Dulcolax suppositories
• If it’s been more than 5 days and nothing is working, you need to call your surgeon or primary care
physician.
What type of dressing will I have after surgery?

• Most Piedmont facilities use a water-proof occlusive dressing that stays on 7-10 days after surgery
o
Your surgeon may use a different dressing. Always follow the instructions given to you by your
surgeon for dressing/incision care.
When can I start showering?

• It’s OK to start showering the day after surgery with the waterproof dressings
o
It’s best to sit to shower the first 2-3 weeks after surgery
Do I purchase DME (Durable Medical Equipment) or will it be provided?

• Best to obtain DME before surgery
o
Only required piece of equipment is the 2 wheeled walker – covered by insurance in some cases if
you have an order from your surgeon
o
Other equipment such as shower chairs, bedside or elevated commodes, tub transfer benches, hip
kits are as needed – most insurance providers do not cover
How long will I be out of work?

• Typically 4-12 weeks depending on the type of work you do
31
Convenient Locations
Piedmont Athens Regional Piedmont Macon
1199 Prince Avenue 350 Hospital Drive
Athens, Georgia 30606 Macon, Georgia 31217
Piedmont Atlanta Piedmont Macon North

1968 Peachtree Road NW 400 Charter Boulevard
Atlanta, Georgia 30309 Macon, Georgia 31210
Piedmont Augusta Piedmont McDuffie

1350 Walton Way 2460 Washington Road
Augusta, Georgia 30901 Thomson, Georgia 30824
Piedmont Cartersville Piedmont Mountainside

960 Joe Frank Harris Pkwy 1266 Highway 515
Cartersville, Georgia 30120 Jasper, Georgia 30143
Piedmont Columbus Regional Piedmont Newnan

Midtown Campus 745 Poplar Road
710 Center Street Newnan, Georgia 30265
Columbus, Georgia 31901
Piedmont Newton
Piedmont Columbus Regional 5126 Hospital Dr NE
Northside Campus Covington, Georgia 30014
100 Frist Court
Columbus, Georgia 31909 Piedmont Rockdale
1412 Milstead Avenue
Piedmont Eastside Conyers, Georgia 30012
1700 Medical Way
Snellville, Georgia 30078 Piedmont Walton
2151 West Spring Street
Piedmont Fayette Monroe, Georgia 30655
1255 Highway 54 West
Fayetteville, Georgia 30214 Piedmont West Surgery Center
Piedmont West Medical Office Park
Piedmont Henry 1800 Howell Mill Road, Suite 250
1133 Eagle’s Landing Parkway Atlanta, Georgia 30318
Stockbridge, Georgia 30281
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piedmont.org/orthopedics
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Your Guide

to Hip & Knee

Our services include:

• Orthopedic navigators (at select locations)

• Online Joint School

• Online physician talks

• Online physical therapy demonstrations

• Online and/or printed guidebook for hips and knees

o Guidebooks are available online and at some Piedmont hospital locations

• Piedmont My Chart (https://www.piedmont.org/patient-tools/mychart)

Thank you for choosing Piedmont. We look forward to taking

Why Joint Replacement May Be Needed

The most common cause of joint disease includes:

• Osteoarthritis occurs as the cartilage thins due to

• Rheumatoid Arthritis may affect many parts of the

• Avascular Necrosis is the death of the bone due to a lack

Normal Hip Joint Arthritic Hip Joint

Talk to your surgeon about what materials, fixation and approach

Normal Knee Joint Arthritic Knee Joint

Talk to your surgeon about the details of your surgery.

Case Manager – nurses or

Four to Six Weeks Before Surgery

One to Two Weeks Before Surgery

Benefits of Joint School

To register for a class please visit https://classes.inquicker.com/?ClientID=12422.

Designate a family member

During your joint replacement

You will be discharged from the hospital when:

Health Care Decisions

• Start walking a minimum of 30 minutes daily

Commercial Name Serving Size Amount of Protein

1. Ankle Pumps 2. Quad Sets 3. Gluteal Sets

4. Abduction and Adduction 5. Heel Slides 6. Short Arc Quads

Additional Exercises Specifically for Hip Replacement

10. Standing Rocks 11. Standing Partial Squats

Coach’s note: The tendency Coach’s note: Encourage

Support for Using a Walker or Cane

Biceps Curls Triceps Curls Seated Press-Ups

Rolling Walker Cane Elevated Toilet Seat

Tub Transfer Bench Handheld Shower Hip Kit

Minimize Tripping and Falling Hazards:

Kitchen Safety & Food Preparation:

Two Days Before Surgery

q Drink at least 8 glasses of water per day

Night Before Surgery

q Follow pre-admission testing instructions

What to Pack in Your Hospital Bag

q Personal hygiene items (toothbrush, deodorant, battery-operated razor, etc.)

What is a clear liquid?

A clear liquid is anything you can see through, such as:

Day of Surgery Timeline

Clean Your Hands

After surgery, you should

What to Expect After Surgery – Pain Management

TYPES OF PAIN AFTER PERFORMING

Incisional pain = soreness/discomfort

Swelling/ bruising= tightness around incision/ joint

Tips for Managing Pain

• Get up and move