Total Joint Replacement

Total Joint Replacement
Before Surgery
Prepare Home
◦Remove rugs, railing for the stairs, bath bench, toilet seat riser, or
grab bars.
Walker/Crutches/Cane
Make sure to set up a ride home after
discharge and a caregiver for
approximately 1 week.
 Will receive two phone calls before surgery
◦ Insurance confirmation - demographic information
◦ Nurse registration – to review medical history and
medications and confirm scheduled procedure
 Any patient on a blood thinner needs to speak with their primary
doctor and surgeon regarding use 1-2 weeks before surgery
Overnight bag
◦ All labeled medications in the prescription bottle (except
pain medication), loose fitting shoes, and comfortable
clothes
◦ CPAP if used for sleep apnea
Day of Surgery
Nothing to eat or drink after midnight
including coffee, water, gum, hard candy,
etc.
Shower as instructed the night
before/morning of surgery.
Medications as instructed during pre-
procedure phone call with nurse.
After Surgery
 Surgeon will speak with family after the
procedure.
 Expect to be in recovery for 1-2 hours
after surgery.
 Wi-Fi is available within the building
Overnight Stay
Expect to stay 1-3 days
◦ See joint recovery plan
◦ Family allowed overnight; one visitor meal provided
per day
Equipment Reason
Ted hose (white socks) Prevent blood clots
Athrombics (leg massage) Prevent blood clots
Ice (polar cooler or packs) Decrease swelling/pain
Incentive spirometry (volurex) Prevent respiratory complications
Continuous Passive Motion (CPM) Assist with range of motion for

Total Knees
Pain
Goal: Well Controlled Pain Levels
◦ Scale 0-10
◦ Pain should be tolerable but not likely pain free.
◦ Be proactive, it is easier to control pain than catch up to
severe pain.
◦ An anesthesiologist will discuss pain control options

prior to surgery.
Common Medications
Narcotics Additional Pain Antibiotics
Medications
 Morphine  Tylenol • Ancef
 Dilaudid  Gabapentin • Clindamycin
 Tramadol  Celebrex
• Vancomycin
• Keflex
 Oxycodone  Toradol
 Hydrocodone  Vistaril • Possible Side
◦Possible Side  Valium Effects:
Effects • Rash
 Naropin • Itching
 Constipation
• Flushed face
Nausea  Exparel
Itching ◦Side effects vary
Drowsiness based on the
Dizziness medication given.
Common Medications Cont.
Nausea & Stool Softners
Blood Thinners Vomiting &
Prevention Laxatives
Fragmin then Zofran Colace
Aspirin Benadryl Miralax
Scopolamine Senna
Xarelto then Patch Milk of
Aspirin Decadron Magnesium
Coumadin Reglan Prunes or Prune
Aspirin Phenergan juice
◦Possible Side
Effects: ◦Possible Side
Drowsiness
◦Possible Side Effects:
Dizziness Abdominal
Effects: Constipation
Mild bleeding Cramping
Bruising Diarrhea
Physical Therapy:
Therapy begins the day of or day after

surgery, depending on your doctor. You
are expected to participate in 2 sessions
per day.
Total Knee Replacement
Patients who have had a total knee

replacement will begin outpatient therapy
within a few days of leaving the hospital.
◦ If you are able to schedule your appointment
before you come for surgery, you will have a
better chance of getting the date and time you
prefer.
◦ A prescription for therapy (2-3 times a week)
will be given to you prior to discharge.
Total Hip Replacement
Standard Total Hip
◦ Hip precautions – to be followed for 8 weeks
unless your surgeon specifies otherwise.
 Do not bend your hip into more than 90 degrees of
flexion (right angle).
 Do not cross your legs, either at the knee or the
ankle.
 Do not let your toes (hip) rotate inward.
Anterior Total Hip
◦ No precautions to follow, unless specified by
your surgeon.
o Outpatient therapy will be ordered after

your first follow up appointment if
needed.
Post-Op Activities
Please consult your physician with
specific questions about returning to
activities.
Driving – per physician guidelines
Kneeling – 8 weeks
Dancing – 8 weeks
Bicycling – 4-8 weeks
Golfing – 6-8 weeks
Exercises
Quad Sets – squeeze top of thigh, pushing
knee flat. Hold for 10 seconds. Repeat 20
times.
Exercises
Hamstring sets – tighten muscles on back
of thigh, digging heel down and back.
Hold 10 seconds. Repeat 20 times.
Exercises
Heel slide – bend knee as far as you
comfortably can. Hold 5 seconds. Repeat
20 times.
Exercises
Short arc quad – with a rolled towel or
coffee can under knee, tighten muscles on
top of thigh and straighten knee. Hold 10
seconds. Repeat 20 times.
Exercises
Straight leg raise – keeping knee straight,
lift leg 6-8 inches off bed. Hold 5 seconds.
Repeat 20 times.
Exercises
Long arc quad – from a seated position,
straighten knee. Hold 5 seconds. Repeat
20 times.
Arm Exercises
Chair push-ups
Bicep curls
Shoulder raises
Side (lateral) shoulder raises
Frequently Asked Questions
Why do I have to start therapy so soon?
How often/how long will I have to go to
outpatient therapy after my knee
replacement?
Do I still have to do my exercises at home
after I start therapy?
Can I just do my exercises at home and
skip outpatient therapy?
FAQ, continued
Why do I need someone to stay with me
after I leave the hospital?
How long will I need a walker/crutches?
Will we practice the stairs?
Will I see my doctor before I leave?
Discharge Planning
A RN will speak with you either the day
of or day after surgery reguarding any
needs or plans for at home.
Assist with ordering equipment
Assist with setting up Home Health Care
or Rehab services if needed.
Please don’t compare your surgery to
anyone else’s or even to a previous surgery
that you’ve had.
Each surgery is unique and each person

heals differently.
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Total Joint Replacement

Continuous Passive Motion (CPM) Assist with range of motion for

◦ An anesthesiologist will discuss pain control options

Therapy begins the day of or day after

Patients who have had a total knee

o Outpatient therapy will be ordered after

Each surgery is unique and each person

Visit www.sfsh.com for Powerpoint

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