Joint Replacement Surgery
At Samaritan Regional Health System, we appreciate the concerns and hesitations you may have in undergoing a major surgical procedure such as a joint replacement. We hope this information will guide you through your journey, whether you have already made the decision to proceed, or whether you are considering joint replacement to reclaim an active life.
If you feel a joint replacement is right for you, contact your doctor. He or she will refer you to an orthopaedic surgeon. The two orthopaedic surgeons who perform joint replacements at Samaritan Hospital are Dr. Matthew Bernhard and Dr. Stephen Yoder.
What to expect…
The fact that more joint replacements are done at Samaritan Regional Health System (SRHS) than any other health care organization in the area, with remarkable patient satisfaction, is no accident. The success of our program is directly related to the comprehensive educational program patients participate in prior to undergoing joint replacement surgery.
Our intense pre-op program that began in 1996 has been perfected over the years, and is unique to joint replacement patients at Samaritan. With other joint replacement patients, you will gather 2-4 weeks before your surgery to learn about the procedure, but most importantly, to begin exercises that will prepare and strengthen your body for what is to come.
The three to four hour session focuses on everything from admission to discharge. Speaking to you during this relaxed session will be a nurse, a social worker, a physical therapist, and a billing specialist.
For your convenience, your pre-op tests will be performed on this day, including lab work and ECG’s. Breakfast will be provided for you and a guest.
Before Surgery…
Anesthesiology Meeting In addition to attending a joint replacement educational session, you might meet with an anesthesiologist before the day of your surgery. This appointment is scheduled in advance for the anesthesiologist to gather important medical information about you, helping the anesthesiologist identify which form of anesthesia is safest and most effective to use during your surgery. The anesthesiologist you meet with may not be the same anesthesiologist who is with you the day of your surgery. However, they all work closely as a team and trust each other’s judgment.
Pre-Op Testing Depending on your health, your surgeon will order a battery of pre-op tests for safety precautions. Every joint replacement patient will undergo standard blood work, ECG and possibly a chest x-ray. A stress test may also be ordered for you. This test unmasks the symptoms of heart disease by allowing health care providers to examine the heart and its blood flow while exercising.
Dental Work For at least one month before surgery and three months after surgery, avoid dental work altogether. Always, for the rest of your life, tell your dentist you’ve had a joint replacement prior to any dental work. The mouth harbors many germs, some that may wedge between teeth even during a routine cleaning. If these germs find their way into the blood stream, they may settle in bones that have been cut. An infection in the bone is one of the hardest to treat, and for that reason, must be avoided at all costs.
Preparing Your Body At the joint replacement educational session, a physical therapist will give you exercises to perform in the comfort of your own home. Perform these exercises daily until your surgery, as they are meant to prepare and strengthen your muscles that will be affected by the surgical procedure. Also at the educational session, you will be taught how to use an incentive spirometer, which is a medical device that improves lung functions. You will take this home to practice, which will help prevent pneumonia, a potential complication of surgery.
Preparing Your Environment Once you return home following surgery, pay extra attention to fall risks, especially the two biggest culprits of falls which are throw rugs and pets. We recommend removing all throw rugs, as you will be “shuffling” around more in the days shortly after your procedure. If you have a lower toilet, you may want to consider purchasing a raised toilet seat that clamps onto the toilet. Have a bag handy to attach to your walker so your hands are free to navigate the walker safely. For those with cloth car seats, place a trash bag or a plastic bag under you for an easier time sliding in and out of the vehicle.
Your Surgery and Hospital Visit…
The Day of Your Surgery You will be told what time to arrive at Samaritan Hospital. Once you are there, sign in at the podium located in the Hospital Lobby, to the right of the Reception Desk. From there, Admitting personnel will direct you to the Pre-Op area on the second floor of the hospital. Your surgeon will talk to you and will sign the extremity that is being operated. The anesthesiologist will also speak with you at this time. An IV will be started, and you will be given medication to help you relax. Typically, this is the last thing patients remember until waking in the recovery room.
Hospital Recovery Your comfort and health is our priority, so please tell your nurse how you are feeling and share any concerns. Remember, we can’t solve a problem if we don’t know about it! Never feel as if you are a burden, and if you feel your needs aren’t being addressed, ask to speak with the nursing supervisor.
Two potential complications of any major surgery include blood clots and pneumonia. To prevent blood clots from forming in your shallow veins, both of your legs will be dressed in compression stockings after surgery. For your deeper veins, you will wear a sequential compression device, or SCD. It works somewhat like a blood pressure cuff, squeezing your leg intermittently to generate the same blood flow as if you were moving. As another precaution, you will be placed on a blood thinner medication, and your blood will be taken periodically to assure appropriate levels are maintained.
Preventing pneumonia is largely up to you. That is why it is so important to strengthen your lungs prior to surgery by using the incentive spirometer. You will continue to use this device throughout your hospital stay, actively opening your airways, keeping them dry to discourage bacteria growth. Even though deep breathing may not seem necessary, you must move your lungs. You will also be turned from side to side during your hospital stay.
To keep the knee joints from stiffening, we use a Continuous Passive Motion (CPM) machine twice a day on each leg for two hours at a time. The machine gently bends and extends your knee, preventing scar tissue from forming. It specifically targets the joints, not the muscles.
Pain and Movement You may experience some pain whenever you move after surgery, but movement is the key to your recovery, so take your pain medication so that pain does not hinder your progress. Remember, your surgeon gave you your new joint to MOVE! You will need assistance to get out of bed. The last thing you want to do is fall and damage or ruin your new joint.
Physical therapy is the KEY to your recovery. There will be some pain; however, the pain should be tolerable, so let your therapist know if you need a break. Focus on a goal, it can be long-term, like walking on the golf course pain-free, or short-term, like bending your knee two degrees more than you did the previous week, but always keep your “eye on the prize”! Remember your reason for undergoing a joint replacement in the first place and let that serve as your motivation, realizing the effort you put into your physical therapy will be rewarded twofold!
Discharge Depending on your needs, you may go home following surgery or you may go to an extended care facility. Our caring team of social workers will see to your discharge planning and make all necessary arrangements for you, including in-home skilled health care. Our goal is to maintain the highest continuum of care so you continue to thrive and recover in the environment deemed most appropriate for your unique circumstances. At our joint replacement educational session, you will meet with a social worker, but know they are always available at 419-289-0491 to address your concerns any time!
As you can see, supportive teamwork is an integral aspect of any surgical procedure. You’ll need to work with us, and we with you as you realize your goals. However, the decision to have a joint replacement rests with you. We encourage you to explore all of your options and actively engage your loved ones in the final decision. As always, we look forward to “partnering with you and your family for a future of wellness.”
