Working Together for Healthy Joints Before, During and After Hip and Knee Replacement June 2018
Introduction Paperwork Washrooms Things that beep
Today s Main Message: Your hospital stay will be anywhere from 8 hours to 2 days so BE PREPARED
Why is LOS only 8 hours to 2 days? NEW standard of care for total joint replacement Reduces the risk of infection Improved activity at home Improved sleep Better use of resources
Today s Session: Hip Surgery & Precautions Knee Surgery & Precautions How to prepare yourself How to prepare your home What to expect in hospital Everyday activities after surgery Medications
Hip X-Rays Healthy Hip Joint Damaged Hip Joint Pfizer 2004 The Arthritis Society
Hip Surgery; Dr. Nelson Greidanus Play video: Pre-op education Joint Replacement Surgery
Hip Precautions Play video: Pre-op education Joint Replacement Surgery
WHY Hip Precautions? Reduce risk of HIP DISLOCATION Bone growth Heal soft tissue Stretch/strengthen muscles
Knee X-Rays Healthy Knee Joint Damaged Knee Joint Pfizer 2004 The Arthritis Society
Knee Surgery; Dr. Bas Masri Play video: Pre-op education Joint Replacement Surgery
3 months of Knee Precautions NO pillow behind the knee NO Squatting NO Kneeling NO Twisting
WHY Knee Precautions? To reduce knee STIFFNESS Heal soft tissue Stretch/strengthen muscles
BEFORE Surgery How to get yourself ready
Home Set-up: General Remove clutter Raise up regularly used items Increase chair and bed heights, toilet height 2 inches above knee height Use firm cushion / bed blocks Meal preparation Pet Care Golfer s reach
Home Set-up: Seat Height Play video: Pre-op education Managing Everyday Activities after Surgery
Home Set-up: Toilet Play video: Pre-op education Managing Everyday Activities after Surgery
Home Set-up: Bathtub Play video: Pre-op education Managing Everyday Activities after Surgery
When can I shower? Need to keep incision dry Staples in for 10-14 days Use a waterproof dressing OR NO showering until staples removed Discuss with hospital staff
Equipment to Bring to Hospital Walker 2 wheeled Crutches Very firm foam cushion Dressing equipment Long-handled reacher Long-handled shoe horn Sock aid Cryotherapy unit (if you purchased one) Please label your equipment!!
Equipment continued Have a friend/family member bring your equipment up to the ward after surgery If you are on your own, or from out of town, bring the equipment with you when you check in Bring your Before, During & After book
Where to get equipment Medical supply stores Rental or purchase Check extended medical Red Cross depots On loan for 3 months Need signed form Supply can be limited Accepts donations Friends, family
Weight-bearing Status Most people are weight bear as tolerated Revision surgery may be different
Two-Wheeled Walker Play video: Pre-op education Managing Everyday Activities after Surgery
Walking with Crutches Play video: Pre-op education Managing Everyday Activities after Surgery
Using a sock aid Play video: Pre-op education Managing Everyday Activities after Surgery
Dressing with a long-handled reacher Play video: Pre-op education Managing Everyday Activities after Surgery
Pre-Admission Clinic Hospital will call you Health history Medication review bring ALL medications & supplements Anesthetic consult Bathing & use of antibacterial wipes before surgery * Sometimes done by phone*
Surgery Time Your surgeon s office will call you the day before surgery For Monday surgeries, they will call Friday If your surgeon has given you different instructions, follow them If you haven t heard from anyone by 4:00pm, call Admitting
Before you come in for surgery No shaving for 2 days prior to surgery (electric razor okay) Pack (lightly!): comfortable clothes walking shoes toiletries No valuables please
Day of Surgery Check-in at Admitting PreOperative area Operating room Recovery Room Orthopedic ward
Average Length of Stay Total Joint Replacement You will be sent home when you meet discharge criteria Medically stable Move around safely with walking aids From 8 hrs to 2 days Partial knee replacement - From 8 hrs to overnight Bilateral - Longer hospital stay, more rehab Revision surgery variable length of stay
Pain scale Pain medication Post-Op Pain Control breakthrough pain medication Possible side effects: nausea, constipation
Activity and Rest Deep breathing and coughing Leg exercises Change position, move when awake Remember: good oral hygiene reduces your risk of complications too!
Physiotherapy After Hospital Generally continues 2 to 3 months after surgery Depends on where you live To be planned by the ward physiotherapist
Heading home Arrange for a ride home Have someone stay with you or nearby for the first 3 days you are home
Getting in and out of bed Play video: Pre-op education Managing Everyday Activities after Surgery
Up and down stairs Play video: Pre-op education Managing Everyday Activities after Surgery
Getting in and out of a car Play video: Pre-op education Managing Everyday Activities after Surgery
Car Travel-When can I drive? Depends on: Surgical leg Strength, response time Standard or automatic Other options: Handidart SPARC parking pass Check your insurance policy before you start driving It may take 6 weeks or more before driving
AIR Travel You may set off metal detectors Do leg exercises hourly to promote blood flow up your legs
Preventing Blood Clots Pill or injection, determined by your surgeon (kidney function, clotting history) Fill your prescription at a pharmacy near the hospital Take the medication as prescribed! Pill daily for up to 35 days Injection daily for 2 weeks
Other Activities You may have questions about: Cooking Housework Returning to work Sexual activity Speak to your OT!
Prevent constipation Get moving Drink plenty of fluids High fibre diet Stool softeners, laxatives Resource: HealthLinkBC 8-1-1 Pharmacist, dietitian or nurse
Keys to a successful surgery: PREPARATION Equipment; get it and learn how to use it Support of friends, family PATIENCE Follow physio exercise plan People heal differently
Questions/Comments Thank you and Good Luck!!!