General Hip/Knee Replacement Info
Quality of Life Means Something Different for Each Individual
For many, it means spending time with family, enjoying a round of golf, a bicycle ride or the pleasure of a simple walk. For everyone, being able to move and walk without pain is an important part of living well. As we age, doing the things we love to do without pain often becomes a challenge. Through high quality compassionate care, research, and surgical advances, we can help revitalize your quality of life.
Joint replacement surgery is the next logical progression in outpatient procedures. A program design has been launched that focuses on the partial knee arthroplasty (PKA), anterior supine intermuscular total hip replacement (ASI), and less invasive total knee replacement (TKR).
This shift from being a hospital “inpatient” to an “outpatient” where recovery takes place out of the hospital and in your home has already happened for procedures such as major ligament reconstruction and rotator cuff repair. Refinement of surgical techniques, anesthesia protocols, and patient selection has enabled this transformation. Our outpatient Arthroplasty system is based on the clinical evidence from thousands of joint replacements and hundreds of research publications of patient outcomes.
With an outpatient focus, the entire joint replacement episode is geared toward efficiency, safety, minimizing pain and accelerating recovery. This focus has led an infection rate that is markedly less than that reported in large hospital inpatient settings.
Review These Frequently Asked Questions to Better Familiarize Yourself with the Joint Replacement Process
By requesting a consultation, your information will be given to one of our world class surgeons. The surgeon and/or his assistant will contact you to gain information about your condition. We will coordinate receiving your x-rays for a free evaluation.
If it is determined that surgery is your best option, your surgery will be scheduled either over the phone or upon an office consultation. At that time, we will work with you to obtain preauthorization from your insurance company. This may take several days to accomplish.
The day of your surgery will be a busy one. Please remember not to eat or drink anything, including mints or gum, after midnight the evening before your surgery. However, you CAN drink water, Gatorade, tea and coffee (NO MILK/CREAM, NO SUGAR) up until 2 hours prior to your surgery time. There may be several hours that pass between the time you check into the Suites and the time that your surgery is completed. Your family should be prepared to wait several hours.
It is important that you arrive at the center with plenty of time to check in and prepare for surgery. You will be instructed on your expected arrival time. When you arrive, park in adjacent parking garage. Parking can be validated by the front desk.
On the morning of surgery, your family member or friend will be able to stay with you until you are ready to be transported to the operating room. At this point, they will be escorted to a family waiting area where they will wait while you have your surgery.
When your joint replacement is complete, a member of the surgical team will contact your family member or friend. At this point, they will be able to speak with your surgeon to discuss your procedure.
Once you are awake and stable from an anesthesia and surgery standpoint, you will be reunited with your family member or friend to complete the recovery process prior to being released from the surgery center.
After surgery, you will be transported to an area called the Post Anesthesia Care Unit (PACU) or recovery room. Your stay in the PACU will depend upon your rate of recovery from the effects of the anesthesia. Following joint replacement, your PACU stay is typically around four hours.
Nurses will check your vital signs; blood pressure, respiratory rate, and heart rate – and monitor your progress. They may also start your ice therapy.
Pain medications will be provided through your IV as needed. Our goal is to use preoperative medications and special medication injections during the surgery that will reduce your pain and therefore the need for postoperative narcotic medications. Nurses will check your bandages, check drainage from your surgical site, and encourage you to cough and take deep breaths. They will also apply leg compression devices to help with circulation.
Once you are awake and ready for your first walk, your family member or “coach” will be able to join you and assist our team with your recovery.
The following is a list of common equipment used after a joint replacement. Your in-home pre-operative physical therapy visit/ will assist you in evaluating the type of equipment you will need following your surgery. Equipment recommendations are based on the individual needs of each patient.
Raised toilet seat/Bedside commode
What Can I Expect During Recovery
To reduce your risk of infection, antibiotics may need to be administered prior to any invasive test, procedure or surgery. The physician or surgeon performing the test, procedure, or surgery should prescribe antibiotics if indicated. If there are any questions, contact your joint replacement surgeon.
Some of the exercises, like ankle pumps, can also be performed should you need to sit for long periods of time. If traveling within 2-4 weeks of your surgery, you should wear your calf compression pumps.
Because your new artificial joint contains metal components, you will likely set off the security systems at airports or shopping malls. This is normal and should not cause concern or significant delay going through security.
Exercise and maintaining an active lifestyle are important parts of health. Most patients with artificial joints are able to enjoy many activities, though some should be avoided or minimized. In general, high impact exercises, like running, jumping, heavy weight lifting, or contact sports, are not encouraged. Participating in these activities, or activities like them, may increase risk of wear or loosening of the components. Low impact activities like swimming, elliptical, walking, gardening, and golf are encouraged. You may kneel on your new knee without damaging it; however, it will likely feel uncomfortable.
Following most routine outpatient left lower leg (hip or knee) replacements, patients can drive when they are off narcotics during the day and when they feel comfortable getting in and out of the car. For right lower extremity (hip or knee) replacements, patients are discouraged from driving for a minimum of two weeks. However, patients should only drive when they feel that they have complete control of their leg and are off of narcotic pain medication during the day.
You will be able to do stairs on the day of surgery and your pre-operative in-home physical therapy visit will instruct you on post-operative stair navigation. We routinel recommend doing one flight of stairs a day until your strength and stamina returns back to where you feel like doing more than flight.
Yes, at least for the first 24-72 hours after you return to your home. It is always considered best to have someone their helping you. After that point, you should be independent enough to allow your family or friends to not be with you throughout the day.
Following your joint replacement surgery, it is important to notify your dentist that you have a joint implant. It is essential that you obtain a prescription from your dentist or surgeon for a prophylactic antibiotic to be taken PRIOR to any dental cleaning or procedure for the rest of your life. You will need to remind your dentist before every scheduled appointment in the future of this requirement in order to reduce the risk of developing an infection in your joint.
Life After Joint Replacement
Contact your surgeon to arrange your post-operative appointments.
Does BCCSC Use Anterior Muscle Sparing Hip Replacment
Yes, in fact Bethesda Chevy Chase Surgery Center is the most experienced outpatient center in the DC region in performing outpatient anterior hip replacement. Anterior hip replacement, in most cases, can afford limited pain during the recovery while allowing the patient to be mobile without hip precautions.
Why is My Surgeon Recommending Partial Knee Replacement
Partial knee replacement has been in existence for several decades. It is not new or experimental. How long these last has been reported to be as good as or even better than a total knee replacement. The concept with partial knee replacement is to do the least amount of surgery necessary to eliminate or reduce your pain.