When someone is considering joint replacement, many questions come to mind about what to expect from the overall process—before surgery, during the hospital stay, and afterwards.
Each year, Deaconess and Orthopaedic Associates
perform more than 1,200 joint replacement surgeries. The majority of those are hip and knee replacements, but we also offer shoulder replacements as well. Because joint issues are so common, lots of people have probably had the same questions you do. Below is a Q&A of those common questions.
What type of patient typically has a joint replacement?
Total joint replacement is usually for patients who have severe arthritic conditions.
Most patients who need joint replacement are over 55 years of age, but the operation is being performed in greater numbers on younger patients thanks to advances in artificial joint technology.
Does every patient who has a severe arthritic condition automatically qualify for joint replacement?
Circumstances vary, but generally patients are considered for total joint replacement if:
- The pain and loss of mobility affect them all the time. They can’t function in their daily lives.
- Pain is not relieved by other conservative methods, such as oral anti-inflammatory medication, joint injection therapy, physical therapy, using a cane, etc.
- X-rays show advanced arthritis or other joint problems.
- Patients must be healthy enough to undergo surgery and participate in their own recovery.
What is the first step in the joint replacement surgery process?
Once your doctor has determined that you should have joint replacement surgery, you’ll begin the process by participating in prehab (physical therapy evaluation prior to surgery), pre-testing, evaluation by a nurse practitioner to determine surgical candidacy at the surgical optimization clinic (SOC), and finally total joint education with a nurse at Orthopaedic Associates.
Prehab is completed at any Orthopaedic Associates location, in which your current function and discharge needs will be evaluated by a physical therapist. This is required prior to proceeding with any other steps in the process.
Pre-testing is done at any Deaconess lab that has EKG capability, or at the hospital. This is completed about 5-7 days prior to your appointment with the surgical optimization clinic. During your evaluation at the SOC, the nurse practitioner will review your medical history, medications, and test results to determine if surgical clearances are needed by specialists. This may require additional appointments, or working towards other goals.
Once the SOC process is completed, and you are deemed eligible for surgery, you will see your surgeon to schedule your surgery. This is an excellent opportunity to ask specific questions related to the procedure. A couple of weeks prior to your surgery, you will be scheduled for education with a nurse at Orthopaedic Associates. You will discuss the dressing, numbing medication if applicable, medication instructions, obtain any medical equipment that will be needed, and answer any final questions that you may have.
What should I expect from the surgery and hospital stay?
Most joint replacement patients are discharged the same day of surgery, once a checklist of criteria is met. On the day of your surgery, you’ll check in at Deaconess Gateway Hospital 2.5 hours before surgery time, and then you’ll be prepped for surgery. The surgery itself takes between one to two hours.
After surgery, you’ll be in recovery for a little while, then moved to your room on the fifth floor in the Orthopedic and Neuroscience Hospital. Within a couple of hours, you’ll likely be taking your first steps with your new joint. Everyone is up and moving the day of their surgery.
After surgery, what is the physical therapy schedule?
You will be expected to attend physical therapy 3 days per week for the first several weeks post operatively. This will be at a Progressive Health location, in the outpatient setting. On the days you do not have physical therapy at an office, you are expected to be completing your exercises at home. Physical therapy will continue for 6-8 weeks depending on your progress.
Time to go home…now what?
Most patients are discharged the same day of surgery, once they have met a checklist of criteria. Prior to being released, your first physical therapy appointment will be scheduled. The goal is for all of our patients to go home after surgery.
Patients will have an appointment at Orthopaedic Associates two weeks after surgery, and then again at intervals based upon progress.
Will I need a lot of help at home, and how quickly will I return to my normal activities?
This will vary from person to person, and is even different depending on what type of joint was replaced. I can definitely tell you that every patient should plan to have help around-the-clock for a full week after surgery.
Shoulder replacement patients have more difficulty with dressing and activities of daily living. Knee and hip replacement patients do tend to be more independent, and get back to daily life earlier.
Someone who is in better physical condition will recover more quickly, but overall, we explain to patients that they are typically 90% recovered at 90 days post-surgery.
Pain and swelling can be expected up to 6 months after surgery, and some patients may not feel fully recovered for up to a year.
However, as patients have commented…. Every day before surgery the pain gets worse, but in the days, weeks and months after surgery, the pain gets better.
What are some of the biggest misconceptions about joint replacement surgery?
Among our most common questions, there are two that would probably be the biggest misconceptions.
“I heard you can only have a joint replaced once in your life, so doctors wait as long as possible to do it so that you won’t outlive the joint.”
FALSE. Joint replacements generally last a couple of decades, and then they can be revised if needed. Joint replacements have come a long way, so the surgery isn’t nearly as extensive.
Joint replacements don’t involve removing large areas of joint and bone. The focus of the surgery is on removing small amounts of damaged bone and then resurfacing that area of the joint.
“I’m scared to get this surgery done because I’ll have to miss months and months of work.”
FALSE. If you have a sedentary (sitting) job, you can go back as early as a few weeks to a month after surgery. If you have a job on your feet all day, it may be longer, but almost everyone is back to work in a period of time covered by FMLA, which is 12 weeks.
If you are considering joint replacement, or know someone who is, we hope this has been a helpful Q&A session for you.
If you have joint pain or want to learn more about joint replacement, you can also call the Orthopaedic Associates
office at 812-424-9291
to request an appointment.