Preparing For Surgery
Once you and I have decided that hip/knee replacement surgery is needed, questions arise. Experience has taught me that each patient has expectations which are different. It is important to me that my patients know what to expect postoperatively and during their hospitalization.
Screening for anemia and blood donation
It is important to assess your overall health before having surgery. This will be done in several ways. You will be checked for anemia. If your red blood cell count is low, recovery from surgery may be more difficult. To correct this, you may receive injections (erythropoietin) during the month before your surgery. These injections help your body to produce more red blood cells, which prevents you from having to donate your own blood prior to surgery. It also significantly reduces your need for a blood transfusion after your operation. Some individuals undergoing total hip replacement will require blood transfusion even with normal blood counts. In general, we prefer to have one to two units of blood available. We give patients the option of donating their own blood or using blood from the blood bank. It is very important for you to know that blood from the blood bank is safe and using this blood rather than your own may be better for you. The risks and benefits of autologous (self) donation versus bank blood may be discussed with us, your medical doctor, or the blood bank personnel. In general, preoperative blood donation is rarely necessary.
Medical clearance
It is always a good idea to see your primary care doctor before having surgery. In most cases, I will require that you have a clearance letter from your primary care doctor before surgery is scheduled. This is especially necessary when a person has multiple or severe medical problems.
Finishing dental work
You will be advised to complete any necessary dental work prior to surgery. This is important because untreated tooth or gum problems and receiving dental work after surgery can put you at risk for developing an infection in your new implants. As a result, it may take you longer to recover from surgery and in some cases the prostheses may have to be removed from the infected hip joint.
Medications
I need to know about all your medications. Some medications are not safe to take before surgery because they interfere with anesthesia or cause increased bleeding. You will be told which prescription and over-the-counter medications you may need to discontinue until after your surgery.
Pre-operative evaluation
At the end of your office visit, you will receive the phone number of the surgery scheduler. We will help you with insurance approval for the surgery and deciding on a surgery date. Once the date of your surgery is set, you will need to get some routine blood and urine tests. In addition, you may need a chest x-ray and electrocardiogram if you have not had these done recently. This information will be used to determine the type of anesthesia you should receive and screen for health problems that may need treatment before your operation. In general, you will need to be seen again by your surgeon just prior to surgery to have a complete history and physical examination performed. At this time, any remaining questions can be answered. You will register at the hospital after your evaluation and complete any lab tests that have been ordered.
Preparing your home
There are several things you can do to prepare for your time at home after your hip/knee replacement surgery. For instance, it helps to put items you may need within reach so that you will not have to climb or bend down for them. Avoiding falls after your surgery is very important. The floor should be kept uncluttered and items such as throw rugs or loose cords should be removed or taped down.
After your hip/knee replacement surgery, you will not be able to drive for 4-6 weeks. It is a good idea to stock up on food and toiletries you may need. Also, having a friend or family member available to help you after surgery is important. Make these arrangements ahead of time.
Before your surgery, a physical therapist may come to your home to evaluate your therapy needs. The therapist will show you what modifications you may need to make for your recovery at home, such as moving into a bedroom downstairs. You may also need assistance devices after surgery, like a cane or walker.
It is preferred that patients recover at home, but if this is not possible, arrangements can be made for a short stay at a rehabilitation facility.
Preparing yourself
Once you have decided to have a hip/knee replacement surgery, it is important to have a good attitude and commit yourself to a successful outcome. Your recovery is a team effort involving you, your family, your surgeon, and the medical staff.
You may also improve your surgical results by losing weight and starting a low-impact exercise program such as walking or cycling. It is important to quit smoking or cut back as much as possible. Total joint replacement classes are held through Mount Clemens Regional Medical Center, which many patients find very helpful.
