The process of preparing for knee replacement surgery begins with your first diagnostic visit to The Leone Center for Orthopedic Care. The Center is located at the Holy Cross HealthPlex facility, just 1.5 miles from Holy Cross Hospital. If knee surgery is indicated, a Nurse Liaison will schedule your procedure. Once you have been given a date for surgery, there are a number of simple steps to be taken in preparation.
Before Your Surgery
The Center will provide you with a packet of materials that contains detailed information about your surgery, as well as all necessary forms. Your Nurse Liaison will review the packet with you, and guide you through the preparatory process step by step. Because we want our patients to have an optimal experience, it is recommended that you consult with your Nurse Liaison to complete each step according to instructions.
Please keep all forms with your packet and bring the packet with you to the hospital for all pre-surgical appointments and on the day of surgery. Doing so will ensure that the logistics of your hospital stay are taken care of in advance and that you are successfully prepared for all aspects of clinical care relating to your knee replacement procedure.
The Orthopedic Patient
Pre-Surgical Agreement Form
This form, included in your packet, details the steps that must be taken in preparation for your surgery:
Obtain Medical Clearance prior to your surgery. Our staff will help you make an appointment, either with your own physician or a different physician who has privileges at Holy Cross Hospital (HCH), who will then be available to see you after your surgery. (If a non-HCH doctor clears you, we still will arrange for a medical doctor to see you in the postoperative period.) It is best that this appointment be made as soon as possible after surgery is scheduled. This helps prevent your surgery from being delayed or cancelled.
Stop taking blood-thinning medications, according to your physician’s/surgeon’s instructions, to reduce the risk of bleeding during surgery. A member of our team will advise you if any medications you are currently taking are blood thinners. (Be certain to inform your nurse of any Over the Counter medications and supplements you are taking.)
Stop or start other medications as advised by your physician/surgeon.
The need for a blood transfusion is much less common than only a few years ago. Our surgical and anesthetic techniques and specialized medications, including those which decrease bleeding, are administered during and after surgery. Also, the prior threshold for transfusion has been lowered as traditional benchmarks have been challenged and refuted in medical literature. I emphasize maintaining the volume of fluid in the vascular system with fluids other than transfused blood. The old thinking was that autologous blood (blood donated before surgery by a patient) was safer than blood donated by another person. This no longer is the case and the change in thinking has largely come about by our ability to test for potential specific diseases that sometimes contaminate blood, such as HIV or hepatitis. We discourage our patients from pre-donating because the percentage of people who need a transfusion is very small. If a transfusion is necessary, one is made available through our blood bank. Read more on my blog.
Follow your surgeon’s recommendation regarding flu vaccination. While the hospital supports the Centers for Disease Control’s advice that individuals receive an annual flu shot between October and March, in an effort to prevent influenza and pneumococcal infections, your surgeon may recommend that you not be vaccinated during your total joint replacement surgery admission process. If so, he may suggest an alternate time for your flu vaccination.
Begin the Home Exercise Program included in your packet. Do the exercises as illustrated, performing ten repetitions of each exercise three times per day. This will increase your range of motion, strengthen your muscles and improve your endurance in preparation for surgery and rehabilitation.
Make an appointment for the pre-operative class at least two weeks prior to surgery. Ask you Nurse Liaison for assistance.
Attend a pre-operative class (details below).
The Pre-Operative Class
The Center has created a very popular and informative pre-operative class. We’ve learned that if our patients are admitted for surgery with more and better information, they feel empowered, are more confident and have a better hospital experience. That is our goal.
At the class, you will meet key members of our team with whom you will be interacting once admitted for surgery. We will review the entire process, from admission to discharge, using personal stories to make it real. We will explain the details of the surgery itself, discuss various methods of implantation, and likely show you an actual prosthesis. We will describe the location of the incision and explain how you can expect it to heal after your surgery. We will cover patients’ concerns about anesthesia extensively.
Therapists and nurses will outline the post-surgical rehabilitation process. Social workers will help you understand exactly what your insurance will cover and all of your care options after discharge.
The day of class is also a perfect time to “pre-admit” so that you will not need to worry about additional logistics on the day of your surgery.
Pre-operative Planning for Knees
An explanation of the technology used to help plan the entire surgical process for knee replacements.