1 T T o o t t a a l l J J o o i i n n t t C C l l a a s s s s I I n n f f o o r r m m a a t t i i o o n n : : The surgeons at St. Cloud Orthopedics are requesting you attend the pre-operative total joint preparation class at the St. Cloud Hospital. This class will prepare you for the following: What to expect prior to surgery, during your hospital stay, and after discharge Treatments for pain or discomfort that you may experience after surgery Learn how to prevent complications of surgery recovery Meet with the Total Joint Specialist RN who specializes in the care of patients who receive a joint replacement Physical Therapist will discuss therapy exercises while in the hospital and when you go home. You will have the opportunity to ask questions about your patient experience. Bring your Total Joint Patient Education binder with you to class. *Please bring a family member or friend to the class who will be assisting you with your care during your hospital stay and after your discharge from the hospital. Your class is scheduled for: Date: ________________ ____ Tuesday from 9:00 a.m. – 10:30 a.m. ____ Wednesday from 3:00 p.m. – 4:30 p.m. The Total Joint classes are held at St. Cloud Hospital on the Bone and Joint Unit. If you need to reschedule at any time, please contact the Total Joint Specialist (320) 251-2700 extension 54671. Directions to Total Joint Class : Please park in the North parking lot or North ramp. Enter through the revolving door at the North entrance. Take the North elevator to 6 th floor. A volunteer is available to assist you in finding the elevator or provide a wheelchair if needed. Please follow the red signs in the building to direct you to Total Joint class. ON-LINE REGISTRATION AVAILABLE! centracare.com click on “classes and events” choose “Joint Replacement”
If you need to reschedule at any time, please contact the Total Joint Specialist
(320) 251-2700 extension 54671.
Directions to Total Joint Class:
Please park in the North parking lot or North ramp. Enter through the revolving door at the
North entrance. Take the North elevator to 6th floor. A volunteer is available to assist you in finding
the elevator or provide a wheelchair if needed. Please follow the red signs in the building to direct
you to Total Joint class.
ON-LINE REGISTRATION AVAILABLE!
centracare.com click on “classes and events” choose “Joint Replacement”
3
Skin Preparation Instructions
An antiseptic cleansing shower can reduce your risk of infection following your surgery. Your
physician would like you to use 4% chlorhexidine gluconate (CHG) antiseptic soap (also called
Hibiclens) solution for cleansing the skin surface prior to your surgery. You will either get a bottle from
the clinic or a script to pick up the soap at your local pharmacy.
Process: Use Chlorhexidine Soap 4%; ONE-THIRD of the bottle each day
2 days before surgery ___________
1. Shower as you would normally and use your own shampoo on your hair.
2. Place chlorhexidine soap onto a clean wet washcloth and turn shower off.
3. Scrub operative area first, and then scrub the rest of your body with the antiseptic soap
from your neck down for a total of 5 minutes.
4. Add additional chlorhexidine soap to your washcloth as needed.
o DO NOT allow the soap to come into contact with the eyes, ears, or mouth. If you
accidently get some of the soap on those areas, rinse immediately.
o Note: If you have any burning or irritation on the skin, rinse immediately and do
not reapply.
5. After a total of 5 minutes rinse or shower off the soap.
6. Do not apply lotion or deodorant after the shower. This is for all 3 showers.
1 Day before surgery (repeat process) ___________
Morning of surgery (repeat process) ___________
5
SUGGESTIONS FOR A DIET HIGH IN NATURAL IRON CONTENT
To get the most benefit from your iron pills and the iron content in your food:
Take vitamin C (ascorbic acid) or drink orange juice with your pills.
Steam vegetables to help them retain iron content.
Other helpful hints:
The intake of high fiber, cellulose foods (celery), caffeine (coffee, tea, cola), and anti-acid medication decrease iron absorption.
Absorption of the iron occurs within 4 hours after eating.
The best rule is to eat regular nutritionally balanced meals and drink plenty of fluids.
If you mix some lean meat, fish or poultry with beans or dark leafy greens at a meal, you can improve absorption of vegetable sources of iron up to three times. Foods rich in vitamin C also increase iron absorption.
**In some people, iron supplements can cause stomach discomfort, nausea, diarrhea, constipation, and black stool. Iron is best absorbed if taken on an empty stomach, but if you are having stomach problems, you may need to take your iron pills with food.
The following is a list of 4 BASIC FOOD GROUPS and the foods which are high in iron content or are helpful in iron absorption. GROUP I: Meat and Meat Substitutes
Excellent Sources of Iron LEAN RED MEATS (Beef, Lamb, Pork, Veal) Organ Meats (Liver, Gizzards) Poultry (Chicken, Turkey) Eggs (especially Egg Yolks) Seafood (Salmon, Tuna, Oysters, Clams, Shrimp, Sardines, Anchovies) Nuts (Almonds, Brazil Nuts, Cashews, Pumpkin Seeds) Bean (Dried Peas, Dried Beans)
GROUP II: Vegetables/Fruit Groups
Good Sources of Iron Vegetables (Dark Leafy Green Vegetables)
Good Sources to Increase Iron Absorption: Citrus Fruits: Oranges, Lemons, Limes, Grapefruit Other Fruits: Cantaloupe, Strawberries Vegetables: Broccoli, Brussels Sprouts, Tomatoes, Potatoes, Peppers White Wine
Iron Absorption Inhibitors: (these decrease absorption of iron) Red Wine, Coffee, Tea
GROUP III: Breads and Cereals
Enriched, fortified and whole grain breads and cereals are often high in iron content (check package contents)
Examples: Cream of Wheat, All-Bran Cereal, Malt-O-Meal, Total Cereal, Special K
Grains (Wild Rice, Brown Rice, Oats, Wheat, Bran, Macaroni)
GROUP IV: Milk and Dairy
Good Sources of Iron Molasses (Blackstrap) Brewers Yeast (Dried) Chocolate
Poor Sources of Iron* Milk Cheeses Ice Cream Yogurt
*While these foods hinder the absorption of iron, they are good sources of calcium. Foods containing calcium and calcium supplements (TUMS) should not be used one hour before or one hour after the ingestion of iron supplements. GROUP V: Miscellaneous Iron Rich Foods
Introduction --------------------------------------------------------------- A 1
A
1
Maps ----------------------------------------------------------------------- A 3-4
Common causes of joint replacement ------------------------------------ A 5-7
Six to eight weeks before surgery --------------------------------------- B 1 Insurance and Medicare -------------------------------------------------- B 2-3 Two weeks before surgery ------------------------------------------------ B 4
Preparing my home ------------------------------------------------------- B 5-8 Equipment needs ---------------------------------------------------------- B 9-10
Night before surgery ------------------------------------------------------ B 11 Morning of surgery -------------------------------------------------------- B 11-12
Safety in surgery ---------------------------------------------------------- C 1-2
Surgery and anesthesia --------------------------------------------------- C 3-4 After surgery and pain expectations ------------------------------------- C 5-10
Preventing blood clots ---------------------------------------------------- C 11-12 Rehabilitation -------------------------------------------------------------- C 14-17
Getting around after surgery --------------------------------------------- D 1-3
Care at home -------------------------------------------------------------- D 4-6 Getting into a car --------------------------------------------------------- D 6-7
Lifetime care --------------------------------------------------------------- D 8-11 My joint replacement experience ----------------------------------------- D 11-12
Exercise information ------------------------------------------------------ E 1 Knee exercises ------------------------------------------------------------ E 2-6
Hip exercises -------------------------------------------------------------- E 7-11 Equipment ----------------------------------------------------------------- E 11 Vendors -------------------------------------------------------------------- E 12-13
Home medications -------------------------------------------------------- F 1 The Role of Hand and Respiratory Hygiene in Infection Prevention ---- F 3
Pain management --------------------------------------------------------- Pathway home -------------------------------------------------------------
F 5-6 F 7
Our commitment to safe skin ---------------------------------------------
F 11-12 Surgical site infections ---------------------------------------------------- F 13-14
Sexual positions after total joint surgery -------------------------------- F 15 Prayer before surgery ----------------------------------------------------- F 17 Questions for your nurse and surgeon ----------------------------------- F 19
Section A -Welcome and clinic
information
Section B - Preparing for surgery
Section E - Exercises
Section C - Surgery and my hospital stay
Section D - Getting back to my life
Section F - References
A-1
Welcome
Thank you for choosing the St. Cloud Hospital’s Total Joint Program!
We are dedicated to providing the highest quality of care, with a goal of increasing your level of activity and decreasing your pain, resulting in improved independence for you.
The Bone & Joint Center, a collaborative effort of St. Cloud Hospital and St. Cloud Orthopedics, offers a full array of specialty and subspecialty care in total joint replacements, foot/ankle surgery, orthopedic trauma/fracture care, total joint revisions, hand/shoulder surgery and sports medicine.
We are pleased to offer you a distinguished orthopedic care center where you can feel confident you are receiving nationally recognized care. Our state-of-the art technology and facilities are the best Minnesota has to offer. Our caring, skilled professionals will work to make your experience a positive one. Certified nurses, fellowship-trained surgeons and orthopedic support staff are proud of the reputation we have built and are committed to providing you with quality care.
We believe that your success also depends on you. We encourage you to be an active participant in your recovery process to return to your maximum function. You will be part of a Total Joint Program that treats more than one thousand patients each year.
The Bone & Joint Center is a unique, dedicated center within the hospital. Patients
typically have their surgery Monday through Friday and return home after a one to two
night hospital stay. Our coordinated health care team works together to provide you
with a superior experience and continuous care. We count on you to help us improve
our care.
Features of our Total Joint Program include:
Preoperative Joint Class
Nurses, therapists, and patient-care-assistants (PCA) who specialize in the care
of joint replacement patients
Total Joint Specialist
Emphasis on individualized care and your active participation
Private rooms, many with a panoramic view of the river
Family and friends educated to participate in your recovery process
A comprehensive patient education binder for you to follow from six weeks before
surgery through your hospital stay and beyond
Public education seminars about hip and knee pain
Physical Therapy gym, which is on the unit for your convenience
From Minnesota Highway 23 Traveling west on HWY 23 - Exit HWY 23 at 10th Ave. N. Turn left onto 10th Ave. Proceed north to 13th St. N. Turn right. Drive three blocks east to 6th Ave. N. Traveling east on HWY 23 - Turn left on Minnesota HWY 15. Proceed to 12th St. N. Turn right. Proceed to 13th St. N. Turn right. Drive .6 miles to 6th Ave. N.
From Minnesota Highway 15 Traveling north on HWY 15 - Turn right at 12th St. N. Proceed to 13th St. N. Turn right. Drive .6 miles to 6th Ave. N. Traveling south on HWY 15 - Turn left at Cty. Rd. 1. Proceed to 9th Ave. N. Turn right. Drive .3 miles to 6th Ave. N. Turn left.
From Interstate 94 Traveling west on I-94 from the Twin Cities - Exit I-94 at Cty. Rd. 75 (exit #171). Drive to 22nd St. S. Turn right. Drive two blocks to Clearwater Rd. Turn left. Clearwater Rd. turns into 9th Ave. Follow 9th Ave. N. to 13th St. N. Turn right. Drive three blocks east to 6th Ave. N. Traveling east on I-94 - Exit I-94 at HWY 15 N. Drive to 12th St. N. Turn right. Proceed to 13th. St. N. Turn right. Drive three blocks east to 6th Ave. N.
From U.S. Highway 10 Traveling east on HWY 10 - Take the HWY 15 exit into St. Cloud. Traveling south on HWY 15 - Turn left at Cty. Rd. 1. Proceed to 9th Ave. N. Turn right. Drive .3 miles to 6th Ave. N. Turn left. Traveling west on HWY 10 - Take the HWY 23 exit into St. Cloud. Exit HWY 23 at 10th Ave. N. Turn left onto 10th Ave. Proceed to 13th St. N. Turn right. Drive three blocks east to 6th Ave. N.
A-4
St. Cloud Hospital map
A-5
Osteoarthritis is a degenerative joint condition affecting the cartilage on the end of bones, caused by wear and tear. This is the most common type of arthritis.
Previous injury or trauma may lead to degenerative changes
Excess body weight causing stress on joint
Lack of regular exercise
Conservative treatments
no longer effective
Rheumatoid Arthritis – disease that attacks your joints
Infection
*A total joint replacement’s longevity will vary in every patient depending on your age, weight, activity level and medical condition.
Common causes of joint replacement
A-6
Works like a door hinge
Femur (thigh bone) meets tibia and fibula (lower leg bones)
Connected with ligaments that act like rubber bands allowing movement and providing stability of the knee joint
Cartilage between the two bones acts like a shock absorber softening the impact of movement and weight bearing
Your surgeon removes the damaged cartilage and bone. New metal and plastic joint surfaces restore alignment and function.
Parts of your new knee:
Femoral – replaces the thigh cartilage
Tibial – replaces the lower leg cartilage
Surgery typically lasts less than one hour. This time does not include the preparation and time spent in the recovery room.
The knee joint
Knee replacement surgery
A-7
Ball and socket joint
Head of femur (ball)
Pelvis (socket)
Joint held together with ligaments which allow movement and stability
Cartilage acts like a shock absorber softening the impact of movement and weight bearing.
Your surgeon removes damaged cartilage and bone. New metal and plastic joint surfaces restore alignment and function.
Parts of your new hip:
Head of femur – ball and neck replaced
Pelvis – socket replaced
Surgery typically lasts less than one hour. This time does not include the preparation and time spent in the recovery room.
