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Your New Hip or Knee FROM…. TO…
Your New Hip or Knee
FROM….TO…
Getting ready for Your New Hip or Knee
• Part One – Therapy, Clothing, Equipment
and Going Home
• Part Two – Nursing and the Hospital
Getting Ready for Your New Hip or Knee:
Your Therapy Team
From Surgery to Therapy to Home Safely and Comfortably
You will go home when…
• You can get in and out of bed safely
• You can walk safely with a walker
• You can safely climb stairs (if needed)
• Doctor indicates you are medically stable
What are the Hip Rules?
Rule #1 Do not bend your hips past 90 degrees andsit so your knees are lower than your hips.
What are the Hip Rules?
Rule #2
Keep your legs separate. Do not cross your legs or ankles.
Keep a pillow between your knees when you are in bed.
What are the Hip Rules?
Rule #3
Do not twist your new hip – no vacuuming, sweeping or golf swing movements.
In Summary:
Three movements should be avoided for 6-12 weeks, depending on your surgeon.
Hip Rules
1. No bending past 90° (sitting
or standing!)
2. No crossing
leg at knee or ankle.
3. No twisting
on your new hip.
What are the Knee Rules?
Do not put a pillow under your new knee.
Guidelines for Recovery
• Move your hip or knee often. Start doing your bed exercises right away.
•Follow the instructions about weight bearing – How much weight that you can put on your surgical leg when walking?
•Sit on firm arm chairs with seat levels at or above knee height.
Equipment:What equipment will I need to rent?
• Standard walker without wheels
• Cane
• Raised toilet seat
• Bath transfer bench
• Shower chair
What equipment will I need to rent?
Bath Transfer Bench for tub showers
Use a
standard
walker if you
have
a Walk-in
shower
OR
Dressing aids after hip surgery
Long handled shoehorn
Long handledreacher
Sponge on a Stick
Sock aid
Dressing aids after hip surgery
How long do I need to rent the equipment?
• For Hips and Knees - Walker for 1 month
• For Hips – Bathroom aids for 6-12 weeks
• For Knees – Bathroom aids for 1 month
Where can I rent the equipment?
You have a list of vendors in your booklet to choose from:
• Local health supply stores
• Veterans Association
Some suppliers are not open on the weekend
What can I do to make my home safe after surgery?
• Remove scatter rugs and mats.
• Plug in night lights in your bathroom, hallway, and bedroom.
• Install hand railings for inside and outside stairs.
What can I do to prepare for after surgery?
• Arrange to have help with meals, shopping, cleaning and pet care for 3 weeks.
• Try to keep your bedroom, bathroom and kitchen to one floor of your home.
• Make your first physiotherapy appointment at your clinic (3-4 days after your surgery date)
• Ask family or friends to help you during this time.
What can I do to prepare my home after surgery?
• Practice with your equipment before surgery. Make sure that the equipment, especially the walker fits!
• Practice using your walker to get in and out of the bathroom.
• We will discuss individual questions after surgery.
What can I do if I live alone?
One option is Respite Care:
• offered at some retirement homes
• provide meals and a room at a cost
• you or your family can arrange for this before your surgery
• your rental equipment should go there with you
We will give you a list of places today,
if you would like one.
Where can I go for Physiotherapy?
• Orthopedic Surgeons recommend that you go to
Outpatient physiotherapy after your surgery – Usually
3-4 days after surgery.
• Please call and make arrangements before surgery.
(some clinics may have long wait lists)
• Choose a clinic that is close and easy to get to
• Our partnership clinic is at the back today if you wish
to see them after class to get appointments
booked. You may choose to go where you like.
Importance of Physiotherapy After Surgery
• Extremely important that you diligently complete all the at home exercises that are prescribed by your therapist in between physio visits in order to maximize your results
• This is especially important for knee patients to ensure your knee is able to bend and straighten adequately
• A risk of not participating in physiotherapy or pushing yourself, is your surgeon may need to complete a further surgical procedure to ensure your leg is able to move enough
Can I drive after surgery?
• No. Do not drive after surgery for 6 weeks.
• Ask for rides to appointments.
• DARTS (Disabled and Aged Regional Transportation Service)
can be set up while you are recovering.
• Speak to your therapist while you are in the hospital to set
this up.
• Canadian Red Cross (transportation available in some cities)
• Your therapist can assist with the paper work to obtain a
Temporary Accessible Parking Permit (wheelchair parking). –
Permit obtained at Service Ontario.
Thank You – Any Questions?
Nursing:What I am going to cover
• Your Patient Booklet & Inserts – Yours to Keep
• Planning and Preparing for your surgery
• How long you will be in hospital
• What to Bring/Not to bring
• The Day of Surgery - What will happen
• What to expect during your hospital stay
• Pain Control
• Discharge Plans - Expectations
Preparing for Surgery
If you are prescribed 2 or more medications:
• Recommended that you meet with your Pharmacist
• Go over your current medications – “Meds Check”
list – Carry it with you everywhere
• Understand the reason that you take the
medication.
• Make sure that you are taking your medications
correctly.
When you go to the Pre Op Clinic at the West End Clinic
690 Main Street West, Hamilton Ontario (Same building as the Urgent Care Centre)
1. Bring ALL medications, including, over the counter
and herbal + Meds Check from your Pharmacist.
2. All patients having Elective surgery are to
purchase “ Pre Op Scrub.” The nurse will direct
you after your pre op appointment to the area to
purchase this.
Cost: $7.00 cash (no credit).
How long will I be in the hospital?
• You will go home once you
meet discharge criterial.
This may be the day after
your surgery (1 sleep).
• Make arrangements before
your surgery to have
someone pick you up.
What should I bring to the hospital?
• Your Health Insurance Card
• Your Patient Education book and questions
• Non-slip shoes with a back and one size larger
• A housecoat
• Lightweight clothes to wear after surgery
• Personal toiletry items – Fragrance Free
• Your CPAP – Clean it, label it and bring it with you
What else do I need to know and do when I come to the hospital?
• Do NOT Bring Jewelry - remove rings or piercing
• Remove artificial nails and nail polish, hands and feet
• Do NOT shave the leg having surgery – Infection
• Do NOT bring large amounts of money, credit cards, valuable items
• There is a phone at each bedside – free for local calls
• TV and wifi available at a cost to the patient
• Limited Cell Phone use. Ok in lobbies, cafeterias, and public hallways.
What do I wear on the day of surgery?
• Wear loose, baggy and comfortable clothing. If needed, wear your:
• glasses
• hearing aids
• Dentures
• All items will be removed right before surgery, labeled with your name and taped to your bed. They will be returned in the recovery room.
Where do I go the day of my surgery?
• Arrive at the Juravinski Hospital 3 hours before your surgery.
• When you enter the hospital you will see the Information desk on the left.
• Patient Registration/Admitting is directly behind the desk.
What will happen at Patient Registration?
• Provide them with your Health Card.
• Check your bracelet to make sure that the information is correct.
• You will be given papers.
• Take the papers with you to Same Day Surgery Level 0.
• This is where you will get ready for surgery.
What will happen in Same Day Surgery?
• A nurse will come to get you to help you prepare for surgery and will:
Check your identification bracelet and consent.
Give you a hospital gown to change into
Start an Intravenous (IV)
• Your surgeon will come and mark the correct leg for surgery.
• The anaesthetist will come to meet you.
• You will stay in Same Day Surgery until it is time for your surgery.
Your surgery will take about 1 to 1 ½ hours.
Time in the Recovery room 1 to 2 hours.
Your family member can wait in the waiting room.
Where do I go from the operating room?
• You will go to the PACU (Post Anaesthetic Care
Unit) for 1 to 2 hours to recover.
• You will start your Deep Breathing and
Coughing exercises, as well as ankle rolling and
knee bending.
• When the nurses feel you are
comfortable and safe, you will go to
E2, the Orthopaedic Surgery Unit.
Welcome to the Orthopedic Surgery Unit -E2!
Meet your team!
What will happen when you arrive on E2?
• Men and women may share a room and are divided with a curtain.
• We also care for patients after they have broken their hip, who may be confused and unwell.
• If you have benefits coverage for private or semi-private rooms please go to “Preferred Accommodations” today in the Patient Registration area (Main level behind the info desk) to get this information on file.
• We will try to accommodate you to these rooms as they are available.
What will happen when you arrive on E2?
• The nurses will check your pain level often and give you pain medication regularly, even overnight.
• The nurses will check your blood pressure, heart rate and breathing, even overnight.
• You may receive oxygen through your nose.
• You will be given water and you will start to eat foods high in protein, calcium and fibre.
• Your call bell will be attached to the bed.
What will happen on E2 on the day of surgery?
• The nurses will check your wound dressing.
• Your leg will be swollen and bruised for 2 to 3 weeks.
• Do your deep breathing exercises, ankle rolling and knee bending every hour while you are awake.
• You will be helped to sit up at the side of the bed for 15 minutes the evening of your surgery.
• You will NOT have a catheter .
• You will be taken to the bathroom in a chair with wheels.
• You will be asked if you would like to take part in meds in hand
Keeping your skin healthy and free of pressure injuries
• When in the hospital you may not be moving around as much, putting your skin at risk for a pressure injury.
• Unrelieved pressure causes skin tissue damage and can lead to a wound.
• A pressure injury can develop in a few hours yet take months to heal.
• To prevent pressure injuries:
Check your skin for areas of redness, blistering, bruising especially over bony areas.
Change your position as often as you can while lying and sitting. Even a slight change can help.
What about pain control?
• You will have pain after surgery.
• Everyone experiences pain differently.
• We will work with you to control your pain with pain
medications and ice packs.
• Pain medications are given in different ways – such
as pills and into your IV.
• The nurses will check your pain level often and give
you pain medication regularly, even overnight.
• Please tell us if your pain medication is not
working, it can be changed.
Pain Scale
Your nurse will be checking your pain level often. Good pain control means that your pain level is 4 out of 10 or less. Please tell us how you are doing with your pain control at rest and with activity.
More about pain control …
• You will need to take pain medication regularlyto be successful with your therapy while in hospital and when you go home.
• It is important to take you pain medication regularly, at least every 4 hours for the
first 2 weeks.
• set an alarm
• write down what time you took a pill
• Many patients are concerned about becoming addicted to pain medication. It is very rare when used for necessary pain relief after surgery.
Meds in Hand
• We are making it easier for you to get home and get better
• We can have your medications ready for you when you are discharged from hospital and going home
• There is no extra cost to you
• First time fill, refills can be done at home pharmacy
What will happen the first day after surgery?
• You will be seen by the blood clot specialist.
• You will start taking blood thinning medication.
• You will be helped to the bathroom.
• You will be taught exercises.
• You will be helped to walk.
• If you have met the discharge criteria, you will go home on this day.
Exercising in bed
Recovery is WORK – Take your pain medication Regularly
Safety First The “Right” Shoes with the “Right” tools
What happens on the day of discharge? When you have met the discharge criteria, your nurse
will review your:
Wound Care plans
Medications and filling of your prescription- you will
be asked about ‘meds in hand’
Follow up appointments
Plan to take pain medication every 4 hours for the
first two weeks.
Ask your nurse for pain medication before going you
going home.
1) The person picking you up parks across the street.2) The person will come in at the front of hospital and bring a wheelchair to take you to the car.3) Go to the Emergency Department exit when leaving hospital.4) Driver pull up to Emergency, park and help you to your car.
On the day of your discharge:
