The Joint Replacement Center at
Johnston Memorial Hospital
Hip Replacement - Hospital Care

Hip Replacement - Preop

Hip Replacement - Hospital Care

Hip Replacement - Postop

Pain Control

What to Do

Plan of Care
Hip Replacement
 Knee Replacement
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Arrive at Johnston Memorial Hospital. You will be given specific directions by the preadmission nurse including arrival time and location.

What to Expect During the Surgical Experience

Upon arrival, you will be prepared for surgery in the outpatient department. A health history will be obtained and the nurse will cleanse the operative site. At the appropriate time you will be escorted to the surgery holding area where you will meet the surgical team. Following surgery you will be taken to a recovery area where you will remain for 30 minutes to an hour. During this time, pain control will be established, your vital signs will be monitored and an X-ray will be taken of your new joint.

The surgeon will talk with your family or "coach" when your surgery is completed to let them know how the surgery went. You will be transferred to your room, where a total joint nurse will care for you. Most of the discomfort occurs the first 24 hours following surgery. During this time, you will be receiving pain medication through  your IV (PCA). You may have physical therapy the first day. It is very important that you begin ankle pumps on this first day. This will help prevent blood clots from forming in your legs. You should also begin using your Incentive Spirometer and  doing the deep breathing exercises that you learned in class. Each day you will receive "Hip Clips," a daily newsletter outlining the day's activities.

Day 1 - After Surgery

On day one after surgery you will be helped out of bed early by physical therapy
and assisted to a chair. You will be seated in a recliner in your room. Your surgeon
or physician's assistant will visit you. The physical therapist will assess your progress and get you walking with a walker. IV pain medication will be tapered and you will
begin oral medication. Remember to ask for your pain pills.

The physical therapist wi

ll begin your exercises with individual therapy sessions twice
a day. As the week progresses and you are able to participate, the therapist may encourage group therapy. Our case manager will visit with you to discuss your needs for discharge from the hospital and begin making any necessary arrangements you will need.

Day 2/3 - After Surgery/Discharge

Today you will walk on stairs. You will be  discharged in the afternoon. This will occur after the afternoon therapy session. Discharge teaching will be done by nursing and physical therapy.

If You are Going Directly Home

Someone responsible needs to drive you. You will receive written discharge instructions concerning medications, physical therapy, activity, etc. Arrangements for equipment will have been done by Case Management.

If You are Going to a Sub-Acute Rehab (Skilled Nursing) Facility

The decision to go home or to sub-acute rehab will be made collectively by you, the case manager, your surgeon, your physical therapist and your insurance company. Every attempt will be made to have this decision finalized in advance but may be delayed until the day of discharge.

We will help you arrange for transportation. Transfer papers will be completed by nursing staff. Either your primary care physician or one of our hospitalists will be caring for you in consultation with your surgeon. Expect to stay for approximately one week, based upon your progress. Upon discharge home, instructions will be given to you by the sub-acute rehab staff.

Please remember that sub-acute stays must be approved by your insurance company. A patient's stay in a sub-acute rehab facility must be done in accordance with guidelines established by Medicare/private insurance. Although you may desire to go to sub-acute when you are discharged, your progress will be monitored by your insurance company while you are in the hospital. Upon evaluation of your progress, you will either meet the criteria to benefit from sub-acute rehab or your insurance company may recommend that you return home with other care arrangements. Therefore, it is important for you to make alternative plans preoperatively for care at home.

In the event sub-acute rehab is not approved by your insurance company, you can always go to sub-acute rehab and pay privately.

Please keep in mind that the majority of our patients do well and don’t meet the guidelines to qualify for sub-acute rehab. Also keep in mind that insurance companies do not become involved in "social issues," such as lack of caregiver, animals, etc. These are issues you will have to address before admission.

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