Every hospital has its own particular procedures, but total joint replacement patients can expect their day-of-surgery experience to follow this basic routine:

• Arrive at the hospital at the appointed time
• Complete the admission process
• Final pre-surgery assessment of vital signs and general health
• Final meeting with anesthesiologist and operating room nurse
• Start IV (intravenous) catheter for administration of fluids and antibiotics
• Transportation to the operating room
• Joint replacement surgery — generally lasts 1 to 2 hours
• Transportation to a recovery room
• Ongoing monitoring of vital signs until condition is stabilized
• Transportation to individual hospital room
• Ongoing monitoring of vital signs and surgical dressing
• Orientation to hospital routine
• Evaluation by physical therapist
• Diet of clear liquids or soft foods, as tolerated
• Begin post-op activities taught during pre-op visit

In the days following surgery, your condition and progress will continue to be closely monitored by your orthopaedic surgeon, nurses, and physical therapists. Much time will be given to exercising the new joint, as well as deep breathing exercises to prevent lung congestion. Gradually, pain medication will be reduced, the IV will be removed, diet will progress to solid food, and you will become increasingly mobile.

Joint replacement patients are generally discharged from the hospital when they are able to achieve certain rehabilitative milestones, such as getting in and out of bed unassisted or walking 100 feet. Whether you are sent directly home or to a facility that assists in rehabilitation will depend on your physician’s assessment of your abilities.

Potential Risks

The complication rate following joint replacement surgery is very low. Serious complications, such as joint infection, occur in less than 2% of patients.1 Nevertheless, as with any major surgical procedure, patients who undergo total joint replacement are at risk for certain complications — the vast majority of which can be successfully avoided and/or treated. Infection may occur in the wound or within the area around the new joint. Following surgery, you will receive antibiotics to help prevent infection. You may also need to take antibiotics before undergoing even minor medical procedures to reduce the chance of infection spreading to the artificial joint. Blood clots can result from several factors, including the patient’s decreased mobility following surgery, which slows the movement of the blood. There are a number of ways to reduce the possibility of blood clots, including:

• Blood thinning medications (anticoagulants)
• Elastic support stockings that improve blood circulation in the legs
• Plastic boots that inflate with air to promote blood flow in the legs
• Elevating the feet and legs to keep blood from pooling
• Walking hourly

Pneumonia is always a risk following major surgery. Ask your doctor for a complete list of risks.