Joint Replacement & Reconstruction

Family Guide to Joint Replacement

Family guide to joint replacementYour loved one is in the best of hands. Thank you for choosing Cooper Bone and Joint Institute and Cooper University Hospital. When it comes to outstanding care, we know you want to make sure you’re getting the best. Here at Cooper, you are!

In fact, we are one of the premier facilities in the region where your loved one will be surrounded by the latest equipment, the most state-of-the art technology and the region’s finest health care professionals. Our care experts have the latest knowledge and experience to handle these surgical cases and do so every day.

This guide is designed to give you a better understanding of the staff, services and support you can expect while you are with us here at Cooper University Hospital. We appreciate your confidence in Our Staff and Cooper University Hospital.

Important Terms You Will Hear During Your Family Member's Joint Replacement

  • PCA Pump – (Patient Controlled Analgesia) patient controlled IV pain medication hooked up to your IV fluids. Designed so patient can press a button to get pain medication safely.
  • CPM – (Continuous Passive Motion) Machine that slowly moves the patient’s leg between flexion and extension (bends your knee).
  • Antiseptic Paint – After the doctor removes your dressing from your wound, the staff will paint the wound with an antiseptic to prevent infection and aid in healing.
  • Flowtrons – soft inflatable stockings that wrap around the lower leg and are affixed by Velcro. They are attached by removable tubing to a pump at the foot of your bed. The stockings automatically inflate and deflate slowly in a gentle massaging motion. The purpose is to lower the risk of blood clots as well as help decrease swelling.
  • Hip Chair – Chair with an elevated seat that keeps your hip flexed at the precise angle to keep your new hip joint in the proper position. It is a higher “bar stool” type of chair that is easier to get out of post surgically.

Joint Replacement Resources from your Staff on South 7

Joint ReplacementHere at the Joint Replacement Center we have many individuals who will be caring for you while you are here. The staff on South 7 that you will come in contact with consists of Physicians, Residents, R.N.’s, L.P.N.’s, nursing assistants, Dietary Orthopaedic Technicians, Medical Students, Physical Therapists, Occupational Therapists, secretaries, and housekeeping staff. All of these individuals are resources to you for your recovery.

Your nurses will be responsible for your medication, postoperative instructions, clarification of your medical history, and preparation of a routine for self care. The nurse assistants will help you gain independence with your bathing, eating, personal needs and movement in and out of bed.

The staff on the orthopaedic unit are prepared and trained to assist you and your family in many aspects of your recovery. As you recover, you will see how we can help you regain your independence. Our staff have worked closely with your physicians in developing and implementing specific protocols that will enable you to gain full recovery. So – whatever you need, please let us help you! You can call us at (856) 342-2247.

Expectations Post Surgically for Good Recovery

DAY OF SURGERY – WHAT TO EXPECT
You will arrive on South 7, from the recovery room, in the afternoon or evening on the day of your surgery. You will go through a medical history review with a nurse to ensure accuracy in your care.

For pain management, you will have an intravenous (IV) line that will allow for Patient-Controlled Analgesic (PCA). You will usually be given IV antibiotics every 6 – 12 hours for 24 hours. You will also be educated on the utilization of Flowtrons. You will be taught in the use of a Spirometer to aid in taking deep breaths after surgery.

DAY ONE AFTER SURGERY – MOBILIZATION
Mobilization is key to recovery and to avoid medical complications. The physical Therapist will evaluate your status and review with you basic sit-tostand procedures. Depending on the status, you may be up and moving with some basic walking patterns.

You will feel a little bit better today. Your IVs will most likely come out as well as the catheter in your bladder. This will now allow you to urinate on your own.

DISCHARGE PLANNING
Joint ReplacementHaving family or friends present during one of your rehabilitation sessions may help with better transition home.Most patients should plan to go home on day three. There are some patients that may need to go to acute or sub acute rehabilitation facilities. You will discuss plans with the joint team. You should notify family and friends to help with your return home.

Some key things to remember after surgery for at least 6 weeks after are:

  • Movement, Range of Motion, and ambulation are vital to your recovery
  • Rehabilitation – follow the directives from the staff
  • Nutrition – eat a well balanced diet
  • Talk to team member about foods that intetract with coumadin

These are general guidelines for a patient after surgery. If you feel you are not following the path exactly – Don’t Worry! Each patient is unique and the staff can address any issues or concerns you may have.

YOUR SUPPORT STRUCTURE – FAMILY AND FRIENDS
How can your family and friends help? Having a support structure is important to any patient healing from surgery. There are always ways in which they can help you. They can help immediately after surgery by helping lift your leg when you are getting out of bed. They can help by shopping or preparing food for you. They can provide encouragement, not criticism. They also can be there to make doctors appointment, drive you to appointments, or just fill out some insurance paperwork.

INSTRUCTIONS AND EDUCATION TO GET YOU READY FOR DISCHARGE
There are many different educational tools to help you feel comfortable and safe to go home. Some of these are located right in the hospital, at our nurse’s station or online.We have listed a few common places to find this information. Just ask one of your nurses for some guidance.

  • TIGR videos on the hospital TV
  • DVDs from the South 7 office
  • AAOS – American Academy of Orthopaedic Surgeons – aaos.org
  • Arthritis Foundation
  • Cooper Library, “micromedex” – from the South 7 nurses
  • Orthopaedic Staff at Cooper on South 7

Instructions for the First 6 Weeks Following Your Joint Replacement

Diet:

  1. May resume your regular diet as tolerated.
  2. It is normal to experience nausea and/or vomiting after general anesthesia. This may also be a side effect of the pain medication. As nausea resolves, start to replenish fluids (drink water) and eat food that are easy to digest (toast, saltines, etc.). If you experience continued nausea/vomiting, then contact us immediately
  3. Constipation may also occur from the pain medication and/or iron pills, if this occurs try to increase fluids, fiber, and fruit intake. You may also buy Colace at the drug store.We will recommend precaution medication.
  4. Remember coumadin related foods.

Medication:

  1. Pain medication will be prescribed for you. Take this as directed. It is important that you be able to participate in rehabilitation and range of motion exercises, so pain control is important.
  2. Usually Coumadin will be prescribed for you, and when you return home, we will arrange for your blood work to be monitored 1-2 times a week. This will allow your primary care physician to regulate your Coumadin dosage appropriately. You will be on Coumadin for six weeks. Alcohol is permitted if allowed by your primary care physician.

Activity Following Knee Replacement Surgery

  1. Joint ReplacementYour success will depend on how hard you work on your recovery.
  2. While in bed, keep operative leg elevated to decrease swelling and pain. Place a rolled blanket or pillow under your HEEL to help maintain FULL EXTENSION. No pillow UNDER knees. The idea is to get full extension of your leg.
  3. Walk with crutches or walker until cleared by Rehabilitation or by your physician.
  4. Walk, isometrics, and Range of Motion exercises. You are allowed to go outside prior to first post-op visit. Bend knee as tolerated, continue exercises as instructed by Rehabilitation to achieve increased range of motion.
  5. When approved, may participate in water aerobics, low impact aerobics, golf, bowling, Nordic track, stationary bike. No aerobics, high impact sports, or heavy lifting indefinitely.
  6. Kneeling is OK with padding.

Activity Following Hip Replacement Surgery

  1. Your success will depend on how hard you work on your recovery.
  2. Sleep on back with pillow between legs for the first six weeks.
  3. Use crutches/walker for first 3 weeks and then may progress to single point cane when able. Hold cane in opposite hand of operative joint.
  4. Walking, isometrics, and Range of Motion exercises. You are allowed to go outside prior to first post-op visit.
  5. When approved, may participate in water aerobics, low impact aerobics, golf, bowling, Nordic track, stationary bike. No aerobics, high impact sports, or heavy lifting indefinitely.
  6. You may often feel “unequal leg lengths.”Most likely, this is a result of “reestablishing” your normal joint space, and lengthening your surgical side to equal the opposite side. For this reason, we will not use a shoe lift until six months after your surgical date. Most likely you will not have a difference in
    leg lengths.

Travel:

  1. You may travel, but you may NOT drive before the first post-operative visit. Ask your physician about specific travel restrictions (ie. riding in car, etc.)
  2. You may travel by plane six weeks after surgery, you may need an aisle seat.

Incision Care:

  1. Do not submerse incision under water (i.e. bathing, swimming) until cleared by your physician.
  2. If you experience any drainage from the incision, redness, swelling, increased pain, or temperature greater than 101 degrees F, call the office immediately.
  3. It is normal to have some numbness around the incision area, this may resolve, but in some cases it is permanent
  4. Bruising and warmth of the incision are normal for 4 to 6 weeks after surgery.
  5. Swelling of the knee, leg, and foot is normal and may persist up to 6 months to a year.
  6. Continue wearing TED stockings on both legs when at home or Rehab as they will aid in reducing swelling.

If you experience increased pain, swelling, drainage from the incision, numbness/tingling, redness, or temperature greater than 101 degrees F, please call us, immediately, at (856) 547-0201 or (856) 233-3626.

Support Services for Joint Replacement Patients

SOCIAL SERVICES/CASE MANAGEMENT: (856) 342-2201
Social Services/Case Management has a Social Worker and a nurse case manager assigned to the Orthopaedic Floor. You will be assigned a Nurse Case Manager and a Social Worker within 24 hours of admission. The case manager will do an assessment and facilitate your plan of care. The social worker will assist as needed for discharge plans such as insurance, extended care and rehabilitation facilities. The case manager and social worker will work together to assist you and your family with any needs that arise.

PASTORAL CARE/CHAPLAIN: (856) 342-2197
There are many clergy members available at any time to assist you and your loved one during the stay. The pastoral staff will assist with contacting specific denomination support as requested. The Hospital Chapel is located on the first floor, Room #111. The Chapel is open 24 hours per day year round.

FAMILY SUPPORT TEAM
Members of this team will be available in a supportive and resource-directing capacity. Please ask your nurse or social worker to contact the team for you.

PARKING
The parking garage is adjacent to the main hospital and is accessible 24 hours a day year round. Rates are posted at the entrance of the lot. Valet Service is available from 9 a.m. – 6 p.m., Monday to Friday. If the main lot is full, the parking attendant will provide direction to alternative parking.

LODGING
Lodging is available for families who live too far to commute back and forth from the hospital. You can find a list of local lodging facilities in our patient guide.

Thank you for choosing Cooper Bone & Joint Institute and Cooper University Hospital. We thank you for trusting us with your care.We wish you well and a speedy recovery. – Cooper Bone & Joint Institute