Preparation for Hip and Knee Replacement
Having a Hip or Knee Replacement?
We will arrange for you to attend a Pre-Operative Joint Surgery Education Class at Danbury Hospital.
"If you are unable to attend the live class, please review the following information."
You have elected to have a joint replacement to improve your quality of life. Our goal is to prepare you to go home and continue your rehabilitation and return to the activities and lifestyle you enjoy.
What to Expect During Your Hip or Knee Joint Replacement
Preoperative Appointments
- Dr Gupta / Physician assistant
- Ask any questions related to your joint replacement.
- Discuss current medications.
- You may need a blood transfusion. You may qualify to donate your own blood before surgery. We would discuss this with you at the time of booking your surgery.
- Review and sign the consent for surgery.
- Primary care doctor for preoperative medical evaluation.
- Your medical history and current medications will be discussed.
- Blood tests, x-rays and an EKG may be done.
- See a dentist, if you have not seen one in the past six months.
- Schedule an appointment with an anesthesiologist at Danbury Hospital to discuss options for anesthesia and pain management. This is optional. Dr Gupta will notify you if this is to be done.
Preparing for Your Arrival Home
If you are planning to go home, give Danbury Visiting Nurse Association a call (203) 792-4120). They will come to your home and make necessary arrangements.
In addition
- Remove throw rugs or area rugs not anchored by furniture.
- Clear any obstacles in halls and walking paths. Tape down any wires that may be in the path.
- Install non-skid mats in the tub/shower you will be using.
- Move most commonly used items in the kitchen, bedroom, and bathrooms to a more comfortable height. This should be about counter or sink level; usually waist level.
- Install night lights in bathrooms and halls.
- Prepare meals prior to your surgery and freeze them.
- Set up a firm armchair to use after surgery. If you are having a total hip replacement, put a pillow on the chair.
- Find a location in your home where your pet can stay while you get settled after your discharge.
- Select a coach.
Selecting a Coach
- Your coach can be a spouse/significant other, family member, or friend.
- He/She will help and support you through the phases of your surgery and rehab.
- He/She will participate in preoperative visits, attend therapy sessions in the hospital, and teaching sessions with your nurse.
The Night before Surgery
A nurse from the Duracell Surgical Unit will call to let you know:
- What time to arrive.
- What medications to take the morning of surgery.
- Do not eat or drink after midnight.
Things to bring the Day of Surgery
- All paperwork given to you by Dr Gupta’s office.
- Two forms of ID (one must be a picture ID).
- A list of ALL medications you take, including vitamins or supplements.
- Toiletries.
- Book, magazines, music, etc.
- Please leave any valuables at home.
The Day of Surgery: Duracell Center
- Arrive at the requested time and report to the reception desk.
- You will be brought to an "assessment room" where:
- A nurse will complete health informaton forms.
- You will receive an ID bracelet.
- All personal belongings are placed in a bag and labeled.
- You will be given a support stocking to put on your non-surgical leg.
- The nurse will take family contact information and your family will go to the waiting room.
The Day of Surgery: Operating Room
- You will be brought to the operating room holding area.
- The operating room nurse will verify health information.
- An anesthesiologist will start an intravenous line and discuss anesthesia/pain management options with you.
- Dr Gupta will verify the surgical site with you and will mark the leg he is operating on.
- You will be brought into the operating room and placed on the operating room bed.
- You will be given medication to help you relax.
- The surgical area will be prepped.
- Once you are asleep, a Foley catheter will be placed in your bladder.
- After surgery is completed, you will be brought to the recovery room, and your surgeon will call your family.
The Day of Surgery: Recovery Room
- Nurses will monitor your vital signs.
- You will have oxygen.
- You may receive a blood transfusion if needed. If you donated your own blood prior to surgery, this is what you will receive.
- You will receive medication for pain and/or nausea/vomiting.
- You will be in the recovery room until you are awake and your pain is managed.
Orthopedic Unit
Dr Gupta or his team will see you each day while you are on the Orthopedic Unit.
- Our dedicated inpatient unit is staffed with orthopedic nurses, a Physician Assistant, and physical therapists skilled in caring for you after your joint replacement.
- Nurse case managers are available to assist with discharge planning needs.
- The Musculoskeletal Care Coordinator is available to answer any questions you may have and assist you during all phases of your surgery and rehabilitation.
- You may be seen by a Hospitalist. Hospitalists are physicians dedicated to the patients at Danbury Hospital. They are available to see patients throughout the day for reassessment and following up on test results.
- Each room has a call bell that rings directly to the nurses’ phones to enable us to assist you as quickly as possible.
- Cell phones may be used on the Orthopedic Unit. Please label your phone if you choose to bring it.
- Because your incision is new, you will not be able to shower while in the hospital. We will provide you with everything you need to feel fresh and clean.
Recovering in the Hospital
After surgery, your IV (intravenous) line will remain in your arm for approximately 48 hours. The IV line delivers fluids, antibiotics and other medications. Should you need a blood transfusion, the IV line can also deliver blood.
The surgical site will be bandaged. A thin tube inserted into the site and attached to a drain prevents blood from accumulating around the hip. This tube is removed the day after surgery and the bandage is removed the second post-surgical day.
For hip replacement, a pillow between your legs will help maintain the proper position of your hip. A nurse will position you in bed and help you turn until you are able to move on your own.
Because anesthesia may temporarily inhibit urination after surgery, a catheter may be inserted into the bladder to remove urine. When the patient regains function, usually within one to two days after surgery, this catheter is removed.
Deep Breathing
After surgery, regular deep breathing, to rid your air passages of mucus, is vitally important. Normally, you take deep breaths almost every hour, usually without being aware of it, whenever you sigh or yawn. When you are in pain, or are drowsy from anesthesia or pain medication, your breathing may be shallow.
To ensure that you breathe deep daily, the nursing staff will provide you with a device called an Incentive Spirometer, along with instructions on its use.
 How to use the Incentive Spirometer
- With the unit in an upright position, place your lips tightly around the mouth-piece and exhale normally.
- To achieve a deep and sustained breath, inhale at a rate sufficient to raise the ball in the chamber.
- Exhale. After performing the exercise, remove the mouthpiece from your lips.
- Relax and breathe normally for a moment after each deep breath
Repeat this exercise 10 times every hour.
Expected Length of Stay
- Total Knee: 3 nights.
- Total Hip: 3 nights.
- Hip resurfacing: 3 nights.
Discharge Planning
- Home:
- Outpatient Physical Therapy.
- Home care services which includes Physical Therapy and any medical equipment you may need.
- Short Term Inpatient Rehab
- Generally between three and seven days.
- Acute Rehab
- Our staff will also help with insurance authorization, following Medicare guidelines, and transportation.
Important Phone Numbers
- Deanna Marchiselli-Flynn, PT, MS- Musculoskeletal Care Coordinator 203-739-6420
- Duracell Ambulatory Care Center 203-739-7823
- Anesthesia 203-739-7118
- Case Management (Discharge Planning) 203-739-6246, 203-739-6249
- Blood Bank 203-739-7747
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