Based on its history of success and long-term outcomes, joint replacement surgery, like hip replacement and knee replacement, have become very common procedures with reproducible results. However, patients must remember that these are major operations that can come with a lengthy recovery time and potential surgical risks. Make sure to discuss these potential risks with your surgeon. As a result, these surgeries are most frequently performed on patients with end stage, bone-on-bone arthritis who have failed conservative treatment. Most patients experience daily pain with walking and activity limitations.
During your appointment, your orthopedic surgeon will confirm that you’re an appropriate candidate for joint replacement surgery. Your surgeon should review the procedure with you, discuss the risks and benefits of the procedure, and discuss the postoperative recovery. A scheduling assistant or nurse will also see you to discuss the procedure in further detail, as well as the steps required prior to surgery.
For patients that have already contemplated joint replacement, many are ready to pick a surgical date the day of this appointment. However, if you are not ready to pick a date, don’t worry. Most surgeons can provide you with educational materials and a contact number to call if you do decide to schedule surgery at a later date. You’re also welcome to schedule a follow-up appointment to discuss the procedure in more detail once you’ve had time to do your own research.
If you decide that joint replacement surgery is the right option for you, the next part of the preoperative process is ensuring your overall medical condition is optimized. For patients already in good health, this generally entails routine blood work, an EKG, and preoperative medical clearance with a medical internist or your general family doctor. For patients with chronic medical problems, this may require additional clearance from other specialists, such as a cardiologist.
Many joint replacement centers now recommend a preoperative educational class before surgery. These classes are generally held at the hospital where your surgery will take place. They’re designed to help you prepare for surgery, to give you a better understanding of what to expect after surgery, as well as to help you make appropriate postoperative care arrangements.
Your surgeon may also recommend attending prehab. Prehab stands for preoperative physical therapy. During prehab, you’ll focus on exercises to help prepare your body for surgery and recovery.
From a financial perspective, joint replacement is considered an elective procedure; however, it’s often covered by health insurance. Once you’re provided a surgical date, the surgeons billing staff will help you determine whether your insurance carrier authorizes the procedure. This authorization is based upon the documentation that your surgeon provides demonstrating that you’re an appropriate candidate for joint replacement surgery, based on your X-rays and medical history. Your surgeon will also submit your medical history showing that you’ve already tried other conservative treatment options that have failed to provide pain relief. For many patients, your out-of-pocket expense with be based upon your health insurance deductible.
The day before your procedure, you will be contacted by the hospital to confirm your surgery and what time you are expected to arrive on the day of surgery. You are generally not able to eat or drink after midnight. In most cases, you will be required to arrive a couple hours before your scheduled procedure.
You will see your surgeon prior to the procedure to discuss any additional questions you have and to ensure the surgical consent forms are completed. At this time, the surgeon will mark the operative leg. You will also meet with the anesthesiologist to discuss the type of anesthesia that is best for you.
The surgical procedure generally takes an hour or two with anesthesia and patient positioning. Following the procedure, you will be transferred to a recovery room where you will stay for an additional hour or two to ensure you wake from anesthesia as expected. You should be able to visit with your family once you are transferred to your hospital room. You can also anticipate being up and moving the day of surgery. The length of your hospital stay will depend on your preoperative plan and your condition after surgery.