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More Information on Joint Replacement

Pre-surgery planning

It is very helpful to plan ahead and prepare for your arrival at home after surgery. The following tips can assist you in this process:

  • Go shopping for food and have groceries stocked in the house.
  • Prepare meals before surgery and freeze them for availability after surgery.
  • Remove throw rugs and secure floor coverings.
  • Remove any cords or clutter in the walkways.
  • Assure you have good lighting.
  • Handrails and steps should be secure, not wobbly
  • Arrange frequently used items within safe, reachable distance.
  • Plan care for pets. You may want to consider having your pet(s) boarded or watched by a friend or neighbor. They may get underfoot and cause you to trip while walking.
  • If you have a two-story home, prepare a place to sleep on the first floor.
  • If you are the care provider for young children, a disabled person, or any other person, make arrangements for their care during your hospital stay. It may also be helpful to have the assistance of someone to help you when you are discharged.

A listing of community resources is available to you if you require additional assistance after your surgery. You may require an additional stay in a skilled nursing facility but our goal for you is for you to return to home under the care of your family. Home health care may be an option after you get home. These possible care options will be discussed with you during your stay.

You will use your arms and upper body to move in bed and transfer from bed to chair after surgery. Upper body strengthening exercises done before surgery can help strengthen these muscle groups.

Total joint replacement checklists. Day of surgery.

What to bring to the hospital

You may wish to bring personal items to use during your hospital stay. You are encouraged to leave valuables at home. Please be aware that you are responsible for any items brought into the facility.

  • Current list of medications (prescription, over the counter, vitamins, and herbal medications), dose, how often taken, and time last dose taken
  • A good, solid, low-heeled pair of shoes (no open back or strapless shoes)
  • Hearing aids
  • Glasses
  • Dentures or partials
  • Loose fitting clothes (for discharge)  Bathrobe (optional)
  • Personal items such as your toothbrush, toothpaste, deodorant, lotion, comb, or brush

One day before surgery

The night before your surgery, shower and use the Chlorhexidine soap.

  • Staff will provide you with instructions for proper use.

Morning of surgery

  • Take medication as instructed
  • Shower again in the morning using the Chlorhexidine soap.

Same day after surgery

  • MOBILITY. The evening after your surgery, have someone help you get out of bed, take a few steps, and sit in a chair.
  • DIET. You will get juice or water, and can drink clear liquids as you feel up to it.
  • PAIN MANAGEMENT. You will get medicine to help with your pain. If you are concerned about any of the medicines or are still having pain, talk to your nurse.

Before you leave the hospital, you should have

  • Hospital discharge instructions.
  • A follow-up appointment with your surgeon within 1-2 weeks after leaving hospital.
  • Any medicine prescriptions you may need.

Days following surgery

First day after surgery

  • MOBILITY. Have someone help you sit in a chair for all your meals. Have someone help you walk at least three times in the hallway.
  • DIET. As you tolerate your clear liquids, you can change to a progressive diet. This diet will include soft foods.
  • PAIN MANAGEMENT. You will get medicine to help with your pain. If you are concerned about any of the medicines or are still having pain, talk to your nurse.
  • INCENTIVE SPIROMETER. To lower the chance of breathing problems after surgery, please use your incentive spirometer. Use it every hour while you are awake, 10 breaths each time.
  • URINARY CATHETER. Your catheter may be removed the day after your surgery. If it is not addressed by your care team, ask them about it.

Second day after surgery

  • MOBILITY. Have someone help you sit in a chair for all your meals. Have someone help you walk at least three times in the hallway.
  • DIET. You may be put on a soft food diet. We may change this diet to more solid foods. This will be decided by your surgeon.
  • PAIN MANAGEMENT. You will get medicine to help with your pain. If you are concerned about any of the medicines or are still having pain, talk to your nurse.
  • INCENTIVE SPIROMETER. To lower your chances of breathing problems after surgery, please use your incentive spirometer. Use it every hour while you are awake, 10 breaths each time.

Your hospital experience

Once you arrive in Kaweah Health Medical Centerʼs Ambulatory Surgical Center (ASC), you will be admitted and prepared for surgery. The following is to help you anticipate and better understand each stage of your experience.

Before surgery

  • It is very important that you do not eat or drink anything after midnight during the night before your surgery, Unless instructed by your surgeon to drink a carbohydrate drink.
  • Your surgeon will let your know which medications may be skipped prior to surgery and which should be taken. If your surgeon advises that you take a medication, please do so with a small sip of water.
  • If you are diabetic, please check your blood sugar as you normally would, but be sure to check with your surgeon before taking any insulin or pills.
  • You will be given a parking permit, good for one day only, to park in the designated Special Services parking area.
  • Arrive at the appointed time in Kaweah Healthʼs ASC, located on the first floor of the hospital, accessed from West Street.
  • If you are scheduled to arrive after 7:00 AM, please be reachable by phone in case your surgery time needs to be adjusted. This may happen due to unforeseeable delays or surgeries running ahead of schedule.
  • When you are admitted, be sure to communicate to the nurse any medications you took that morning along with your complete medical history.

When you are admitted

  • You will be asked to change into a hospital gown and get onto a gurney. There are other patients in the ASC, but curtains will provide for your privacy.
  • Because of various risks during surgery, all personal clothing and jewelry must be removed. We will ask that a family member be responsible for your personal items until they can be safely returned to you.
  • A nurse will start an intravenous line (IV) in your hand or arm so that fluids and medications can be given to your during and after surgery.
  • Once you are prepared for surgery, your family members may rejoin you in ASC until it is time to be taken to the operating room suite.
  • Due to special constraints and to decrease noise, visitors in the ASC must be limited to one at a time. Visitors may take turns to accommodate larger groups.
  • The anesthesiologist will discuss with you what type of anesthesia is most appropriate for you during the surgical procedure.
  • The operating room staffs of KDMC follow Universal Protocol for Correct Side/Site Surgery. In accordance with this protocol, the operating room nurse will interview you, verify the correct procedure, and side prior to your surgery. The surgeon will then mark their initials on the correct side.
  • The nurse will be able to answer any questions or address any concerns you may have.
  • When the operating room is ready, you will be taken down a hallway into the suite where your surgery will be performed. It is cool in the surgical suite and the nurse will provide you with warm blankets as needed.
  • If you would like to visit with one of our chaplains prior to your procedure, please notify your nurse and a call will be made to our chaplain services.

Immediately after surgery

  • You will wake up in the recovery room.
  • Your family will be notified when you arrive in the Recovery Room and again when you are transferred to your room.
  • During your stay in the Recovery Room, you will be continuously monitored and cared for by a Registered Nurse.
  • Your IV will have fluids running in and you will receive any needed medications through the I.V. as well.
  • You will have other equipment applied to monitor your vital signs, including a blood pressure cuff, heart, and oxygen monitor.
  • You may have a foley catheter draining your bladder.
  • You may have a mask or nasal cannula on your face to deliver supplemental oxygen until you are more awake and alert.
  • You may have various compression devices on your legs to prevent blood clots due to immobility. These may include tight stockings (TED hose) or alternating leg pressure systems (ALPS).
  • When you are awake and alert enough to leave the Recovery Room, you will be taken to either 4 South or the Broderick Pavillion on 3 East, depending on bed availability
  • You will be discharged from ASC based on discussions with your surgeon.

Decision making

Kaweah Health supports our patients' right to make informed medical treatment decisions regarding their care. The District complies with California laws and court decisions on Advance Health Care Directives. We do not condition or otherwise discriminate against anyone based on whether or not you have completed an Advance Health Care Directive. We have formal policies to ensure that your wishes about treatment will be followed.