Working Together for Healthy Joints

Before, During and After

Hip and Knee Replacement

Education Webinar

Updated June 2021

Questions?

OASIS Website: oasis.vch.ca

More questions after class?

oasis@vch.ca

http://www.oasis.vch.ca/

Today’s Main Message:

Your hospital stay is short. 8 hours to 2 days so …

BE PREPARED

Why is Length of Stay (LOS) short?

8 hours – 2 days: NEW standard of care for total joint

replacement

Reduces the risk of infection

Improved activity at home

Improved sleep

Better use of resources

Average Length of Stay

Total Joint Replacement

You will be sent home when you meet discharge criteria

• Medically stable

• Move around safely with walking aids

From 8 hrs to 2 days

Bilateral - Longer hospital stay, more rehab

Revision surgery – variable length of stay

Today’s Session:

Hip Precautions

Knee Precautions

How to prepare yourself

How to prepare your home

What to expect in hospital

Everyday activities after surgery

Medications

Hip X-Rays

Healthy Hip Joint Damaged Hip Joint

Pfizer 2004 – The Arthritis Society

6 weeks-3 months Hip Precautions

NO Bending

past 90º

NO Crossing

NO Twisting

90º

WHY Hip Precautions?

Reduce risk of HIP DISLOCATION

Bone growth

Heal soft tissue

Stretch/strengthen muscles

Knee X-Rays

Healthy Knee Joint Damaged Knee Joint

Pfizer 2004 – The Arthritis Society

3 months of Knee Precautions

NO pillow behind the knee

NO Squatting

NO Kneeling

NO Twisting

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WHY Knee Precautions?

To reduce knee STIFFNESS

Heal soft tissue

Stretch/strengthen muscles

BEFORE Surgery: Home Set-up

Remove clutter

Raise up regularly used items

Increase chair, bed and toilet heights

2 inches above knee height

Use firm cushion / bed blocks

How to Measure Seat Height

Stand next to chairs and sofa

Measure from the top of the

chair to 2” above your knee

If the chair is too low, add a

high density foam cushion (2”, 4”,

6” etc.) to increase the seat

height to 2” above knee height

Bathroom Equipment

Raised toilet seat

Bath stool or bench

Rubber bath mats

Grab bars

How to Measure Toilet Height

Lift the toilet seat up

Stand next to your toilet

With a measuring tape,

measure from the top of the

toilet bowl to 2” above your

knee

This is the height of the raised

toilet seat that you need

When can I shower?

Need to keep incision dry

Staples in for 10 -14 days

Use a waterproof dressing

OR

NO showering until staples

removed

Discuss with hospital staff

Equipment

2 wheeled walker

NO 4W/WALKERS!

Crutches

Very Firm foam cushion

Equipment for getting dressed

Long-handled reacher

Long-handled shoe horn

Sock aid

Cryotherapy unit (if you purchased one)

Please label your equipment!!

2 wheeled walker Sock aid

Remember . . .

Review your “Before, During & After” book

Bring your completed Pre-Op Self

Assessment Form (LGH – no pre-op self-

assessment form)

The foam cushion and dressing equipment

is optional for knee replacement surgery

Ice machines and CPAP machines can be

brought to hospital – discuss with hospital

specific Pre-Admission Clinic

Hospital-specific Info

UBC or VGH patients:

Take your equipment to the hospital on the morning of

your surgery. You will use it during your hospital stay:

2w/walker, crutches, foam cushion, equipment for dressing

St. Paul’s, Richmond and Lions Gate Hospital patients:

Do NOT take your equipment to hospital, but have it

ready for when you are discharged (ice machine ok)

Where to get equipment

Medical supply stores

Rental or purchase

Before you go:

• Check extended medical - prescription may be needed

• Measure, photograph or trace toilet bowl

• Note what side the taps are in the bathtub

Friends, family

Medical Equipment Provision Program

Has replaced the Red Cross loan program

Provides equipment for people with NO

other means to rent or buy

Must sign disclaimer re: financial need

If you need to access MEPP, stay at the

end of class to complete application forms

Weight-bearing Status

Most people are “weight bear as tolerated”

First use a 2 wheeled walker in hospital

Practice stairs in hospital with crutches

Revision surgery may be different…

Pre-Admission Clinic

Hospital will call you

Health history

Medication review

bring ALL medications & supplements

Anesthetic consult

Will advise about bathing &

shaving before surgery

* Sometimes done by phone*

Surgery Time

Your surgeon’s office will call you the day before surgery For Monday surgeries, they will

call Friday If your surgeon has given you

different instructions, follow them

If you haven’t heard from anyone by 4:00pm, call Admitting

Before you come in for surgery

Pack (lightly!):

comfortable clothes

walking shoes

toiletries

No valuables please

Day of Surgery

Check-in at Admitting

PreOperative area

Operating room

Recovery Room

Orthopedic ward

Post-Op Pain Control

Pain scale

Pain medication

‘breakthrough’ pain medication

Possible side effects: nausea, constipation

Physiotherapy After Hospital

Generally continues 2 to 3

months after surgery

Depends on where you

live

To be planned by the ward

physiotherapist

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Heading home

Arrange for a ride home

Have someone stay with

you or nearby for the first

3 days you are home

Car Travel-When can I drive?

Depends on:

Surgical leg

Strength, response time

Standard or automatic

Other options:

Handidart

SPARC parking pass

Check your insurance provider before you start driving

It may take 6 weeks or more before driving

Preventing Blood Clots

Pill or injection, determined by your

surgeon (kidney function, clotting history)

Fill your prescription at a pharmacy near

the hospital

Take the medication as prescribed!

Pill daily for up to 35 days

Injection daily for 2 weeks

Other Activities…

You may have questions about:

Cooking

Housework

Returning to work

Sexual activity

Speak to your occupational

therapist (OT)!

Prevent constipation

Get moving

Drink plenty of

fluids

High fibre diet

Stool softeners,

laxatives

Resource: HealthLinkBC 8-1-1

Pharmacist, dietitian or nurse

Keys to a successful surgery:

PREPARATION

Equipment; get it and learn how to use it

Support of friends, family

PATIENCE

Follow physio exercise plan

People heal differently

To Review…

Please go to oasis.vch.ca to

review videos.

Please refer to your “Before,

During and After” booklet for

further content.

http://www.oasis.vch.ca/

Questions?

To send your feedback about this session please email:

oasis@vch.ca

Thank you for you attending!

mailto:oasis@vch.ca

Accessing Red Cross MEPP

Email oasis@vch.ca

By emailing us for access, you consent

to the following

I consent for my personal information to be shared with the Red Cross MEPP Program

The Medical Equipment Provision Program has been reviewed with me and I acknowledge I meet the requirements of the program.

I hereby authorize the BC Health Authority Staff and/or its representatives to release or to obtain from such agencies, individuals, medical centres or hospitals, any and all pertinent information which may be necessary to assist in providing or obtaining essential medical equipment on my behalf. I consent to the collection, use and disclosure of the personal information provided in accordance with the VCH Privacy Policy, until I notify you otherwise. If you have any questions about the collection of information, speak to the Health Authority contacts above. I understand this equipment is prescribed for the period stated above and must be returned when required or instructed to do so.

mailto:oasis@vch.ca

MEPP – email to oasis@vch.ca

Personal Information:

Full name

Weight & Height

Alternate contact person with phone number

Required Equipment

2-wheeled walker, crutches

Height of raised toilet seat (2”, 4”, 5” or 6”) with or without

armrests OR Commode – height adjustable with arms

Tub transfer bench (bathtub) with taps on right or left side

OR bath chair (walk-in shower)

Red Cross location Thanks and Good

Luck!