Orthopedics / Neurology
Patient Education
Joint Replacement Team (Hip/Knee)
BHMC-LR has long been a leader in Orthopedic services. We have the experience and expertise you are seeking. We will assist
you before, during and after surgery so you can resume an active,
pain-free lifestyle as quickly as possible.
Our Joint Replacement Team is dedicated exclusively to the surgical
care and rehabilitation of patients requiring joint replacement
surgery. The surgery is performed in operating rooms dedicated to
orthopedics. Patients know what to expect and are better prepared
for the joint replacement experience. Education is the foundation
for your care. Before your surgery, our experienced SPA (Surgical
pre-admission) staff will coordinate and conduct your pre-admission
testing and provide you with video and print materials and access
to educational classes that will prepare you for the procedure.
After surgery, you will recover under the watchful eye of physicians,
nurses, physical therapy staff and occupational therapist that will
help manage your pain and begin the process of helping you regain
mobility and strength in the affected joint.
Common Causes of Joint Pain
The most common cause of joint pain is arthritis. There are two
major forms of arthritis Rheumatoid and Osteoarthritis. In cases
of Rheumatoid arthritis, the body's immune system appears to go
awry and attacks healthy parts of the body, particularly the joints.
Osteoarthritis, the most common form of arthritis is also called
degenerative joint disease or "wear and tear" arthritis. It most
frequently occurs in weight-bearing joints, mainly knees, hips and
ankles. This form of arthritis slowly and gradually breaks down
the cartilage that covers the ends of each bone in a joint. Normally,
cartilage acts as a shock absorber, providing a smooth surface between
the bones. But with osteoarthritis, the smooth surface becomes rough
and pitted. In advanced stages, it may wear away completely. Without
the normal gliding surfaces, the bones grind against one another,
causing inflammation, pain and restricted movement.
Information about the Unicompartmental Knee
(partial knee replacement)
A new procedure for the Uni-compartmental knee (partial knee) has
been developed to provide patients with a minimally invasive solution
for osteoarthritis of the knee. Uni-knee replacements are generally
indivcated for individuals whose arthritis affects only one side-or
condyle- of the knee. Orthopedic surgeons today are implanting a
proven prosthesis, removing only the diseased portion of the knee.
UNIKNEE | STANDARD
KNEE |
| 2-3
inch incision |
8-12 inch incision |
| Removes
only diseased portion of knee | Removes
more parts |
| 5
weeks rehab | 12
weeks rehab |
| Patients
age 55 plus | Patients
age 65 plus |
Information
about Knee Replacement
The knee works as a hinge for the tibia(shin) and femur(thigh) bones
and is held together by ligaments, muscle, tendons and cartilage.
Ligaments include the medial collateral, lateral collateral, anterior
and posterior cruciates. Major muscles include the quadriceps and
hamstrings. Cartilage acts as a shock absorber between the bones.
Most total knee arthroplasty patients are female (64 percent) and
older than 65 (66.8 percent). About 32 percent of patients are between
40 and 64 years of old and 1.1 percent are younger than age 40.Approximately
267,000 total knee replacements are performed annually in the United
States.
Total knee arthroplasty is generally indicated for severe degenerative
joint disorders where the articular, or moving surfaces of the knee
deteriorate, leading to severe pain, limitation or loss of function,
and/or deformity of the joint. Total knee arthroplasty is also indicated
for fractures and failed previous prostheses.
Before total knee replacement takes place, other treatment options
are usually considered, including:
- anti-inflammatory drugs in degenerative joint disorders
- synovectomy (surgical removal of inflamed synovial tissue)
- osteotomy (restructuring of the bones to shift stresses from
diseased to more healthy tissue)
Information about Hip Replacement
The hip works as a ball and socket for the femur (thigh) and pelvic
bones and is held together by ligaments, muscle, tendons and cartilage.
Ligaments include the iliofemoral, pubofemoral, and ischiofemoral.
Major muscle groups include the flexotrs, extensors, abductors,
adductors and rotators. Cartilage acts as a shock absorber between
the bones.
Most total hip patients are female (59.4 percent) and older than
65 (60.7 percent). About 34 percent of patients are between 40 and
64 years of old and 5.5 percent are younger than age 40. The statistics
for hips replaced as a result of a fracture differ. Again most of
the patients are female, but a larger percentage (77.1), and they
are an older group (90.6 percent over 65).
Total hip arthroplasty is generally indicated for severe degenerative
joint disorders where the articular, or moving surfaces of the hip
deteriorate, leading to severe pain, limitation or loss of function
and/or deformity of the joint. Total hip arthroplasty is also indicated
for fractures and failed previous prostheses.
Before total hip replacement takes place, other treatment options
are usually considered, including:
- anti-inflammatory drugs in degenerative joint disorders
- osteotomies in the young, active patient.
What To Expect Before, During and After Your
Surgery
Before surgery:
Your surgeon will set an appointment for you to be seen in our SPA
(surgical pre-admission) department. During this visit, the SPA
staff will initiate the following:
- A medical history that includes home medications, allergies,
past surgeries and significant medical problems. Inform your doctor
of any medications that you are presently taking (including over
the counter ones), especially the following: aspirin or medications
containing aspirin, arthritis medications, pain medications, blood
thinners or vitamin E.
- Blood tests, EKG, chest x-ray and a physical exam may be done
to evaluate your state of health.
- The surgical procedure is explained.
- Patient rights are discussed.
- Your anesthesiologist discusses options for anesthesia during
surgery.
- Coughing and deep breathing exercises are reviewed.
- After care and discharge plans are reviewed with a social worker.
- Basic post-operative exercises will be taught by a physical
therapist.
- Nothing to eat or drink after midnight.
- Donate your own blood so that, if needed, you may receive it
during or after surgery.
Day of surgery:
- You will have nothing to eat or drink before surgery.
- An intravenous line will be started so that you can receive
fluids/medication in your vein prior to surgery.
- Your knee replacement surgery takes one to two hours and your
hip replacement surgery takes two to three hours. Both surgeries
have a minimum of one to two hours in the recovery room.
After Surgery:
- Your blood pressure, pulse and breathing are checked frequently
and your temperature is taken. The frequency gradually decreases
over the next few days.
- You will receive Intravenous fluids and antibiotics.
- You will receive a clear liquid diet. Once tolerated, the diet
can be advanced.
- Medication for pain is given according to physician orders.
- Please inform your nurse if the pain is not relieved or if you
are experiencing nausea.
- You need to cough and deep breathe hourly while awake.
- You are on bedrest the night of surgery but will be given a
bedpan or urinal to urinate if you do not have a catheter.
- Patients who have knee replacement surgery may be put on a CPM
(continuous passive motion) machine to begin motion in your knee.
- The first day after surgery you are given a progressive ambulation
program with a physical therapist.
- You are assisted with bathing and personal care.