What kinds of tests will I need before surgery?
The testing and clearances that we request are an attempt to minimize the risks of surgery. In preparation for surgery, you will need:
- Complete Blood Count (CBC)
- Basic Metabolic Panel (BMP)
- Staph nasal swab
- Hemoglobin A1c (if diabetic) – must be below 7.5
- Serum albumin and total lymphocyte count (history of bariatric surgery or malnutrition)
- Chest Xray
- Medical Clearance – primary care and cardiology/pulmonology (if applicable)
You may also be asked to obtain additional imaging in preparation for your surgery. This may include additional X-rays with sizing markers or a specialized MRI.
Will I need to donate blood before surgery?
The risk of needing a blood transfusion after hip/knee replacement is approximately 20% nationwide. While we used to recommend donating your own blood before surgery, we no longer do this as it actually has a higher rate of requiring a transfusion. If needed, you will receive highly tested blood. Hospitals follow universal guidelines in screening blood and blood products to optimize the patient’s safety.
How long will I be in the hospital?
For joint replacement surgery, most patients are hospitalized for 1-3 days, including the day of surgery. Hospital stays vary, but our improvements in pain control over the past decade has led to more patients returning home much sooner after surgery.
What is the typical recovery time?
Everyone heals from surgery at a different pace. It is difficult to compare yourself with others, as individual situations lead some patients to recover faster than others; however, in general, patients will use a walker or crutches while in the hospital. These devices are typically for balance, and patients may weight-bear as their comfort allows.
It is our experience that as patients comfort, confidence, and strength allows, they may progress to a cane. Typically, patients may progress to a cane at 2-3 weeks. By 4-6 weeks’ time, many patients are not requiring any external supports. It may take 6-9 months to return to normal function and patients continue to improve, as far as their comfort, mobility, and function for 12-18 months after their surgery.
Will I go home or to rehab?
Most patients are able to go home after their operation; however, you may go to a rehabilitation facility in order to gain the skills you need to safely return home. Many factors will be considered in this decision, including the availability of friends or family to assist you at home, a safe home environment, postoperative functional status as determined by a physical therapist in the hospital, and overall evaluation by your hospital team.
When can I drive?
This varies from patient to patient depending upon one’s comfort and confidence. Typically, patients may drive when they are using a cane comfortably and not taking narcotics. Classic teaching is that break-response time is diminished for 6 weeks after surgery. With newer techniques for pain control and more rapid therapy progression, many patients are now safe to drive 2-4 weeks after surgery. A good rule-of thumb is: “Would you feel safe behind the wheel if you were driving home and your child’s ball rolled into the street?”
When can I return to work?
It depends on your profession. If you have a sedentary or desk job, you may return to work in approximately 3-6 weeks. If your work is more labor intensive, it may take 3 months before you can return to full duty. Even with successful joint replacement, some job tasks may be difficult to complete.
How long will my joint last?
Current implant design is better than it has ever been. In general, each year after surgery adds 0.5-1% risk of revision. At 10 years following hip/knee replacement, there is a 90-95% chance that your joint will still function well. At 20 years, 80-85% have still not required revision. We continue to hope that the latest implants and designs will extend the life beyond these numbers.