Orthopedic center

• Advanced diagnostic services that allow our experts to pinpoint the cause of your orthopedic issue or pain.
• Multiple minimally invasive surgical approaches, which can have you back on your feet sooner with fewer complications.
• Surgical suites that have the most advanced equipment to allow our board-certified surgeons to easily visualize your surgical area. This allows us to complete our surgeries faster, with fewer complications.
• Surgical teams that specialize in orthopedics to deliver the highest-quality care.
• Structured education to help you prepare for your surgery.
• Communication and care pathways that allow you to return home faster.
• Highest-quality surgical devices and implants.
• Comprehensive, one-on-one rehabilitation services.
• Wide variety of free community events to help you learn and decide on the best course of treatment.
• Variety of programs on topics that include returning to work and ergonomics and prevention.
• Five sites of care that offer early morning, evening and Saturday outpatient visits.

• Osteoarthritis
• Degenerative joint disease (also known as arthritis or osteoarthritis)
• Rheumatoid arthritis
• Anterior cruciate ligament (ACL) injuries
• Hip dysplasia
• Long bone, pelvic and hip fractures
• Meniscus tears
• Severe fracture/dislocation
• Rotator cuff tears
• Spine disorders

Leading-edge procedures

We always explore nonsurgical treatments first, but sometimes surgery is necessary. If that's your best option, you can rest assured knowing our experienced surgeons have access to state-of-the-art technology and use minimally invasive techniques whenever possible, which can lead to quicker recovery and less pain. Our procedures include:

• Anterior cruciate ligament (ACL) reconstruction surgery
• Total knee replacement
• Partial knee replacement
• Hemiarthroplasty
• Hip arthroscopy
• Hip resurfacing
• Revision surgery for failed joint replacements
• Rotator cuff repair
• Total shoulder replacement
• Total reverse shoulder replacement

Rehabilitation options

Whether rehabilitation is your primary treatment or a part of your surgery follow-up care, we have a full range of services available to help you meet your goals. Your personalized care plan could include physical therapy, occupational therapy or balance services led by experienced specialists who'll give you the one-on-one attention you deserve. Learn more about our rehabilitation services.

• Prepare for joint replacement (view our checklist now [PDF])

Pre-admission testing:

One of our nurses will call you before your surgery to give you instructions and answer questions. However, please review the list below and be sure you:

• Schedule an appointment with your primary care physician to be cleared for surgery.
• Know that lab tests may be ordered by your primary care physician to make sure you're healthy for surgery.
• Receive medication instructions from your surgeon leading up to and for the day of your surgery.

After surgery

After your surgery, you'll be staying on the fourth floor of the Main Building at Condell Medical Center. You may be awake when you arrive in your room, although you still may be sleepy the rest of the day.

Monitoring: Staff will check your vital signs (blood pressure, pulse, breathing), oxygen level, pain level, circulation, drains (if applicable) and bandage. These checks will be frequent at first and then less frequent as you progress.

IVs: You'll have an IV during your stay. It'll be used to give you medications and fluids until you're taking liquids. It'll be removed on the day you're discharged.

Oxygen: Immediately after surgery, you may have oxygen on if needed. The nurses will assess you and will wean you off oxygen based on your needs. You'll be instructed on the use of the Incentive Spirometer. This helps you clear the anesthetic from your lungs and prevent pneumonia. You also will be asked to take deep breaths and to cough frequently right after surgery.

Diet: You'll be given ice chips and clear liquids if you're not nauseated. Your diet will be advanced slowly.

Equipment:

• If you have drains, they'll be removed one or two days after surgery.
• Knee replacement: You may have a cooling pad wrapped into your bandage to help reduce pain and swelling in your knee.
• Hip replacement: Some patients have an "abductor pillow" to help remind them to keep their legs apart.

Preventing blood clots: This is very important after joint replacement surgery.

• You'll have a wrap that goes around both legs (hip replacement) or just your non-operated leg (knee replacement). It intermittently inflates to keep the blood flowing.
• You can help prevent blood clots by exercising your feet and ankles.
• You will be on blood-thinning medication to help prevent blood clots.

Medications and pain management: Your physicians will restart your home medications as appropriate. You'll receive antibiotics for 24 hours after surgery. To prevent constipation, you'll receive stool softener medications and a laxative, if needed. Your surgeon will decide what other medication you'll receive for pain. Discuss options for pain medication with your surgeon before your surgery.

Physical and occupational therapy: You'll have physician orders to get out of bed the afternoon or evening after surgery depending on what time of day your surgery takes place.

• Physical therapy staff assists you with performing exercises that enhance your recovery by improving your mobility and strength and by focusing on the activities you do on a daily basis.
• Occupational therapy staff trains you in "activities of daily living," which include bathing, dressing and going to the bathroom, among other things.

Therapy goals for your hospital stay include:

• Get in and out of bed safely
• Walk safely with a walker (or crutches or a cane, as directed by your physician)
• Complete your exercise program with the least amount of assistance possible
• Bathe yourself with the least amount of assistance possible
• Dress yourself with the least amount of assistance possible

Your surgeon: Your surgeon or his/her staff will see you on a daily basis. Your primary care doctor also may visit you while you're in the hospital. If your primary care physician doesn't come to Condell Medical Center or you don't have a primary care physician, you may be assigned to a physician called a hospitalist. This physician will see you daily in addition to your surgeon.

Preparing for your return home

After surgery, most patients return directly home from the hospital after two days with ongoing therapy and/or nursing care. Your physician will discuss discharge plans with you prior to hospitalization. Depending on your personal medical needs, you could transition to:

• Home with outpatient therapy services
• Home with home health care therapy and/or nursing care
• Skilled nursing facility where nursing and therapy services are provided

Your case manager will assist you with arrangements for ongoing care as needed, including equipment needs, home health care or skilled nursing facility placement. For your safety and convenience when you get home, here are some suggestions on how you can prepare your home before you come to the hospital:

• Remove clutter and throw rugs. Remove or tape down any cords/wires. Know where flooring is uneven (thresholds).
• Have all areas of the home well lit (consider night lights in bathrooms and bedrooms).
• Widen pathways so you can get your walker through.
• Have handrails on stairs. Consider grab bars in the bathroom for assistance standing.
• Move things you might need to areas where you can reach them.
• Prepare meals to put in the freezer to simplify cooking.
• Arrange for help with shopping and transportation to appointments.

Caring for yourself at home

You'll be discharged from the hospital approximately two days after your orthopedic surgery. Most patients are able to go directly home after their hospital stay.

• Plan to have your "coach" or a family member/significant other help you at home the first day or two. You shouldn't be at home alone the first night after your surgery.
• If you have young children at home, you shouldn't plan to care for them the first day after you return home.
• Your surgeon will give you instructions about the activity level you should maintain at home.
• Generally, you may be up and about as you are comfortable with no strenuous activity (i.e. pushing or pulling heavy objects). Going up and down stairs is permitted depending on how well you have done with stairs during therapy.
• Follow your exercise instructions.
• Sit in chairs that give adequate support and have arms that you can use to help yourself stand up.
• Don't cross your legs when you sit or stand. Don't twist your affected joint.
• Ask for help to put on shoes and socks.
• You may bathe or shower as your surgeon instructs.
• No driving until released to do so by your physician (prescription medication can impair your judgment).
• Keep your incision clean and dry. Change your dressing as instructed.
• Get plenty of rest.
• Knee: If you have a nerve block, a home health nurse will remove the tube after you go home.

Notify your surgeon if you have:

• Redness and/or swelling at the incision site
• Drainage from the surgical incision
• Pain in the calf of your leg or increased swelling in your leg
• A fever greater than 101 degrees Fahrenheit
• Pain that isn't controlled by the medication prescribed for you for home

Other reminders:

• Remember that your new joint may set off metal detectors in airports and other places.
• Let your doctor or dentist know before you have other procedures or surgery done. Antibiotics may be necessary before these invasive procedures to prevent infection.