FAQS: Before Surgery Total Hip and Knee

Medical Tests
All patients are required to have urinalysis and standard blood tests within two weeks of surgery. Patients over fifty years old will need a chest x-ray and an electrogram. It is strongly recommended that these tests be performed at the NYU Hospital for Joint Diseases as part of a preoperative meeting with the Department of Anesthesia. At this same visit patients will have a physical examination. If medical problems are found further tests or studies may be necessary. Patients with known medical problems and all patients over fifty will require a medical clearance from their own physician. Some patients may need  medical follow in addition to their regular surgical care during their hospitalization. Whenever necessary or desired, patients are followed in consultation by physicians from our New York University medical staff.

Medications and Diet
While many medications can be continued up to surgery, some may cause problems with the surgery, anesthesia, or healing process. Non-prescription drugs, and alternate medicines may also cause significant side effects. If there are any medications, drugs or natural or alternate agents that you have not already included in your history, it is important to contact our office with this information. Bring a list of these agents to your pre-admission evaluation so that the anesthesiologist may review this list and advise accordingly.

There is no special diet recommended prior to surgery. Patients in most circumstances should look to eat balanced nutritional meals. Drastic diets may be problematic and patients are advised to discuss any such diets with their medical doctors. Iron supplements and multivitamins may be indicated. This should be discussed with the patient's medical doctor.

Blood and Transfusion Questions
Both hip and knee replacement surgery may cause enough blood loss to warrant transfusion. Accordingly, in many circumstances it is advisable to make plans for blood donation. The safest blood for any patient is their own. Giving one's own blood for surgery or Autologous Blood Donation is scheduled within a month from the date of surgery. One unit of blood can be given each week with a maximum of two units total. Donated blood only lasts one month. To insure this blood remains available, the date of surgery is set first, then the dates for blood donation are made. For patient safety,  blood levels must be monitored before each donation.

Patients who cannot give blood for medical reasons may benefit from the use of Cell-Saver, a device that processes and reinfuses blood lost at surgery. Additionally these patients may be treated with Erythropoieten, a hormone that causes the body to make blood. Arrangements for injections of this hormone must be made with the patient's medical doctor.

Patients whose religious convictions preclude transfusion may also consider Erythropoieten.

Anesthesia
Patients meet with the Anesthesiologists in the pre-admission visit approximately one week before surgery. This is the best time for patients to learn about the various anesthesia techniques and find out what may best suit their needs. For most patients we feel that spinal anesthesia is the safest, and brings about the fastest recovery. Patients undergoing spinal anesthesia are usually also given medications such that they are not aware during the procedure.

Admission to the Hospital and Length of Stay
Most patients are admitted the day of surgery. The hospital will call the night before surgery advising time for arrival. The arrival time is usually one to two hours before the time the surgery is scheduled. This time is necessary to prepare patients for their procedures.

The routine length of stay is three to four days in the hospital. During this time patients begin sessions with physical therapy. Most can be up and walking, fully weight-bearing from the first day. Therapy begins with a walker and progresses to crutches then a cane at the patients own rate. In addition to ambulation, patients have sessions on stair-climbing, and activities of daily living including: dressing, transfers to and from the bed, chair, bathroom and car.

Patients not ready to go home by the third or fourth day may be transferred to a rehabilitation/therapy unit either at the hospital or to a unit closer to home. The options for admission to rehabilitation or subacute nursing facilities, however, are often influenced by the insurance coverage.

What to bring to the Hospital
• Personal toiletries and shaving items
• Closed back non-skid slip-on shoes
• Loose fitting comfortable clothing that is easy to put on and take off
• A list of current medications and dosages
• Who to call with questions before surgery
• Many people have questions or need assurance of some part of their care.

Do not hesitate to call or contact our office.

Return to Previous Page