Graham Regional Medical Center

Under the direction of Board Certified Orthopedic Surgeon Michael T. Hay, M.D., Graham Regional’s orthopedic clinic offers a full range of surgical and non-surgical services to help relieve pain and restore the ability to live an active and healthy lifestyle.

For appointments, call 940-521-5360. 8am – 4pm Monday-Thursday | 8am – Noon Friday

For new and Current Users, please click the Orthopedic Clinic Patient Portal to log in.

What You Need to Know About Joint Replacement Surgery

It may surprise you that total joint replacement patients are usually encouraged to get up and start moving around as soon as possible after surgery – as early as the day of surgery. When you are medically stable, the physical therapist will recommend specific exercises for the affected joint. Physical therapy is a vital part of recovery. The more quickly a joint replacement patient moves again, the more likely they will regain independence. Pain medication is recommended before therapy to ease the discomfort the activity will initially cause. In addition, the physical therapist will discuss plans for rehabilitation following hospital discharge.

What is Joint Replacement Surgery?

Hip replacement involves replacing the femur (head of the thigh bone) and the acetabulum (hip socket). Typically, the artificial stem is made of a strong metal, and the artificial socket is made of polyethylene (a durable, wear-resistant plastic).

In total knee replacement, the artificial joint comprises metal and polyethylene to replace the diseased joint. The prosthesis is anchored with bone cement or covered with an advanced material that allows bone tissue to grow into it. Total hip and knee joint replacements have been performed since the 1960s. While the expected life of conventional joint replacements is difficult to estimate, it is not infinite.

Preparing for Joint Replacement Surgery

Preparing for total joint replacement begins weeks before the actual surgery date. In general, your doctor may discuss the following with you:

  • Exercising under a physician’s supervision: it is essential to be in the best possible overall health to help promote the best possible surgical experience. Increasing upper body strength is vital because a walker or crutches is needed after hip or knee replacement. Strengthening the lower body is crucial because increasing leg strength before surgery can reduce recovery time.
  • General physical examination: patients considering total joint replacement should be evaluated by their primary care physician.
  • Dental examination: dental procedures such as extractions and periodontal work should be completed before joint replacement surgery to reduce the potential of infection.
  • Medications: your doctor can advise which over-the-counter and prescription medications should not be taken before surgery.
  • Stop smoking: to help reduce the risk of post-operative lung problems and improve healing.
  • Lose weight: in patients who are obese, losing weight will help reduce stress on the new joint.
  • Arrange a pre-op visit: a vital opportunity to meet with healthcare professionals to discuss your hospital care plan.
  • Laboratory tests: blood tests, urine tests, an EKG or cardiogram, and chest X-ray may be prescribed to confirm that you are fit for surgery.
  • Evaluate post-surgical needs for at-home care: every patient who undergoes total joint replacement will need help at home for the first few weeks.

What You May Experience on the Day of Surgery

Every hospital has its particular procedure, but total joint replacement patients can expect their day-of-surgery experience to follow this basic routine:

  • Arrive at the hospital at the appointed time
  • Complete the admissions process
  • Final pre-surgery assessment of vital signs and general health
  • Final meeting with anesthesiologist and operating room nurse
  • Start IV (intravenous) catheter for administration of fluids and antibiotics
  • Transportation to the operating room
  • Joint replacement surgery – generally lasts 1 to 2 hours
  • Transportation to a recovery room
  • Ongoing monitoring of vital signs until the condition is stabilized
  • Transportation to individual hospital room
  • Ongoing monitoring of vital signs and surgical dressing
  • Orientation to hospital routine
  • Evaluation by physical therapist
  • Diet of clear liquids or soft foods, as tolerated
  • Begin post-op activities taught during the pre-op visit

In the days following surgery, your condition and progress will be closely monitored by your orthopedic surgeon, nurses, and physical therapists. Much time will be given to exercising the new joint and deep breathing exercises to prevent lung congestion. Gradually, pain medication will be reduced, the IV will be removed, the diet will progress to solid food, and you will become increasingly mobile.

Whether you are sent directly home or to a facility that assists in rehabilitation will depend on your physician’s assessment of your abilities.

Potential Risks

The complication rate following joint replacement surgery is meager. Serious complications, such as common infections, occur in less than 2% of patients. Nevertheless, as with any major surgical procedure, patients who undergo total joint replacement are at risk for certain complications – the vast majority of which can be successfully avoided and treated. Infection may occur in the wound or within the area around the new joint. Following surgery, you will receive antibiotics to help prevent disease. You may also need to take antibiotics before undergoing even minor medical procedures to reduce the chance of infection spreading to the artificial joint. Blood clots can result from several factors, including the patient’s decreased mobility following surgery, which slows the movement of the blood. There are several ways to reduce the possibility of blood clots, including:

  • Blood thinning medications (anticoagulants)
  • Elastic support stockings that improve blood circulation in the legs
  • Plastic boots that inflate with air to promote blood flow in the legs
  • Elevating the feet and legs to keep blood from pooling
  • Walking hourly

Life after Total Joint Replacement

The vast majority of individuals who have joint replacement surgery experience a dramatic reduction in joint pain and a significant improvement in their ability to participate in the activities of daily living. However, joint replacement surgery will not allow you to do more than you could before joint problems develop. Your physician will recommend the most appropriate activity level following joint replacement surgery.

In the weeks following total joint replacement, certain limitations are placed on every patient’s activities. After joint replacement, a good rule of thumb is that acceptable physical activities should:

  • Not cause pain, including pain felt later
  • Not jar the joint, as happens with running or jumping
  • Not place the joint in the extremes of its range of motion
  • Be pleasurable

Pneumonia is always a risk following major surgery. Ask your doctor for a complete list of risks.

Questions or Comments? Please contact the Orthopedic Clinic at (940) 521-5360.