• Upcoming Surgery

    • What testing will I need before surgery?
      All patients are required to have pre-admission testing (PAT) before surgery to assess if they are medically fit to tolerate the surgical procedure. If you are having your surgery in New Albany, this will be scheduled with General Medical Consultants, a physicians group located in the same building as the Joint Implant Surgeons main office. If you are having your surgery in Athens, this pre-admission test will be scheduled with a local medical group in Athens. In some cases your insurance may require pre-admission testing be done by your primary care physician. Pre-admission testing will include a history and physical, routine blood work, electrocardiogram (EKG) and chest x-ray. In some instances other testing may be ordered. For example if you have a history of heart disease, a stress test may be ordered.
    • What about my daily medications before surgery?
      At the time of your preadmission testing, the medical doctor will review the medications you take routinely. You will be advised by the medical doctor of any medications that need to be stopped before surgery, such as anti-inflammatory pills. You will also be told which medications you may take the morning of surgery. Specific instructions will be given to you by the medical doctor regarding blood-thinning medications, and how far before surgery to discontinue.
    • How long will I be at the facility?
      Many joint replacement surgeries are performed as an “outpatient” and you can actually go home the same day as surgery! The length of your stay is determined by your current medical conditions, insurance type, and how well you progress after the surgery. Insurance authorizations are frequently required and our staff will take care of this for you. If additional days are needed, a facility representative will contact the insurance company to provide medical information and obtain additional authorized days.
    • Will I need a blood transfusion?
      It is very rare that patients need blood transfusions after joint replacements. The decision is largely based on postoperative blood count. Other considerations include whether there are associated symptoms such as lightheadedness, fast heart rate, and low blood pressure. The decision to proceed with a transfusion will be between you, your surgeon, and the medical doctors taking care of you in the hospital. We always respect patient rights regarding blood transfusion.
    • What should I bring?
      If you have purchased your walker or assistive device prior to surgery, be certain that it is available so that your family can bring it to your room after your surgery. The facility's physical therapist will check for proper size and adjust for proper height. A hospital gown, slipper socks, and a small toiletries supply will be provided to you at the facility. If you are likely to stay overnight, it is suggested that you bring personal toiletries, shaving items, and non-skid shoes or slippers. Bring comfortable clothing to wear home such as loose “one size too big” sweat pants. DO NOT BRING large amounts of cash, valuable items, or large suitcases of clothing. If possible, bring a copy of your living will and/or advanced directive.
    • When should I arrive at the facility for my surgery?
      Notification of your arrival time will depend on where you are having your surgery. The facility will call you on the afternoon before your surgery and tell you what time to arrive. Once you arrive at the facility you will go through the admission process, change into hospital clothing, see the anesthesiologist, and meet hospital staff that will be caring for you. Typically you can expect to undergo your surgery within a few hours of the arrival time. Occasionally situations occur which may result in a delay. At the time of your pre-admission testing, diet before surgery will be discussed. You are not permitted to have any food after midnight before your surgery day, but you are allowed to drink clear liquids up to 6 hours before your arrival to the facility. In cases where you have been instructed to take medications the morning of surgery, you should do so with the least amount of water necessary.
    • Will I have an opportunity to ask questions?
      Questions and concerns will be addressed at the time of your visit with the surgeon. Other opportunities include at the time of your pre-admission testing when you will meet with an internal medicine physician and a licensed physical therapist. Routinely, your surgeon will greet you, confirm the operative side (right/left) and type of procedure, and answer any remaining questions prior to surgery. Additionally, you will be given a booklet that contains valuable information that should answer most if not all of your questions.
    • How long will my joint replacement last?
      Lifestyle, age, employment, and weight impact the life of your implant. Work types involving intense activities like heavy lifting or sports that involve high impact activities like running may accelerate the wear of your joint replacement. Overall, today’s modern implants are expected to last many years before revision is required. Annual follow-up is important to monitor the implants for wear so the surgeon can intervene when appropriate. Most research suggests that the need for another operation on your new joint is less than 1% per year, meaning that after 20 years, you have a better than 80% chance that your new joint is still performing well.
  • Day of Surgery Questions

    • What nature of anesthesia will I have?
      Surgeries are performed using general, epidural, spinal, or nerve block anesthesia, or a combination of these. In some cases the medical physician or anesthesiologist will have specific recommendations. The anesthesiologist will meet with you the day of surgery. At that time feel free to voice any questions.
    • How long will surgery take?
      Replacement surgeries typically require 40 minutes to one hour of operative time. If the surgery is a revision or a difficult case the procedure may take several hours.
    • How will my family know when my surgery has come to a conclusion?
      Following your procedure the surgeon will speak with your family members.
  • Post Surgery Questions

    • What happens after surgery?
      You will be taken to the Recovery Room (PACU) where you will be monitored closely for one to three hours. You will then be transferred to your hospital or rapid recovery room. Your nurse will perform a total body assessment; your pulse, blood pressure and oxygen levels will be checked frequently. Pain medication will be administered on an as needed basis. You will have an intravenous lines (IV), oxygen, and calf pumps on both legs that will intermittently pump to keep blood circulating to prevent blood clots. Some patients may have a heart monitor. You will be instructed to perform several exercises every hour including: deep breathing, ankle pumps, quad sets, and a buttock squeeze.

      If you have to stay overnight, the knee or shoulder dressing will be removed in the morning, and either a light dressing or gauze will be put on. The hip incision is typically covered with a clear waterproof dressing that requires very little care and can be gently removed after 7 days. Replacement patients often use support stockings (TED hose) for approximately two weeks after surgery to control leg swelling. However, this is NOT mandatory. The support hose can be removed at night if you wish.

      Your incision may be closed several ways depending on factors that include if the surgery was a primary or revision. Routine primary surgeries are typically closed with absorbable suture under the skin covered with a skin adhesive (glue). For more complex revision surgeries, your incision may be closed with the more traditional skin staples, which will be removed three weeks after your surgery.

      Either the day of or the day after surgery you will begin therapy sessions. If you stay overnight, these are scheduled for twice a day, each day during your stay. Therapists are a very important part of your rehab and will be instructing you on exercises, walking, stairs, getting in and out of the car, using the bathroom, and reviewing “Do” and “Don’t” precautions.
    • When will I see my surgeon?
      The surgeon and orthopaedic team make rounds each morning whenever possible. If your surgeon is not available you will be seen by his associate.
    • When will I be ready for discharge?
      Many joint replacement patients in our practice go home the same day as their surgery. However, if you need to stay overnight in the facility, the average length of stay is between 1 and 2 days. In some cases, insurance mandates a 3-night stay to be eligible for transfer to a rehabilitation center, but the overwhelming majority of our patients are discharged directly to their homes. Activity progress, medical progress, wound condition, and home situation all determine the length of stay and the need for a potential rehabilitation center. Preparations, if needed, for transfer to a rehabilitation center, or other nursing facility will be evaluated and overseen by you, the case manager and social worker.
    • Will I be discharged home or somewhere else for rehab?
      We believe that independence at home is the best way to recover and we always prefer that our patients be discharged directly to home. You will usually be discharged once your physician determines that therapy goals of independence and safety have been met. It is important for most people that you have family or friends with you for several days. For knee and shoulder replacement patients, outpatient therapy is often recommended and you will be given a prescription for this at discharge. On special occasions, in-home therapy can be arranged by the social worker. Hip replacement patients receive detailed instruction on a home program and generally do not need formal physical therapy sessions. In situations where goals have not been met, or if you live alone and there are problems with independence and safety, inpatient rehabilitation may be needed. Patient choice, availability, and insurance criteria impact transfer issues.
  • Discharge and Recovery

    • Can I go up and down stairs?
      Before you are discharged to home the physical therapist will instruct you on stair climbing. We discourage more than one flight up and down a day for several weeks.
    • Do I have any special precautions after my hip replacement?
      After most routine total hip replacements performed by our surgeons at JIS, there are no precautions on weight bearing, walking, or leg position. However, there may be certain situations like revision surgeries where this might change and your nurse or therapist will review this with you after surgery.
    • What about pain management at home?
      You will likely need pain medication for several weeks. You will be provided with prescriptions when you leave the hospital. It is helpful to coordinate medication doses before exercises and bedtime. Should you need additional medication beyond this prescription, you will need to contact our office during regular business hours for a refill. The refill of narcotic pain medications CANNOT be phoned in to your pharmacy and must be mailed to you or picked up at our office. NOTE: We are not able to respond to pain medication refills after hours or on the weekend.
    • How long will I need to use my walker or crutches?
      You may need to use an assistive device for walking such as a walker, crutches or cane, for up to 4 to 6 weeks after surgery. The choice of the aid depends upon the type and extent of your surgery as well as your general physical condition.
    • When may I drive?
      If surgery was performed on the right leg, driving is deferred for up to 6 weeks after surgery. For those patients that are progressing quickly, and off both pain medications and an assistive device, we can administer a “driving test” (brake response test) in our office earlier than 6 weeks. For left leg surgeries, patients are able to drive when: they are off pain medication, no longer require a walker or crutches, and feel safe and comfortable. For shoulder surgery, you must be out of the sling before you can safely drive, and your surgeon will determine the length of time in the sling.
    • When can I go back to work?
      Usually patients are away from work for anywhere from 4 to 12 weeks. Decisions to return to work are based on patient progress, unique situation, work type, and patient choice.
    • When can I resume participating in sports?
      Individual ability and endurance will differ between patients. Activities such as swimming, bike riding, golf, hiking, and low impact sport activities can be resumed somewhere between 6 and 12 weeks after hip and knee replacements. Shoulder replacements require 4 months of recovery before upper extremity sports.
    • When can I resume intercourse after surgery?
      Sexual intimacy may be resumed when you feel comfortable to do so. Keep in mind that postoperative fatigue, pain levels, and some postoperative restrictions will play a part for some patients.
    • Are there any special concerns when going to the dentist or another doctor?
      Antibiotics are recommended for all patients who have had a joint replacement for the life of the implant when you are undergoing a dental cleaning, extraction, root canal or filling. In other procedures involving skin penetration, or testing involving the gastrointestinal and genitourinary tract, we also recommend preventative antibiotics. Prescriptions for antibiotics for dental appointments can be obtained by calling our office. It is recommended that you report your joint replacement procedure to any physician you may see.
    • Will my joint set off a metal detector?
      It is possible that your hip or knee replacement will set off a metal detector, such as those found in airports. You will be provided with a card identifying you as a joint replacement patient in the event a metal detector would be activated. However, airport security may still require more detailed screening.
    • What about other conservative treatments for oseteoarthritis?
      Modifications in lifestyle, weight loss, diet changes, and controlled low-impact exercise can benefit the arthritic patient.

      Non-steroidal anti-inflammatory (NSAIDs) medications have long been used to treat arthritis pain and symptoms. As with all medications, there are certain potential side effects like gastrointestinal ulcers, kidney damage, and cardiac risks. Regular use of this medication should be discussed with your primary doctor who has better knowledge of your other medical conditions.

      Cortisone injections and lubrication injections directly into the joint space can provide temporary relief of arthritis symptoms. However, the efficacy of these injections is different for every patient.

      Glucosamine and chondroitin sulfate are substances normally found in our bodies and act as building blocks for healthy cartilage and joint lubrication. Over-the-counter supplementation can provide some benefit, but the response is quite variable. These are generally well tolerated without toxic effects.
    • What about "platlet" injections or stem cells for the treatment of arthritis? Does it work?
      We are glad you asked! We have an entire section dedicted to Regenerative Medicine. We Can't Wait to See you