Preparing for Surgery

Signing the consent form for surgery is only the first step in your joint replacement journey. To help maximize your outcome and an enjoy smooth recovery, health conditions should be optimized prior to surgery by your primary care physician or other physicians as much as possible. Please discuss smoking cessation and weight optimization prior to surgery to help improve your recovery from joint replacement.

The surgical aspect of joint replacement is only part of the treatment. Optimizing your health, building strength and pre-habilitating your muscles will help improve your recovery from joint replacement as well as contribute to other positive health outcomes. The Osteoarthritis Service Integration System (OASIS) team has developed a wealth of patient resources to guide them through the pre- and post-operative process. They have a specific PreHab class which instructs patients how best to get ready for surgery as well as provides them with a wealth of other valuable information. Please visit their website to help you get ready for surgery.

 

Patients booked for surgery will be contacted by OASIS to attend their free PreHab session. If you are on a surgical waitlist and have not been contacted, please visit the OASIS website via the link above to contact them.

Preoperative rehabilitation, or “prehab”, is a multidisciplinary healthcare intervention intended to educate, empower, and prepare you for surgery. Participating in the educational sessions will help you (and your family) have less anxiety and stress related to the surgery. Everyone benefits from an enhanced understanding of their upcoming surgery and we encourage you to visit the OASIS prehab weblink to schedule a prehab webinar and to access the online resources. In addition, participating in exercises and optimization of your muscles, joints, and health conditions will ensure you have the lowest risk of complications, reduces hospital length of stay, and will help you get a “jump start” on an accelerated recovery pathway coming out of surgery. At VHKRI we partner with a multidisciplinary team of health educators, physiotherapists, and allied health care professionals to provide you with the most appropriate and evidence-based optimization and prehab prior to surgery. At the time of your consultation and discussion about upcoming surgery we recommend that you do a detailed assessment of all aspects of your health and any obstacles to your mobility. We encourage you to use the available time while you are on the “surgical waiting list” to use prescribed exercise and/or physiotherapy to target the muscles and joint to prepare for an accelerated recovery. Furthermore, we would encourage you to have all other aspects of your health optimized (for example hypertension, diabetes, body weight, skin conditions, among others). There are numerous studies that demonstrate that the best recovery, and fewest complications, arise in patients that are fully “optimized” prior to their surgery. In certain situations, we may recommend additional consultation with other specialists to ensure you are in the best possible condition for surgery. You are the most important stakeholder in your health and mobility, we encourage you to actively pursue and participate in prehab interventions regardless of where you live in BC.
Most patients after routine hip and knee replacement return home either the same day or next day so it is important your home be set up for your recovery in advance. Some important considerations may be:
  • Moving items that could make you trip or fall
  • Ensure easy bathroom access
  • Ensure stairs have railings
  • Arrange for family or friends to help in the early days after surgery
  • Prepare meals in advance or pre-arrange delivery service
The OASIS website provides an excellent resource for the pre- and post-operative considerations, equipment, and classes. Please visit their website for access to this information.

You will need some or all of the following equipment for your hospital stay as well as at home. These items should be arranged pre-operatively to ensure that you are ready.

  • Walker (two-wheeled)
  • Crutches
  • Long handled shoehorn
  • Long-handled Reacher
  • Sock aid
  • Raised (4inch) toilet Seat Cover
  • Tub transfer bench or shower chair
  • Non-slip bathmat
  • Ice machine (cryotherapy)

A full list can be found here.

You can purchase or rent the equipment from medical supply stores in the lower mainland. If financial resources are limited, you can borrow equipment from the Red Cross for a temporary period of 3 months.

The Red Cross website is located here.

Some medical supply companies in the lower mainland can be found here.

You may wish to purchase an ice machine, or cryocuff. For more information, please refer here.

In partnership with Vancouver Coastal Health, we are currently developing an advanced practice physiotherapy resource for our patients. More information to come.

Poorly controlled diabetes can cause a delay in wound healing which increases the risk for infection of newly replaced joints. Infection of joints can be a catastrophic complication leading to poor outcomes and as such, your surgeon may delay surgery if your diabetes is poorly controlled. A marker of diabetic control is called the Hemoglobin A1C (HBGA1C) should be 7 or less to have an elective joint replacement.