Developed by physicians and other healthcare professionals, the Total Joint Program at EJGH is an important aid to recovery after hip or knee replacement surgery. This service is provided at no extra charge to the patient.

The Total Joint Program consists of preoperative education, an individual inpatient guide to recovery, assistance in discharge planning, and monitoring of recovery and progress at home.

Preoperative Class
This class, led by a nurse and physical or occupational therapist, prepares patients for surgery by describing what they can expect during surgery and throughout their hospital stay. Components of physical and occupational therapy are discussed along with options following discharge. Family members or friends who will care for patients after discharge are welcome to attend the class.

The Surgery Experience
The following are examples of what a patient might experience before, during and after hip or knee replacement surgery.

Preadmission Visit
During the preadmission visit, a clinical representative draws blood, takes a urine sample, takes a chest x-ray and performs an EKG. The patient then meets with the anesthesiologist and signs any necessary consent forms. At the end of the visit a nurse reviews instructions and tells the patient where and when to report on the morning of surgery.

Day of Surgery
In the recovery room, nurses monitor vital signs and determine the need for pain medication. Monitoring continues when the patient returns to his or her room. The patient may have an intravenous (IV) tube in one arm, as well as a catheter inserted for urination.

The patient must rest in bed for several hours and will be given something to eat and drink when he or she feels ready. The patient also begins simple breathing and ankle exercises.

Post Surgery: Day One
The patient begins physical and occupational therapy. The IV is discontinued and the patient begins to take care of his or her own physical needs. Breathing and ankle exercises are continued.

Post Surgery: Day Two
The patient begins practicing self-care skills, including dressing and moving to a toilet or bathtub. The urinary catheter is removed. Breathing and ankle exercises are continued.

Post Surgery: Day Three
The patient walks 78 to 80 feet with a walker and continues practicing self-care skills. Plans for the patient's discharge begin and the need for further care in a rehabilitation unit or skilled nursing facility is assessed.

Post Surgery: Day Four
The patient practices climbing stairs. Plans for home care are discussed if the patient is returning home. If further rehabilitation is necessary, the patient is transferred to a rehabilitation unit or skilled nursing facility.

Home/Recovery
The patient may continue rehabilitation with a home health physical and/or occupational therapist. Therapy may also continue at an outpatient facility. Within three to five days after discharge, a nurse from the EJGH Call Center telephones the patient to check on progress, ensure the patient has the correct medications, and answer any questions the patient may have.

A nursing representative will call the patient at six and twelve months to help assess the patient's quality of life after surgery.