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Thank you for choosing Cleveland Clinic for your total joint replacement surgery. Your hip or knee replacement surgery will be performed by one of the most experienced orthopaedic surgical teams in the United States.
Each year, our surgeons perform thousands of joint replacements. Our surgeons have also developed many of the new techniques and technologies that are now used worldwide for a range of orthopaedic problems.
This guide is designed to give you the important information you need to achieve the best outcome from your joint replacement surgery. This guide is your workbook. It discusses:
• How to prepare for your upcoming surgery
• What to expect before, during, and after surgery and during your hospital stay
• What to expect and what to do to continue your successful recovery at home
The Complete Care Program
Cleveland Clinic offers a unique approach – our Complete Care Program -- to prepare and care for patients who are undergoing total joint replacement surgery. The Complete Care Program is a team approach. It includes your surgeon and healthcare team, a Specialty Care Coordinator, and you. Most patients who have undergone joint replacement surgery at the Cleveland Clinic have been managed through our Complete Care Program. Patients who become active partners in their own care achieve better outcomes. By participating in the Complete Care Program, patients experience:
• Shorter hospital stays
• Lower infection rates
• Shorter recovery with early return to activity
How Does The Complete Care Program Work? Your surgeon and healthcare team evaluate and address your individual needs and develop a customized care plan. A Specialty Care Coordinator will work with you to help you prepare for surgery, ensure your plan of care is completed and, if necessary, assist with your discharge and follow-up care. This caregiver will be a key contact for you and your family before, during, and after your surgery and hospital stay. Before your surgery, your Specialty Care Coordinator will contact you.
Overview of Total Knee Replacement
The knee joint is the largest joint in the body. It is the “hinge” joint of the leg. It’s the joint that allows the leg to bend and straighten. The knee joint is located at the meeting point of the thigh bone (femur) and the shin bone (tibia). The knee cap (patella) covers the area where the two bones meet. During total knee replacement surgery, the damaged part of your knee is removed and replaced with an implant. Implants are made of various materials: stainless steel, titanium, chrome, cobalt, or polyethylene. Bone cement may also be used in the repair. The choice of implants varies from person to person. Factors considered are your age, activity level, body type, and the amount and strength of your bone and bone tissue. Your surgeon will choose the implant that is best suited for your needs and lifestyle. During total knee replacement surgery, a relatively thin amount of bone is removed from the end of the thigh bone, the top of the leg bone, and the underside of the kneecap. This creates bone surfaces that allow the implant to have a good fit. Most of the major ligaments and tendons of the knee are left in place so that the knee can bend and straighten, yet remains steady in position from side-to-side and front-to-back.
Overview of Total Hip Replacement
The hip joint helps us keep our balance and supports our weight in all of its movements. The upper end of the leg bone (femur) has a rounded head (femoral head) that fits into a socket (acetabulum) in the pelvis to form the hip joint. During total hip replacement surgery, the damaged part of the hip is removed and replaced with implants, called components. Your surgeon selects the components that are best for you based on your age, activity level, and body type.
Total Hip Replacement Components Location of Components in the Hip
Preparing for Surgery
Exercise
Exercising, up to the day before your surgery, helps improve your strength, range of motion and endurance. This helps lead to a successful outcome and recovery. Talk with your surgeon about a referral to physical therapy if you would like help developing an exercise program. In addition, see the exercises at the end of this guide.
Why is exercise so important for your recovery?
• Strengthening exercises for the hip or knee joint improves recovery.
• Upper body conditioning exercises help reduce muscle soreness and fatigue caused by the use of a walker crutches, a cane, or other aids.
• A walking or water exercise program increases endurance, flexibility, and overall strength
Circulation Exercises
Although swelling is a normal response after surgery, circulation exercises help control swelling and prevent more serious complications, such as blood clots. Review and learn the circulation exercises (see Physical Therapy section) before surgery to make them easier to perform after your surgery.
Diet and Nutrition
Healthy eating and proper nutrition before your surgery aids the healing process.
• Drink plenty of fluids and stay hydrated.
• Eat more fiber to help avoid constipation (often caused by pain medications). Foods that contain fiber include corn, peas, beans, avocados, whole wheat pasta and breads, broccoli, almonds.
• Eat foods rich in iron, such as lean red meat, dark green leafy vegetables, raisins, and prunes.
• Eat foods high in Vitamin C to help your body absorb iron. Foods that are high in vitamin C include oranges, cantaloupe, and tomatoes.
• Make sure you are getting enough calcium, which is needed to keep your bones strong. Foods that are high in calcium include milk, cheese, yogurt, dark leafy greens, and fortified cereal.
Eat light meals, especially the day before surgery. The combined effects of anesthesia and your medication may slow down your bowel function. This can cause constipation after surgery.
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