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You should not eat anything after midnight before your surgery. We encourage clear liquid (water, Powerade, Gatorade) up to 2 hours before your surgery. You should NOT have toast, cookie, cracker, or anything solid or chew gum or tobacco at least 8 hours before surgery.
The anesthesia/pre-op nurse will let you know which medicines to take the day of your surgery.
Stop all over the counter supplements 7 days before surgery. NSAIDs (aspirin, Advil, Motrin, ibuprofen, Aleve, naproxen etc.) should be stopped 7 days before surgery. It is important that you give me a detailed list of your medicines (prescription and over the counter) well in advance so that we can go over them and determine which ones need to be stopped.
You should plan on arriving at least 2 hours prior to your surgery start time so you can be appropriately prepared for surgery.
About 90% of my patients who have knee or hip replacement surgery go home within 24 hours of surgery. I am a firm believer that hospitals are for sick people. So if you are not sick, then you should go home and recover.
No. Blood transfusion after hip or knee replacement is very rare. You will be given medications after surgery which will minimize the amount of blood loss that occurs.
I STRONGLY believe that the BEST RECOVERY occurs in the comfort of your own home and by utilizing the SwiftPath Method we have discussed. In order to qualify to go home same day of surgery you should have someone at home with you, your pain should be controlled, you should be able to use the restroom, you should demonstrate ability to walk with a walker, you should not be nauseated or throwing up.
Although not required, it is very helpful to have someone available consistently to help for the first week after surgery. As you recover, you will notice that your mobility is increasing, and you are able to do tasks much easier.
NO. I typically DO NOT arrange home therapist or nurse unless there are special circumstances. There is an exercise/physical therapy regimen listed in your SwiftPath book that you should follow. These are also available on my website with detailed videos. My job as your surgeon is to not only do your surgery, but also guide you through your recovery.
I typically let you decide when you can drive. I do have 3 requirements: you should not be taking any narcotics before you drive, you should be able to get in and out of your vehicle safely, you should go in an empty parking lot before you drive and make sure you are able to brake firmly in case of an emergency. For right sided surgery this occurs between 3-6 weeks after surgery and sometimes even sooner.
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As discussed during our office visit, a knee replacement is removing the arthritic components of a knee and replacing them with an artificial knee. This does not mean that your entire knee joint is removed, but rather a cover is put on the end of the thigh (femur) bone and on top of the shin (tibia) bone. It is designed to function much like your normal knee joint.
The metal component of the knee replacement is a combination of cobalt-chromium-molybdenum, also known an alloy as well as titanium. There is also a high-grade plastic or a polyethylene component of the knee replacement.
Minimally invasive knee replacement is a method specific to SwiftPath that minimizes the damage to your muscles and ligaments. This has clinically been proven to reduce your pain, length of stay in hospital, need for narcotic medications, and allows earlier recovery.
Computer navigated and robotic knee replacement refers to advanced computer technology that is used to do knee replacement more accurately. This requires experience and specialized training. I am fortunate to have had that specialized training in knee replacement.
You should let me know that you are allergic to metal. The most common metal people are allergic to is Nickel. If that is the case, I use special implants that do not have any nickel in them.
A knee replacement typically takes about 75-90 minutes. This can vary depending on the how bad your knee is and also on your size. This is the time from when I make the incision to when the dressing is put on. It does not include the time for going to sleep, waking up and the setting up of surgery. With all that included, total operative room time can be anywhere between 2.5-3 hours.
The amount of pain is variable and depends on each person’s pain tolerance. Expect to have the worst pain during the first 3-5 days following surgery. It can be managed by following the SwiftPath protocols that we have discussed and that are listed in the book.
There are very detailed exercises and a regimen that is listed in the book. Your progress will be monitored by me closely during the weeks following surgery. If I feel you are not progressing as expected, then I will arrange for you to go see a physical therapist.
As a general rule of thumb, I give everyone 3 months off work whether you are a construction worker or have a desk job. Most people are ready to return to work at about 6 weeks after knee replacement surgery. In some instances, more time is required if the job is very labor intensive or requires you to be on your feet all day.
I encourage all my patients to exercise regularly and recommend that you do low impact exercises which build strength and stamina such as stationary bike, elliptical, brisk walking, swimming. You should not do high impact exercises such as crossfit, jumping exercises or long-distance running. Think of it as a car. If you buy a brand-new car and drive it through potholes all day, it will break down sooner.
Yes. Most people don’t like to kneel on their knee because they say it feels “strange” or “funny”. You will not damage it by kneeling.
Yes. In some people scar tissue in the knee can be thick and make the knee look larger compared to the other side. It should not interfere with the function of the knee.
Yes. Most people will have some numbness along the outside part of the knee after surgery. That is because very small nerves that are not visible are cut when I make skin incision.
Knee replacements are designed to last for 20-25 years if you take care of it and yourself. That means you should do low impact exercise regularly, so you keep a healthy weight.
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Hip replacement surgery is where the top of the thigh bone is replaced with an artificial ball and the cup in the pelvis is replaced with a metal cup.
It typically takes about 90 minutes to replace your hip. This is the time from when your surgery starts, and the dressing is put on. This does not include the time it takes for you to get prepped for surgery and wake up from surgery. That can add an additional hour to your time.
I do hip replacement with you lying flat on your back and the incision is on the front of your hip also known as ANTERIOR APPROACH. No muscle is cut or split. This decreases inflammation and pain postoperatively.
I do hip replacement surgery from the front to avoid any restrictions. It is very rare that I restrict certain movement. I do ask that you avoid any extremes of range of motion such as when doing yoga.
You should anticipate using a walker for 1-2 weeks after surgery followed by a cane for another 2 weeks. Most people get rid of a cane around the house but continue to take it with them when they leave their home for up to 6 weeks after surgery. Return to normal activity occurs at 4-6 weeks after surgery but can vary depending on your age and prior activity level. Your muscles continue to get stronger and full recovery (strength and stamina) can take up to full year. Keep in mind, this does not mean you are bed ridden for a whole year. I expect you to exercise very soon after your hip replacement surgery to continue building your strength and stamina.
Please perform the exercises after surgery and your need for physical therapy will be determined on a case by case basis at your post op visits.
Hip replacement is designed to last 20-25 years as long as you take care of it and yourself. This means low impact exercises and maintaining a healthy weight
Perfect execution of joint replacement surgery requires patient engagement throughout the entire process. In the SwiftPath program, you and your caregiver will be given the tools to help make the best decisions for your care, decrease surgical pain and the need for narcotics, reduce complications, and help to guarantee the outcome of your surgery.