ARTHROPLASTY NURSE SPECIALIST
ARTHROPLASTY NURSE SPECIALIST
Your Arthroplasty Nurse Specialist coordinates your knee replacement journey and will be one of your main points of contact in the hospital if you need to talk to a member of the team.
Preparing for your hospital stay.
Preparing for your hospital stay will ensure you are ready to start your rehabilitation as quickly as possible and gain the most benefit from your new knee replacement.
01 Length of Stay
The duration that patients spend in hospital varies depending on a lot of factors such as medical conditions, family support and pre surgery fitness. The average length of stay is 1-4 days.
02 Get dressed
We advise patients to get dressed in normal clothes the day following surgery in either a tracksuit or loose fitting clothes.
One week of bed rest results in 10% muscle loss. Loss of strength could make the difference between dependence and independence. It also results in a higher risk of infection, loss of mobility and fitness. It is of key importance to begin rehabilitation as soon as possible.
03 What to bring
Having comfortable footwear such as runners is essential and we do not recommend slippers.
It is very important that you bring your medications in to hospital with you.
You are also advised to bring your glasses, contact lenses, hearing aids and walking aids with you.
What To Pack Checklist
An example of a patient's hospital stay
Day Before surgery
1. Shower or bath with antiseptic soap,
do not shave the area.
2. Pack your hospital bag making sure to pack your medication
3. Adhere to fasting guidlines that have been given to you, the majority of patients fast from midnight the night before surgery, ie nothing to eat or drink.
4. Ensure you have checked your house for trip and falls hazards by following the NOCA checklist below. Ask your carer to do this for you if you are unable.
5. Have a plan for your recovery, who can do your shopping, prepare meals, do the housework etc. You will require some help folloing surgery.
Day of Surgery
1. Shower or bath with antiseptic soap.
2. Most patients arrive at hospital on the morning of surgery fasting.
3. Once on the ward you will meet the ward nurse, the admitting doctor and surgeon and the anesthesist.
4. Multiple checks will happen, this is our normal protocol.
5. You may have some blood tests and other tests done prior to surgery
6. You will be brought to theatre and have your surgery, following surgery you will go to recovery to be monitored and brought back to the orthopaedic ward.
7. You will be given something to eat and drink after a couple of hours.
8. You will pass urine, sometimes using a camode or bedpan. Ocassionally patients have difficulty doing this and require a temporary urinary cathether for 24 hours.
9. It is very important to do deep breathing exercises and foot and ankle movements straight away.
Day 1 Following Surgery
1. The nusing team will check your vital signs regularly and give you your medications including pain relief
2. The orthopaedic doctors normally do a ward round in the morning to check on how you are doing
3. Following breakfast you should get dressed in your normal clothes and be ready for your rehabilitation sessions to start.
4. You will meet your physiotherapist who will get you out of bed and walking with the help of a walking aid.
5. You will be shown some exercises to complete.
Day 2 Following Surgery
1. Similar to day 1 where you will be checked on regularly by nursing and medical staff.
2. Following breakfast you will be encouraged to get dressed in your normal clothes ad start your exercises that you have been shown the previous day.
3. The physiotherapist will continue with your rehabilitation programme.
4. You may attempt the stairs if sufficient progress has been made.
Day of Discharge
1. Following nursing and medical checks you should get dressed in your normal clothes and start your exercises.
2. The rehabilitation team will see you again prior to discharge. You have to meet agreed goals to be deemed eligible for discharge such as independant at walking, toileting and dressing.
3. You should organise to have your carer collect you from hospital at the time advised that morning.
4. On discharge you will recieve a prescription for pain medication and a letter for your GP.
Day 1 At Home
1. Although you will be tired we encourage you to get up and get dressed at home to prepare yourself for your rehabilitation programme.
2. It is very important to take regular short walks to help with your rehabilitation and to prevent clots forming.
3. Keep pain well controlled by taking the pain medication that you have been prescribed and using ice packs.
4. It is very important to make sure that your diet is providing enough key nutrients to enable healing such a protein, carbohydrates, vitamins and minerals.
Your follow up
Every Orthopaedic Unit has their own protocol and you will be given specific instructions on what you need to do priorto discharge.
Most surgeons would prefer to know if there are any concerns with your knee following surgery. This can be achieved by calling the secretary or the joint replacement nurse
2 Weeks
Most patients will have a wound review prior to or at two weeks. This is to review the wound, remove staples or sutures if present and ensure the wound is healing well.
This is either carried out by your GP, public health nurse or your orthopaedic team
6 Months
This appointment is normally carried out by your joint replacement nurse specialist. She/He will ask you questions about your new joint and compare the answers to before you had the surgery.
6 Weeks
Most patients have a review at 6 weeks. an X ray may be preformed. Your gait (walikng) will be assessed and your rehabilitation progress checked. You may be advised to stop using crutches at this stage and allowed to return to driving if sufficient progress has been made.
2 & 5 Years
The joint replacement nurse specialist will carry out follow up checks at 2 years and at 5 years and every 5 years after that to ensure that you have no difficulties with your new knee.
Intimacy and Sex
Intimacy and sex can be enjoyed following a Total Knee Replacement with a few guidlines to keep you safe. Most patients can resume sexual relationships at 6 weeks following surgery.
Resuming Sexual Intercourse Following Total Knee Replacement
This booklet provides some guidance and suggests some safe positions for you to try. These positions are intended for use for weeks 6-12. Most people will be able to resume normal positions from 12 weeks.
If you have any questions or concerns ask any of your orthopaedic team who can advise you.
Make your sexual relations with your partner positive. Keep a sense of humour. Learn to laugh if something isn’t quite like it used to be. If one position doesn’t work, try another. Healing takes time. What doesn’t work today may work tomorrow.
The most important message is that you can still enjoy sex after joint replacement. However, you will have to make some short term changes in your sex life to protect your new joint as it heals.
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