Joint SurgeryGetting to the Hospital
Be sure to allow enough time for the drive to the hospital, but also enough time to park your car and find the surgery registration area. Many hospitals set aside certain parking areas for surgery patients.
Registration
If you pre-registered for surgery, your time at the registration desk will be relatively brief. You'll need to present medical insurance and prescription cards, and you'll answer a few administrative questions. When you finish at the registration desk, give your caregiver your medical identification cards and any other paperwork you brought along. This would be a good time, too, for you to give your caregiver any other personal affects - a watch, wedding rings, earrings, wallet - that you have with you. Most likely, you'll be directed to wait in a lounge area until someone on the hospital surgery team takes you to the surgical pre-op area, or you may be sent directly to surgical pre-op.
Pre-Op
In surgery pre-op you will be asked to remove some or all of your clothing and put on a hospital gown. Your caregiver may or may not be allowed to stay with you during this time, depending on your preference and the hospital's policy on visitors in this area. After you have changed into a gown, the surgical care team will begin:
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Surgical nurses. The surgical nurses assigned to you will introduce themselves and ask you questions - what medications you've taken, what food you've eaten, which joint is being replaced, and many others. They'll check your blood pressure, pulse and respiratory rates, and your temperature. If you have not yet signed surgery consent forms, one of the surgery nurses will likely bring the forms in for you to sign. You will be asked to point to the joint being replaced and your surgical nurse will write on that joint with a marker. The nurses will also verify that your caregiver is the person to contact after surgery with information about you, and that he or she will be waiting in the hospital while you are in surgery.
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The anesthesiologist. The anesthesiologist will discuss the anesthesia he or she will be using and explain how the drug works. The anesthesiologist will also ask about what foods have been eaten and what medications have been taken, as both can significantly impact the safety and effectiveness of anesthesia. Also, if you or anyone in your family has had a reaction to anesthesia, be sure to tell the doctor. The anesthesiologist will also discuss what you can expect upon waking up in the recovery room after surgery. Discuss what pain medication will be administered and when and how it will be administered with the anesthesiologist and with your surgeon.
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The surgeon. Your orthopaedic surgeon will come into surgical pre-op to once again discuss the procedure and answer any last-minute questions you may have.
During this time you may be given a sedative, and an intravenous line (I.V.) will be inserted. If you are wearing nail polish and/or artificial nails the polish will be removed by the nursing staff and a pulse oximeter, which is used to measure blood oxygenation during surgery, will be attached to one finger (some anesthesiologists require all artificial nails and nail polish be removed). You'll be given a loose-fitting hospital cap and asked to cover your hair, and if you are wearing contacts you'll be asked to remove them. The surgical site may or may not be shaved at this time.
When the surgery team is ready to begin, you'll either say your good-byes in surgical pre-op or your caregiver may be allowed to walk as far as the surgery corridor with the nurses or surgical assistants who roll your hospital bed into the operating room. Your caregiver will be directed to a surgical waiting area.
You may be taken directly to the operating room or you may be rolled into a holding area until your operating room is open. Occasionally, an emergency need for an operating room may cause your surgery to be delayed. Typically, a good estimate for the amount of time needed from check-in to surgery is two hours.
The Operating Room
In the operating room you will be transferred from your pre-op hospital bed to an operating room table. The room is equipped with special overhead surgical lights and anesthetic equipment. The temperature in the operating room is cooler than the rest of the hospital, and when all you're wearing is a thin hospital gown, the coolness can make you quiver. If you have to wait for more than a few minutes for the anesthesiologist to begin, may be offered a warm blanket.
You may or may not be awake for some of the surgical preparations that go on in the operating room: Trays of instruments are moved around the room; all of the members of the surgery team come into the room. An antiseptic solution is applied to the skin around your joint, and a sterile drape is placed around the site. Whether you notice these activities or not will depend upon when your anesthesiologist starts your anesthesia.
The actual joint replacement surgical procedure may take two to four hours. Following the procedure, you'll be moved to a recovery area where you will be monitored by the surgical nurses until you are moved to your room.
