General Information

INFORMATION CONCERNING PRE-OPERATIVE HISTORY AND PHYSICAL APPOINTMENT WITH THE PHYSICIAN ASSISTANT

Below are answers to many questions that are commonly asked. There will always be questions that are not covered in this section. Your questions are always welcomed and you are to feel free to ask at any time. You will always have a contact person at Raleigh Orthopaedic Clinic.

A foley catheter is placed into your bladder prior to surgery once anesthesia has been administered. The foley catheter remains for 24 hours.

Total Knee Replacement surgery patients generally have a wrap groin to toes and immobilizer on their operative leg. It is used for compression and stabilization. Physical Therapy will determine when the immobilizer is discontinued. It is not uncommon to feel as though the leg is “heavy” and difficult to move initially.

All incisions are closed with staples. A dressing called “Aquacel” may be used. You may shower (NO TUB BATHS) with the Aquacel on and when after it is off. You will be instructed as to when to remove the dressing

Unless contraindicated, all Total Joint Replacements patients are up and out of bed with the assistance of Physical Therapy the same day of surgery. Physical Therapy will help patients stand, take some steps, possibly sit in a chair, and begin early mobilization. The majority of the time you will weight bear as tolerated, unless Dr. Vaughn has indicated otherwise. The patient will be advised post-operatively should the weight-bearing status be anything other than weight-bearing as tolerated.

Average hospitalization time is two to three days. During this time Case Managers work with you to assist you with your post-operative plans, including physical therapy with any adaptive equipment or other services that are necessary. Because most patients are put on an anti-coagulant (blood thinner) after surgery to cut down on the risk of a blood clot, labs must be obtained on a weekly basis. When you are discharged home, your case manager will make the necessary arrangements. There are exceptions and inpatient rehab may be arranged. Your insurance company makes the final determination.

On the day of discharge from the hospital you must check out by 12 Noon.

Discharge to home from the hospital is the preferred choice. There will always be exceptions to this based on individual cases. There are no studies to show that patients discharged to rehab do any better than those discharged to home. If you are discharged to a rehab facility you will stay a minimum of FIVE (5) nights. NO exceptions.

At the time of discharge from the hospital (if you are going home) all prescriptions for pain medication and any other prescriptions will be given to you. The nursing staff from the Orthopaedic floor will review your Do’s and Don’ts for home. Home health physical therapy and all medical equipment will be arranged prior to discharge. If you are going to inpatient rehabilitation, all appropriate paperwork will be completed and transportation will have been discussed with you and arranged prior to your discharge time. If you are going home from the hospital your follow-up appointment in the office is usually 10-14 days following surgery. If you are going to inpatient rehabilitation, you will remain a minimum of FIVE (5) nights. You must return to Raleigh Orthopaedic Clinic to have your staples out, whether you are at home or in rehab. This is not negotiable.

Your first visit in the office after surgery of wound check and staple removal is scheduled with a Physician Assistant or Nurse Practitioner, unless otherwise indicated prior to your discharge. Your wound will be evaluated, staples will be removed, questions will be answered, prescriptions will be provided for pain medication, if necessary, and orders will be given for Physical Therapy whether it is to continue home health physical therapy or to begin outpatient physical therapy. A follow-up visit will be made for x-rays and evaluation with Dr. Vaughn four to six weeks from the initial follow-up appointment.

All total joint replacement patients are followed on a routine basis. The general schedule is, unless otherwise indicated, 10-14 days for the first post-operative visit, 6-8 weeks from surgery for initial x-rays and then as indicated by Dr Vaughn. Should you need visits in the interim, you will be accommodated.

At the time of your pre-operative history and physical appointment, you must come with all written information from your medical doctor’s office, a current list of medications, and a list of any questions that you may have. You may be required to have further tests or evaluations after that visit.

When you have made the decision to undergo Total Joint Replacement surgery, you will be provided with the necessary information for review before your Pre-operative History and Physical appointment. Dr. Vaughn has requested that you obtain medical evaluation(s) prior to your elective surgery. You will be provided with forms for your doctor(s). It is YOUR responsibility to get these forms to your doctor(s). Getting the medical evaluation(s) IS NOT AN OPTION. Our office MUST receive the completed forms from your doctor(s) BEFORE your pre-operative appointment with Liz, or your surgery WILL BE RESCHEDULED. All pre-operative medical information is crucial to your pre-operative and post-operative care. Please contact the office should you have any questions regarding this. Many of the primary care physicians are very familiar with Dr. Vaughn and the pre-operative routine and are quite good about getting medical information to our office prior to your Pre-operative History and Physical appointment.

On the day of your surgery you must be “On Time”. Brenda, the surgery scheduler, will give your the necessary arrival time. Please follow her directions.

The hospital is a “smoke free” campus. Patients are not allowed to smoke or use any type of tobacco products while they are in the hospital. They are not allowed to leave the floor to smoke outside. There are no exceptions to this rule.