From the moment you arrive at HSS to the first hours after your procedure.
Arrive at the time given to you in the pre-operative phone call, typically two hours before your scheduled procedure. You and your support person will check in at Patient Access Services in the first-floor lobby and then be directed to the pre-surgery care area.
Do not eat or drink after the time specified in your instructions. This includes water, gum, and mints. Take only the medications your team specifically approved, with a small sip of water.
In the pre-operative area, a nurse will review your medical history, start an IV, and confirm your allergies. Your support person can stay with you during this time.
Most hip and knee replacements at HSS are performed under regional anesthesia, a spinal or epidural block that numbs you from the waist down so there is no pain during surgery. You are also given sedation so that you are relaxed and sleepy throughout. General anesthesia is an option when regional is not appropriate, and the anesthesiologist will discuss the best choice for you.
HSS uses a multimodal pain-control approach: nerve blocks around the joint, anti-inflammatory medication, non-narcotic pain medicines, and narcotic medication only as needed. The goal is excellent pain control with as little opioid medication as possible.
The surgery itself typically takes 1 to 2 hours. The operating team positions and drapes the leg, makes the incision, prepares the bone, and places the implant. When robotic or computer-assisted technology is used, the plan is built from pre-operative imaging and the system guides the bone preparation with sub-millimeter precision. Ligaments and soft tissues are balanced, and the incision is closed in layers.
Your support person waits in the surgical family waiting area. Dr. Debbi will speak with them directly once the surgery is complete.
After surgery you will be taken to the Post-Anesthesia Care Unit for about 1 to 1½ hours of monitoring while the anesthesia wears off. The nursing staff will check vital signs, manage any nausea, and start pain medication as needed.
Once you are stable, you will be moved to your hospital room. Rehabilitation begins almost immediately, often the same day of surgery.
Many patients are discharged the same day or stay one night, depending on overall health, how well pain is controlled, and how comfortable you are moving. Before discharge, a physical therapist will have you practice getting in and out of bed, walking with a walker or cane, and going up and down stairs if needed.
A case manager will help coordinate your transition home, whether that includes a home health agency, outpatient physical therapy, or a short rehab stay.
