Preparing patients for hip and knee replacement surgery

By Caitlin Moorcroft, Markham Stouffville Hospital communications and public affairs coordinator

Helping patients prepare for their orthopaedic surgical journey can be a stressful experience. Patients are often scared and anxious, making it difficult for them to understand instructions from hospital staff on how to prepare for hip and knee replacement surgery to make sure they have support at home.

Markham Stouffville Hospital (MSH) is helping support patients pre-surgery, post-surgery and during recovery with the help of the orthopaedic patient navigator.

“My job is to give our patients the best experience, support them and give them a constant point of contact throughout their orthopaedic surgical journey ensuring a seamless transition from hospital to home,” says Maria Caruso, MSH’s orthopaedic patient navigator.   ”Your care doesn’t end when you are discharged from the hospital.  We will continue to work with our community partners to ensure your successful recovery and help you maximize your health.”

Patients are first seen by an advanced practice practitioner in our Orthopaedic and Joint Assessment Centre and within two weeks of receiving their referral and then expedited access to an orthopaedic surgeon.  From there they meet with the orthopaedic patient navigator approximately month before their hip or knee replacement surgery in the total joint pre-operative education class and supports them up to 90 days after their surgery.  She is there to guide patients and make the process as seamless as possible.

“I’m available either by phone or email Monday to Friday to help answer questions. I also make sure our patients are prepared to go home after surgery. It‘s helpful for patients if they have someone who can offer some assistance for a few weeks after surgery with various tasks for example driving and if they don’t, I provide them with community resources in the area that can assist them,” says Caruso.

In MSH’s total joint pre-operative education class, patients meet members of the surgical team including a surgical nurse practitioner, a pharmacist, an occupational therapist, a physiotherapist, pain specialist, registered nurses, and the orthopaedic patient navigator. The class covers a variety of topics including questions around medications, what exercises to do before surgery, what equipment may be required, how to set up your home for after surgery, and the surgical journey.

Following are some of the most common questions Caruso hears and her answers.

When do I start going for therapy and how often?

While in the hospital, patients begin therapy immediately after surgery. Our physiotherapists and occupational therapists visit patients in the hospital to start their therapy. Patients are given exercises before surgery and after surgery to help them recover. The more frequently patients do these exercises, the faster they will recover.  They will also receive a referral to go to an outpatient physiotherapy clinic one to two weeks after surgery (depending if it was a hip or knee replacement) and will have therapy one to two times a week. Patients are encouraged to maintain normal movement like walking upstairs or getting in and out of a car as moving their body will also help them recover.

When do I get my staples out?

Patients will typically need their staples removed 12 to 14 days after surgery. To have the staples removed; patients are advised to make an appointment with their family doctor.  If their family doctor is unavailable, patients can visit a walk-in clinic, or if they prefer they can ask for an appointment at MSH’s surgical wellness clinic. The MSH surgical wellness clinic is staffed with a nurse practitioner and is there to support patients after discharge from the hospital.

When can I drive again?

At your follow-up appointment a few weeks after surgery the surgeon will assess you and advise when you can begin driving.

“The entire surgical team at MSH works together to make sure our patients are as prepared as possible for their surgery and well on their way to a successful recovery.  Our goal is to provide our patients with seamless transitions throughout their surgical journey,” says Caruso.

MSH is hosting a joint health education night to help our community learn more about joint health, surgical options, exercise and pain management on Oct. 10. Visit for more information about the event and to register.

Photo: Maria Caruso, Markham Stouffville Hospital orthopaedic patient navigator.

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