Hospital Stay

Day of Surgery

Hospital admission usually occurs on the day of your surgery. You will be asked to arrive at the hospital one and a half hours before surgery. After checking in at the Surgical Center Registration, you will be taken to the pre-operative holding area. Your belongings will be stored and delivered to your room later in the day.

A nurse in the pre-operative area will coordinate your preparation for surgery, which includes:

• Meeting your perioperative team who will assist your surgeon. Your team includes nurses, an anesthesiologist and/or nurse anesthetist and the resident.
• Checking your vital signs (temperature, blood pressure, pulse and respirations).
• Placing an intravenous (IV) tube in your arm so that you can receive fluids, medications and blood transfusion if necessary.

Your family is welcome to stay with you until it is time to go to the Operating Room (OR). When you are taken to the OR, your family will be directed to the family waiting area where they can wait during your surgery.

Surgery

In the OR, the surgical team will work to ensure your procedure goes smoothly. They will be continuously watching your heart rate, blood pressure and breathing. A catheter (small tube) may be placed in your bladder to keep track of fluids during surgery. Your surgeon will speak with your family when surgery is completed. 

Details of the Surgical Procedure

After Surgery - Post Anesthesia Care Unit

After surgery, you will wake up in your bed in the recovery room known as the Post Anesthesia Care Unit (PACU). You may not remember much of this part of your stay. Here are some of the routine activities that will be happening as you wake up from your surgery.

• Your vital signs will be taken frequently.
• You will have oxygen and cardiac monitoring while you wake up from the anesthesia.
• You will be wearing compression boots to promote circulation. Compression boots are wraps that are placed on your legs. The wraps are attached to a machine that automatically inflates and deflates.
• You may have a small drain from your incision that drains extra fluid from under the skin.
• You may have a catheter (tube) from your bladder.
• The nurse will check on IV fluids and antibiotics you receive.
• You will have an ice wrap around your knee to control swelling and discomfort. When you are awake, comfortable and your vital signs are stable you will be moved to your Hospital room.

Pain Management

We are aware that you will have pain after surgery. You may wake up in PACU with pain. Your pain management will begin there. Your comfort is important to us. Do not wait for someone to offer medicine. Let your nurse and doctor know right away if you feel pain. Your nurse will check to make sure you are as comfortable as possible. The staff will ask you how strong the pain is.

We will use a scale from 1 to 10.

Be sure to tell your nurse if your pain becomes worse. We want you to be as comfortable as possible while you heal. Although feeling pain is a natural occurrence after surgery there are many pain control methods available:

• Oral narcotic medications are often given with non-narcotic medicines such as Tylenol and celebrex to provide pain relief. These may even begin before surgery.
• Patient controlled analgesia (PCA). A pump releases pain medicine in small doses through your IV. Your physician will order the amount and type of medication for you.
  • If your pain is being controlled by the PCA pump, you can give yourself a dose of pain medication by pushing the button that controls the pump. In all cases, the pump is set with individual limits ordered by your physician.
  • Pain medication, both narcotic and non-narcotic, can also be taken by mouth. Keep in mind that it is important to take pain medicine when you are having pain. This will help you get up and move around in a shorter amount of time.
• Epidural catheter. Continuous pain medication that is given through a small tube or catheter into your back.
• Infusion of medication into your joint space via a small catheter.
• Cold therapy to assist with pain relief.

Additional Info During Your Stay

Care of your incision. Your incision will be covered with a bandage (dressing) for the first few days after surgery. If you have a wound drain, your surgeon will remove the drain on the day after surgery.

Diet. Your diet will go from liquids to solids as your stomach settles down in the days after surgery. Meal service is provided three times daily. You will be given menus to choose foods that you like. A dietary worker or patient care assistant can help you complete the menus. Snacks and beverages are almost always available at the Nursing Station.

Discharge planning. Early in your stay, your health care team will work with you and your family to plan for your needs after leaving the Hospital. 

Foley catheter. Your nurse will check the drainage from the catheter (tube) from your bladder.

Ice. You may receive ice to apply to your knee to decrease pain and swelling.

Incentive Spirometer (IS). You will be asked to cough and breathe deeply every hour while you are awake, and use an incentive spirometer (clear plastic tube to assist with deep breathing).

IV (Intravenous catheter). Your nurse will also check on IV fluids and antibiotics you receive.

Medications. Your physician will order your medications. If you have any questions about your medicines, please be sure to ask your nurse. You will be on a blood thinning medication to prevent blood clots. 

Physical Therapy/Occupational Therapy. The Rehabilitation staff will see you one to two times daily after an initial evaluation session. PT will teach you how to get in and out of bed, move about the room and walk with an assistive device. OT will teach you strategies to assist with activities of daily living such as dressing, bathing and meal preparation.

Positioning. Your leg may be in a splint with a towel rolled under your ankle or heel, or placed in a continuous passive motion (CPM) machine. This device gently bends and straightens your knee.

Rounds. Your surgeon is the leader of your health care team. During your hospital stay various members of your health care team may visit you.

Tests. You may have more tests including lab work or X-rays. 

Vital signs. A nurse or patient care assistant will take your vital signs several times a day. This may include your temperature, blood pressure, heart rate, oxygen level and pain levels.