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Top 5 things you can do before orthopedic surgery to ensure a successful outcome

Roughly 7 million orthopedic procedures are performed each year[1]. Some of the biggest concerns of people undergoing surgery are a fear of pain and loss of independence[2]. It’s hard to completely avoid such concerns after orthopedic surgery, since procedures involving the joints often take some time to recover from. But the good news is there are many steps someone can take to prepare themselves for both orthopedic surgery and their rehabilitation.

Write Down Questions for Your Surgeon

Your surgeon may set aside time to provide you with some information you need before surgery. During your consultation, you will learn about your surgery along with what you need to do before and after it takes place. It’s possible you will still have questions after your surgeon speaks with you, and that’s perfectly okay. It’s important to ask them anything you need to be comfortable with your procedure.

Even though it’s your health care team’s job to answer your questions, research shows that only 29% of surgeons ask patients if they have questions during surgery consultations[3]. This means you should be comfortable speaking up even if your surgeon doesn’t directly ask you to. Be sure you are clear about the following areas:

  • Getting anesthesia and medical clearance from your primary doctor
  • Doing lab tests (also known as blood work) before your surgery
  • Registering with the hospital or clinic where your surgery will take place
  • Drawing your blood in case you need to donate to yourself during surgery
  • Stopping medications before surgery
  • Timing for restarting activities such as driving, exercise, work, and household chores
  • Financial aspects of surgery:
    1. If your surgeon and hospital/clinic are in network with your insurance
    2. If you need prior approval from your insurance company before surgery
    3. If therapy after surgery will be covered
    4. What, if anything, you will need to pay out of pocket after insurance

Knowing the basics (and more) about your surgery will not only put your mind at ease going into the procedure, but it will also help you play a more active role in your care. Studies show that patients who are more involved in health care decision-making experience better outcomes[4]. In terms of surgery, this means quicker recovery times, better functioning, and greater quality of life.

Get a Jumpstart on Your Recovery

Most people think the recovery process begins when your surgery is finished. But there are several ways you can make your recovery more successful before you even enter the operating room. One habit you should get into before surgery is eating a balanced diet rich in protein, calcium, and Vitamin C. Protein helps with muscle growth and repair, calcium is important for the formation of strong bones, and Vitamin C boosts the immune system. Between 24% and 65% of patients undergoing surgery are at risk of improper nutrition[5], which is why this lifestyle change is especially important for those undergoing orthopedic surgery. It’s best to adjust your diet as soon as you know you’re having surgery. Try to get 20 to 40 grams (g) of protein[6], 1200 to 1500 milligrams (mg) of calcium, and 500 mg of Vitamin C each day[7]. If you are having trouble getting other nutrients, it may help to take a daily multivitamin with iron.

Smoking and alcohol use also slow someone’s ability to heal after surgery. Individuals who regularly smoke and consume alcohol are at a greater risk of surgical complications such as infection and slow wound healing[8]. They are also more likely to return to the hospital shortly after their surgery and require a second operation to repair wounds or treat infections. This is why it’s best to stop using these substances before surgery so your body can focus on recovering. If you cannot entirely quit, cutting down on the amount you use should also help.

Other advice to follow is exercising according to your surgeon’s instructions. Some people may think they shouldn’t exercise before surgery, but this is yet another practice that will help speed up your recovery. Most people favor their joints that do not hurt, which puts added pressure on the joints that do cause them discomfort. This only makes those painful joints weaker and the recovery process harder. Exercise can help strengthen all of the joints and muscles, which will make it easier to continue physical activity after your surgery.

Be Honest with Your Surgeon

At some point before your procedure, your surgeon will ask you questions to help decide if surgery is a good option for you. It’s always best to be honest when answering, since your providers should have all the information they need to make the right decision. You can bring notes to help you accurately tell your surgeon:

  • Your medical history (conditions you have had in the past or currently have)
  • Your family history (conditions that run in your mother’s and father’s families)
  • Your lifestyle, including exercise, diet, smoking, alcohol and substance use, hobbies, household responsibilities, work duties, and stress levels
  • Surgical history (any procedures you have had, either for the same orthopedic concern you have now or other reasons)
  • Treatment history, which should include anything you’ve done to treat your current condition such as using over-the-counter pain relievers, prescription medication, cortisone shots, ice or heat, physical or occupational therapy, and other home remedies

Research shows that one in four people who have surgery are also living with a chronic condition, such as diabetes or high blood pressure[9]. While you may not think of them often, it’s essential that you tell your surgeon about any chronic conditions you have. If these conditions are not under control, you are more likely to experience complications or poor results from surgery. You should be in generally good health before your procedure, so your surgeon will need to know what you are doing to manage these conditions. This may include taking medication, getting regular checkups, testing blood glucose levels, or other practices.

Prepare for Your Aftercare

Your surgeon will tell you what you can and cannot do after your procedure. You will get a lot of information, so keep the papers they give you to help plan for after your surgery. You will be told to take pain medication at certain times. Most experts recommend you take no more than 1 pill every 6 hours, but follow your surgeon’s instructions. Pain medication will be most helpful for healing if you take it when you have discomfort and not when you are in severe pain.

Depending on the procedure and your surgeon’s orders, you may need some of the following items after surgery:

  • Fresh bandages to place on your wound/li>
  • Ice packs or heat packs
  • A mobility device (such as crutches, a cane, or a walker)
  • Over-the-counter pain medication

Prescription pain medications can cause you to have constipation, or trouble using the bathroom. If you are concerned about this, ask your surgeon if stool softeners or other over-the-counter medications will help. Also, anesthesia used during surgery can cause an upset stomach for a few days. Your surgeon may recommend some products to help with this, so it’s good to have them on hand in case you need them.

Your surgeon will also give you information on when and how you will participate in physical and/or occupational therapy, so you can call the clinic to provide your insurance information and make arrangements. These therapists may give you simple exercises to begin shortly after surgery, so you can ask them if you need anything specific to participate.

Follow Safety Precautions

Many health care providers will tell you the best way to recover after orthopedic surgery is to follow your doctor’s orders for safety. If you had orthopedic surgery on your legs, physical and occupational therapists will help you learn how to get in and out of bed, use the bathroom, and move around in the safest way possible. This often means moving slowly and carefully, since it takes time to get used to the new methods you learn.

Expert Insight

Preparing for Orthopedic Surgery – Rehab After Surgery (3 of 3)

Safely and effectively managing your home is an important part of recovery for individuals who have orthopedic surgery on their legs[10]. This means you may need to arrange your home to make it easier to get around and do things. Managing your home also means getting help with certain tasks you cannot do. If your home is not ready, be sure you or a loved one makes the following changes:

  • Clear walkways of loose wires, small objects, clutter, throw rugs, and anything else you can trip on
  • Rearrange furniture so you can get to and around it more easily
  • Place important items (glasses, pills, hearing aids, phone) near where you spend the most time, such as on a nightstand by the bed or on a waist-level tray table by the couch
  • If you have two stories in your home, arrange your first floor so you can sleep there while you recover
  • Install or secure handrails near all stairways
  • Buy or borrow mobility devices your doctor recommends, such as a walker, crutches, cane, reacher, elevated toilet seat, or shower chair
  • Be sure there is good lighting in the home, especially in areas where you walk
  • Sit in a firm couch, chair, or recliner that is at least as tall as your knees and has armrests

Anyone who had surgery on their arm or hand would also benefit from keeping important items nearby and not lifting anything awkward or heavy. Your surgeon will tell you what the heaviest object you can lift is. People who have orthopedic surgery of any kind may also be unable to do household tasks for a period of time. If you know that is the case for you, plan ahead for help with these tasks:

  • Prepare and freeze single-serving meals for around 2 weeks
  • Do yard work, including mowing the lawn or removing snow
  • Get the mail and bring packages in
  • Grocery shop
  • Care for pets
  • Arrange transportation to doctor’s appointments or other errands as needed

The recovery process differs for each person based on their health conditions and the type of operation they had. However, you can get the most out of the procedure by getting (and giving) all the information you can before your surgery, following a healthy lifestyle including safety precautions and recommended exercises, and adjusting your home to avoid injury and encourage healing. If you have any concerns about your recovery along the way, speak with your surgeon.

Sources
1
Blom, A. W., Donovan, R. L., Beswick, A. D., Whitehouse, M. R., & Kunutsor, S. K. (2021). Common elective orthopaedic procedures and their clinical effectiveness: umbrella review of level 1 evidence. BMJ (Clinical Research ed.), 374, n1511. https://doi.org/10.1136/bmj.n1511
2
Ruhaiyem, M. E., Alshehri, A. A., Saade, M., Shoabi, T. A., Zahoor, H., & Tawfeeq, N. A. (2016). Fear of going under general anesthesia: A cross-sectional study. Saudi Journal of Anaesthesia, 10(3), 317–321. https://doi.org/10.4103/1658-354X.179094
3
Menendez, M. E., van Hoorn, B. T., Mackert, M., Donovan, E. E., Chen, N. C., & Ring, D. (2017). Patients With Limited Health Literacy Ask Fewer Questions During Office Visits With Hand Surgeons. Clinical Orthopaedics and Related Research, 475(5), 1291–1297. https://doi.org/10.1007/s11999-016-5140-5
4
Centers for Disease Control and Prevention. (2021). Patient Engagement. Retrieved from https://www.cdc.gov/healthliteracy/researchevaluate/patient-engage.html
5
Thomas, M. N., Kufeldt, J., Kisser, U., Hornung, H. M., Hoffmann, J., Andraschko, M., Werner, J., & Rittler, P. (2016). Effects of malnutrition on complication rates, length of hospital stay, and revenue in elective surgical patients in the G-DRG-system. Nutrition (Burbank, Los Angeles County, Calif.), 32(2), 249–254. https://doi.org/10.1016/j.nut.2015.08.021
6
Hirsch, K. R., Wolfe, R. R., & Ferrando, A. A. (2021). Pre- and Post-Surgical Nutrition for Preservation of Muscle Mass, Strength, and Functionality Following Orthopedic Surgery. Nutrients, 13(5), 1675. https://doi.org/10.3390/nu13051675
7
Fukushima, R., & Yamazaki, E. (2010). Vitamin C requirement in surgical patients. Current Opinion in Clinical Nutrition and Metabolic Care, 13(6), 669–676. https://doi.org/10.1097/MCO.0b013e32833e05bc
8
Fernandez, A. C., Bohnert, K. M., Bicket, M. C., Weng, W., Singh, K., & Englesbe, M. (2022). Adverse Surgical Outcomes Linked to co-occurring Smoking and Risky Alcohol Use Among General Surgery Patients. Annals of Surgery, Advance online publication. https://doi.org/10.1097/SLA.0000000000005735
9
Fowler, A. J., Wahedally, M. A. H., Abbott, T. E. F., Smuk, M., Prowle, J. R., Pearse, R. M., & Cromwell, D. A. (2022). Death after surgery among patients with chronic disease: prospective study of routinely collected data in the English NHS. British Journal of Anaesthesia, 128(2), 333–342. https://doi.org/10.1016/j.bja.2021.11.011
10
Smith, T. O., Jepson, P., Beswick, A., Sands, G., Drummond, A., Davis, E. T., & Sackley, C. M. (2016). Assistive devices, hip precautions, environmental modifications and training to prevent dislocation and improve function after hip arthroplasty. The Cochrane Database of Systematic Reviews, 7(7), CD010815. https://doi.org/10.1002/14651858.CD010815.pub2
Last edited on June 1st, 2023 9:20 pm