Initial Clinic Visit
 Office schedules surgery
Patient goes home, make appointments with Primary Care Physician and Pre-Surgical Testing unit
Patient needs to see Primary Care Physician 3-4 weeks before surgery
30-60 days before surgery
Patient goes to pre-surgical testing unit
Donate first unit of blood for bilateral total knee replacement or total hip replacement
Complete lab work: urinalysis, blood chemistry, blood count
Possible electrocardiogram (EKG)
PT/INR (blood work)
Stop all Vitamins, minerals, and supplements 6 weeks before surgery
1 month before surgery
Patient begins to take oral iron supplement
Office begins insurance calls
(Medicare-none)
(PPO-call)
2 weeks before surgery
Patient goes to pre-surgical testing unit to donate 1 more unit of blood if necessary at Lutheran General Hospital; Lifesource for Rush North Shore
Stop taking NSAID’s and blood thinners unless discussed with Dr. Goldstein’s staff
May take Tylenol or Ultracet for pain
3-7 days prior to surgery
Type and Cross blood work completed for revision patient and patients who cannot donate blood
Hemogram and platelet function tests for Lutheran General Hospital
Seven days before surgery, wash surgical leg with Hibiclens soap daily.
Surgery Day
Arrive at hospital
Pre-op antibiotic dose IV
After surgery patient wears plexi-pulse boots and TED hose, starts Coumadin, pain control measures
Hospital Day 1
Coumadin, plexi-pulse boots, TED hose, pain control measures
3 doses of antibiotics
Oral iron
Get out of bed, may ambulate
Physical therapy x 2
Hospital Day 2
Coumadin, plexi-pulse boots, TED hose, pain control measures
Oral iron and Vitamin C
Get out of bed, ambulate
Remove bulky dressings
Physical therapy x 2
Hospital Day 3
Coumadin, plexi-pulse boots, TED hose, pain control measures
Oral iron and Vitamin C
Get out of bed, ambulate
Physical therapy x 1
Discharged to home or rehab facility
Home or rehab facility
If in ECF, 7-10 days, depends on insurance
PT/INR drawn approximately twice a week
Coumadin, TED hose, oral pain control measures
Oral iron and Vitamin C
Physical therapy in rehab facility (x3) daily, in the home, or as outpatient (x3) weekly
Can shower with assistance 1 week after surgery with the incision covered
Dressing checked and changed daily until no drainage
Home
Coumadin, TED hose, oral pain control measures
PT/INR drawn approximately twice a week at home; results called in to Dr. Goldstein’s office
Physical therapy at home or out patient 3 times per week
Clinic Visit 3 weeks postoperatively
Will be seen by Physician Assistant
Can drive at 3-6 weeks, depending on pain medications
Stop iron, Coumadin and Vitamin C
Wound check and/or staples removed
Hip and revision patients have an x-ray and pain medications if needed
Maintain hip precautions for total hip replacement patients
Clinic Visit 6 weeks postoperatively
Will be seen by Dr. Goldstein
All patients have an x-ray
Tylenol for pain
Maintain hip precautions
Clinic Visit 14 weeks postoperatively
Will be seen by Dr. Goldstein
All patients have an x-ray
Further follow-up
At one year, then every 24 months
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