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Patient Surgery Schedule

Below you will find outlines of what to expect before, during, and after your surgery.  Please read carefully.

Before Surgery

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Initial Clinic Visit

  • Our offices schedules surgery and gives patient a letter with steps to follow to prepare for surgery
  • Within a few days, patient makes appointment with a Primary Care Physician who must be on staff at Advocate Lutheran General Hospital. If they are not on staff, contact “Doctors of the North Shore” Physicians to make an appointment at 847-967-5010.
  • Patient must see a Primary Care Physician 3-4 weeks before surgery or surgery may be cancelled
  • If patient has a history of cardiac issues, they need to see their Cardiologist prior to seeing the Primary Care Physician
  • If the patient is going to a Rehab facility after surgery, they need to choose the location and make a reservation
  • If patient is a SINGLE joint replacement and on Medicare:
    • Patient will receive a phone call from an IBJI Physical Therapist prior to their surgery to arrange an at-home preoperative evaluation to begin planning their physical therapy needs.

6 Weeks Before Surgery

  • Go to LifeSource location for blood donation if indicated on the letter given to the patient by our office when surgery is scheduled. Blood is good for 42 days. Donate first unit for bilateral total knee replacement or total hip replacement  (See Blood Donation for more information)

4 Weeks Before Surgery

  • Patient goes to Physician for preoperative physical and testing
  • Complete lab work: urinalysis, blood chemistry, blood count, PT/INR and MRSA screening
  • Electrocardiogram (EKG)
  • Possible Stress Test
  • Patient begins to take oral iron supplement
    • “Solgar” available at DME Services at IBJI on first floor
    • "Slow Fe" available at pharmacies. Take one tablet daily.
    • If unable to find “Solgar” or “SlowFe,” any over-the-counter Iron Supplement with 45-65mg Iron or 325mg Ferrous Sulfate will be acceptable.

2 Weeks Before Surgery

  • Stop all vitamins, minerals and supplements
  • Stop taking NSAID’s and blood thinners unless discussed with Dr. Goldstein’s staff
  • Physician Assistant (PA) appointment at IBJI

1 Week Before Surgery

  • Wash surgical knee or hip with Hibiclens soap soap DAILY (Hibiclens is available at DME Servies 1st floor or at any pharmacy). NOTE: This is necessary to help prevent infection and if you fail to follow these steps, your surgery will be cancelled.
    • Knees: wash the area from mid-thigh to ankle
    • Hips: wash the area from the waist to the knee
  • Office begins insurance calls to pre-certify coverage

Day before Surgery

  • Hospital will call with final instructions and time to arrive at hospital on day of surgery
   

On the Day of your Surgery

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Surgery Day

  • Arrive at hospital
  • IV will be started
  • Pre-op antibiotics given
  • After surgery patient follows blood clot prevention and receives pain control measures
   

After Surgery

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Hospital Day 1

  • Blood clot prevention and pain control measures
  • Antibiotics for 24 hours
  • Get out of bed, may ambulate
  • Physical Therapy

Hospital Day 2

  • Blood clot prevention and pain control measures
  • Oral iron
  • Get out of bed, ambulate
  • Physical Therapy

Hospital Day 3 (Medicare patients stay until Day 4)

  • Blood clot prevention and pain control measures
  • Oral iron
  • Get out of bed, ambulate
  • Physical Therapy
  • Discharged to home or extended care facility (ECF)

Home or Extended Care Facility (ECF)

  • If patient is in an ECF, plan to stay 7-14 days, depending on insurance coverage, and patient’s progress and type of surgery
  • PT/INR blood testing done approximately twice a week (on Mon and Thurs)if patient is taking Coumadin
  • Blood clot prevention and oral pain control measures
  • Oral Iron continued
  • Physical Therapy daily in ECF, in the home or as an Outpatient (2-3 times a week)
  • Patients can shower with assistance one week after surgery with their incision covered
  • Dressing should be checked and changed daily until no drainage noted. If incision is dry, it does not need to be covered. Aquacel dressing is on for 1 week, then replaced with a regular dressing if drainage is still present
  • Follow hip precautions for 6 weeks after surgery for hip replacement patients
   

Follow-Up

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Clinic Visit 3 Weeks Postoperatively

  • Will be seen by Physician Assistant (PA)
  • Can drive at 3-6 weeks, depending on pain medication needs
  • Stop taking Iron
  • Wound check and/or staples removed (knees), wound check for hips
  • Hip patients will have an x-ray taken
  • Oral pain medications as needed
  • Maintain hip precautions for total hip patients
  • Prescription given for outpatient Physical Therapy, if patient is not already in outpatient Physical Therapy

Clinic Visit 6 Weeks Postoperatively

  • Will be seen by Physician Assistant (PA) or Dr. Goldstein
  • All patients have an x-ray taken
  • Oral pain medications as needed
  • Discontinue hip precautions unless otherwise specified

Clinic Visit 12 Weeks Postoperatively

  • Will be seen by Physician Assistant or Dr. Goldstein
  • All patients have an x-ray taken

Further Follow-Up at 1 year Anniversary and then Every 2 Years thereafter Unless Patient is Having a Problem and Needs to be Seen Earlier

  • Will be seen by Physician Assistant (PA) or Dr. Goldstein
  • All patients will have an x-ray taken

 

   

Blood Donation

Blood DonationPrior to your surgery, you may need to donate your own blood (autologous) or have someone donate for you who has the same blood type (donor-directed). If neither of these options will work for you, the hospital can also give you blood from their blood bank.

To schedule your blood donation before surgery call Lifesource at 847-299-7386.  You can choose any Lifesource location to attend for your donation. Each unit must be donated 7-10 days apart. The last donation you give should be 8 days or more prior to your surgery.  If you are unable to donate, please notify our office at 847-324-3913 to let us know so that we can send Lifesource a “donor-directed” form.

Based on your type of surgery, please follow these directions in how many units of blood will be needed.

Information Regarding Handicapped Parking

Handicapped ParkingAccording to Illinois State law (625 ILCS 5/1-159.1), joint replacement surgery does not constitute a disability and therefore the doctor can not authorize handicapped parking privileges except on a temporary basis of 90 days from your surgery date.

The application specifically states “Cannot walk 200 feet without stopping to rest” is no longer a qualifying disability; and further states that physicians can be fined for making false or misleading statements on the application.

ILLINOIS BONE AND JOINT INSTITUTE PHYSICIANS WILL NOT BREAK THE LAW.

Antibiotic Pre-Medication Information After Your Surgery

Once you have an artificial joint, it is especially important to prevent bacterial infection from settling in your joint implant. You should take antibiotics 1 hour before an invasive procedure whenever there is the possibility of bacteria entering your blood, such as when you have dental work and/or cleaning or have an invasive procedure that might spread bacteria into your blood stream.

Healthy patients should follow this guideline for 2 years after their total joint replacement. Patients at risk as described below should likely follow this for life. We recommend you consult your primary care physician if you are in doubt about your immune status.  

Be sure to notify your dentist or physician that you have a joint implant and contact Dr. Goldstein at 847-324-3913 for your first prescription for antibiotics to take 1 hour prior to the procedure.  You should contact your dentist or physician performing the procedure for subsequent prescriptions.

You are considered at risk for an infection if you have any of the following:

  • Immunosuppression
  • Inflammatory diseases such as Lupus or Rheumatoid Arthritis
  • Diabetes
  • HIV
  • Smoking
  • Obesity

Antibiotic Pre-Medication Information SheetFor complete antibiotic recommendations for your dentist/physician, please download and print the Antibiotic Pre-Medication Information Sheet. (PDF)


Call Us Today!  Call for an appointment: 847.375.3000