Pre-op

Q: Is there a better time of year to have the surgery?

A: This is a personal decision; some patients like to have the surgery in good weather so that they may walk outdoors as part of their recovery; others prefer to do the surgery in the winter so that they may recover in time to participate in springtime activities.

Q: I read that Dr. Jacob uses several different implants for hip and knee replacement. Which will I get?

A: Dr. Jacob uses implants from Stryker, Smith and Nephew, Biomet, and Depuy. For most cases, he is using the Stryker hip and knee implants, as these implants have an excellent track record in the European Joint Registry Databank. For patients with a metal allergy, Smith and Nephew’s Oxinium implant is Dr. Jacob’s implant of choice. If a patient has a preference for one of these devices, it can often times be accommodated.

Q: I am planning on having a partial knee replacement, is there a possibility that I will wake up with a total knee replacement ?

A: Yes, there is always a small possibility that a partial knee will not be feasible because of poor bone quality, structural deficiencies, or advanced arthritis not identified on imaging. If this is the case, then a total knee replacement would be better.

Q: Am I eligible for outpatient joint replacement?

A: During your consultation with Dr. Jacob, your overall health and well being will be assessed. If you are eligible and would like to consider outpatient joint replacement, this can be discussed with Dr. Jacob during your consultation.

Q: How long is the incision?

A: The incision length will vary depending upon how much tissue you have between your skin and the joint, how muscular you are, and how stiff your hip or knee is. Generally, the incision is between 5-8 inches in length.

Q: When should I stop taking my medications?

A: You can continue taking most medications up until the day of surgery, with the exception of anti-inflammatories like Ibuprofen or Naprosyn. You should discontinue any blood thinners about 1 week prior to surgery. This will be reviewed with you during your preoperative consultation with a medical doctor, as well as in your preoperative education class.

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Q: In the pre-op class, what will be addressed?

A: The pre-operative class is designed to give you an excellent understanding of what you can expect during the three phases of your surgery (pre-op, surgery, and post-op). The team of nurse educators will thoroughly educate you on what to expect throughout your surgical experience. It is also important to bring the person who will be your primary caregiver during your peri-operative period with you to the class so that he or she feel prepared as well.

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Q: Should I be doing any special exercises for the operative extremity preop? Should I go to physical therapy?

A: Although there is nothing in particular you are required to do prior to surgery, the more flexible and in shape you are prior to surgery, the quicker your recovery. Cycling, swimming, and yoga are good ways to achieve these goals without incurring the expense of formal treatment

Q: Should I take any supplements to help strengthen my bones preop

A: Dr. Jacob recommends calcium and vitamin D supplements to keep the bones strong. 1500 mg of calcium citrate and 5000 IU of vitamin D should be adequate. Always check with your primary care doctor before starting any new medication.

Q: Should I have a bone density test preoperatively?

A: Generally, for men, this is not necessary. For women, if your bone density is in question, Dr. Jacob may ask you to obtain a DEXA bone density scan.

Q: How long do I need time off work after the surgery?

A: The post-operative recovery period varies based on the particular surgery. Generally it is recommended patients take three to six weeks off work to recover from any surgery. If your employer allows, Dr. Jacob may choose to allow your to return to work earlier than 3 weeks based on his return to work criteria. Dr. Jacob will give you specific instructions to follow for a successful recovery.

Q: How long before I can resume driving?

A: You must wait at least two week before driving after surgery. The effects of anesthetic, pain medication, and surgery can affect judgment and reflexes during the first weeks following your surgery. You must be off of your pain medication prior to driving.

Q: When can I resume exercise?

A: Your doctor and physical therapist will instruct you about post-treatment exercises – the type and the duration to be followed. You may be referred to a physical therapist to help with strengthening and range of motion exercises following surgery.

Q: When can I return to daily activities?

A: This varies depending on the type of procedure undergone, and can range from a few days to a few months. Return to all activities, sports and exercise can take up to four to six months. Your doctor will advise you depending on your particular health condition.

Q: How do I contact after hours?

A: There will be a point of contact 24 hours a day for any concerns you may have. Dr Jacob has an answering service that is available after hours at 405-424-5426. He is notified of all patient concerns. You will be contacted by a member of the staff if requested.