The Joint Solutions Center has implemented a comprehensive patient- and family-planned course of treatment. We believe that you play a key role in promoting a successful recovery. Our goal is to involve you in your treatment through each step of the program. This guide will give you the necessary information to promote a more successful surgical outcome.

1. JOINT
REPLACEMENT
GUIDEBOOK

2. 2 PATIENT GUIDEBOOK
ABOUT DEKALB MEDICAL
Founded in 1961, DeKalb Regional Health System, Inc., known
as DeKalb Medical, is comprised of more than 800 physicians
skilled in 55 medical specialties across three campuses and over
25 practices. The 627-bed system includes DeKalb Medical at
North Decatur (451 beds), DeKalb Medical Long Term Acute Care
at Downtown Decatur (76 beds), DeKalb Medical at Hillandale
(100 beds), and DeKalb Medical Physicians Group and the DeKalb
Medical Foundation.
VISION
In partnership with the best physicians, employees and volunteers,
DeKalb Medical will be the healthcare provider of choice by
delivering a superior patient experience every time.
MISSION
To earn our patients’ trust every day through uncompromising
commitment to quality.
VALUES (I REACH!)
Integrity | Respect | Excellence | Accountability | Compassion | Helping Hands

3. 3
TABLE OF CONTENTS
Welcome
What to Expect
Preparing for Your Surgery
Range of Motion
Before Your Surgery
Day of Surgery
Post-Surgical Recovery
After Surgery
Discharge
4
5
6
9
11
11
13
14
15

4. 4 PATIENT GUIDEBOOK
WELCOME
Thank you for choosing The Joint Solutions Center to help restore
you to a higher quality of living with your new prosthetic joint.
If you have not already done so, please contact the joint care
coordinator (404.501.5697) between 8 a.m. and 4:30 p.m.
Monday through Friday to schedule your joint care class prior to
surgery.
Over 700,000 persons every year undergo total joint replacement
surgery. Primary candidates are individuals with chronic joint pain
from arthritis that interferes with daily activities, walking, exercise,
leisure, recreation and work. Total joint replacement patients
typically recover quickly. Patients will be able to walk the first day
of surgery. Generally, patients are able to return to driving in two
to four weeks, dancing in four to six weeks and golfing in six to 12
weeks.
The Joint Solutions Center has implemented a comprehensive
patient- and family-planned course of treatment. We believe that
you play a key role in promoting a successful recovery. Our goal is
to involve you in your treatment through each step of the program.
This guide will give you the necessary information to promote a
more successful surgical outcome.

5. 5
Your team includes physicians, physicians’ assistants, patient care
technicians (PCT’s), nurses, physical and occupational therapists
specializing in total joint care. Every detail, from before-surgery
teaching to after-surgery exercising, is considered and reviewed with
you. The Joint Care Coordinator will plan your individual treatment
program and guide you through the surgical experience.
WHAT TO EXPECT
The Joint Solutions Center is unique. It is a dedicated center within
DeKalb Medical. Patients have their surgery on Monday, Tuesday
or Wednesday, and typically return home after a two-to-three-night
stay in the hospital.
• You may wear your own clothes
• Nurses and therapists specializing in the care of total joint
replacement patients
• Private rooms
• Unlimited visiting hours for family and friends
• Emphasis on group activities and individual care
• Personal recovery coach – We encourage you to bring someone with you
• Cooked-to-order menu every Wednesday in the Walker’s Café
• Hourly rounding addressing The Four Ps – pain, potty, position and
possession

6. 6 PATIENT GUIDEBOOK
PREPARING FOR YOUR SURGERY
Enlist A Coach Find a family member or close friend to be your
personal recovery coach. Every patient benefits from having a coach.
Your coach will serve in a support role to help build your confidence
as you regain strength and stability in your new joint through therapy
and exercise. A stronger and more stable joint means you will go home
earlier, recover quicker and have a satisfactory outcome.
Check With Your Physician You should have an appointment with
your surgeon about two weeks before your surgery that serves as a
final check-up and a time for you to ask questions. You will also be
asked to stop or start taking certain medications prior to surgery
including medications that may increase bleeding, such as aspirin,
Advil, Naproxen, Celebrex, Plavix, or Coumadin.
Your surgeon may inform you to
stop taking diabetic medications
the day of surgery and will
instruct you on which blood
pressure and heart medications
to take on the day of surgery.
Prepare Your Home For Your
Return Have your house ready for
your arrival back home. Clean,
do the laundry, and put it away.
Put clean linens on the bed.
Prepare meals and freeze them
in single-serving containers. Cut
the grass, tend to the garden and
finish any other yard work. Pick
up throw rugs and tack down
loose carpeting.

7. 7
Remove electrical cords and
other obstructions from
walkways. Install night lights
in bathrooms, bedrooms and
hallways. Arrange to have
someone collect your mail
and take care of pets or family
members if necessary.
Exercise Start pre-op exercises
as your doctor orders. It is
important to be as fit as
possible before undergoing
a total joint replacement.
Always consult your physician
before starting the before-
surgery exercise plan.
Following the surgeon’s
instructions will make your
recovery time much faster.
Your physician and therapist have provided exercises for you to
perform prior to surgery. Performing these exercises will help you
during the after surgery period. You should be able to complete
these exercises in 15–20 minutes and it is typically recommended
that you do all of them twice a day.
Also, remember that you need to strengthen your entire body, not
just your leg. It is very important that you strengthen your arms by
doing chair push-ups (exercise #8 on page 9) because you will be
relying on your arms to help you get in and out of bed, in and out
of a chair, walk, and to do your exercises postoperatively.
Exercise should not be painful. Please stop doing any movements
that cause pain to your joint.

8. 8 PATIENT GUIDEBOOK
RANGE OF MOTION & STRENGTHENING EXERCISES
1. ANKLE PUMPS
Flex foot. Point toes. Repeat 20 times.
2. QUAD SETS (KNEE PUSHDOWNS)
Lie on back with knee straight, press knee into mat,
tightening muscles on front of thigh. Do NOT hold
breath. Keep muscles tightened to count of five. Repeat
20 times.
3. GLUTEAL SETS (BOTTOM SQUEEZES)
Squeeze bottom together. Do NOT hold breath. Keep
muscles tightened to count of five. Repeat 20 times.
4.HIPABDUCTIONANDADDUCTION—(STANDING)
Standing at counter top or chair back, swing affected leg
out to side away from body. Bring leg back toward body.
Repeat 20 times.
5. HEEL SLIDES — (SLIDE HEELS UP AND DOWN)
Lie on couch or bed. Slide heel toward your bottom, then
slowly lower. Repeat 20 times.
6. SHORT ARC QUADS
Lie on back, place towel roll under thigh. Lift foot,
straightening knee. Do not raise thigh off roll. Hold to a
count of five. Slowly lower. Repeat 20 times.

9. 9
7. KNEE EXTENSION — LONG ARC
Sit with back against chair. Straighten knee. Hold to
count of five. Lower leg. Repeat 20 times on each leg.
8. ARM CHAIR PUSH-UPS
This exercise will help strengthen your arms for walking
with crutches or a walker. Sit in an armchair. Place
hands on armrests. Straighten arms, raising bottom up
off chair seat if possible. Feet should be flat on floor.
Repeat 20 times.
9. SEATED HAMSTRING STRETCH
Sit on chair with leg extended. Lean forward until
stretch is felt. Hold for 20–30 seconds. Keep back
straight. Relax. Repeat five times.
10. STRAIGHT LEG RAISES
Lie on back, unaffected knee bent, and foot flat. Lift
opposite leg up 12 inches. Keep knee straight and toes
pointed up. Relax. Repeat 20 times.
11. KNEE EXTENSION STRETCH
Prop foot of involved leg up on chair. Place towel roll
under ankle and ice pack over knee. Do for 10 minutes.
12. MINI SQUATS
Holding on to a stable object, slightly bend knees and
slowly straighten. Repeat 20 times.

10. 10 PATIENT GUIDEBOOK
24 HOURS BEFORE YOUR SURGERY
It is important you remember to:
• Not eat or drink after midnight
• Take a very good shower
• Bring this guidebook to the hospital
• Bring a copy of advanced directives
• Bring loose-fitting clothing
• Bring any special equipment required for other medical conditions
DAY OF SURGERY
Please report to surgery one to two hours early. You will be
prepared for surgery in the Surgery Admitting Area. This includes
starting an IV and scrubbing the area for surgery. Your operating
room nurse and anesthesiologist may interview you and they may
escort you to the operating room where you will see your surgeon, if
you have NOT seen him in the Surgery Admitting Area.
Following surgery, you will be taken to a recovery area where you
will remain for one to two hours. During this time, pain control
is typically established, your vital signs will be monitored, and an
X-ray may be taken of your new joint.
Your family waiting in the Surgery Admitting Area will be updated on
your progress by the surgeon and afterwards you will be informed on
the location of your family member on the Joint Solutions floor/unit.
You will be taken to the Joint Solutions Center where highly trained
staff in total joint care and orthopedics will care for you, and prepare
you for discharge home or another level of care.
Most patients will get out of bed the day of surgery. It is very
important that you begin ankle pumps on this first day. This will
help prevent blood clots from forming in your legs. Your surgeon
may choose to use a “Continuous Passive Motion” machine (CPM)
to begin knee motion to help improve flexion.

11. 11
You should also begin using your Incentive Spirometer and doing
the deep breathing exercises that you learned in class immediately
after surgery 10 times every one hour.
Nursing staff will round on you minimally every hour to address any
pain issues, bathroom breaks, positioning, and make certain all
items are in your possession during the day and every two hours at
bedtime to allow for a restful night.
Each day you will receive a copy of the “New Joint News,” a daily
newsletter outlining the activities for the day.

12. 12 PATIENT GUIDEBOOK
POST-SURGICAL RECOVERY
Potential Complications As you and your surgeon discussed before
surgery, there are potential complications during and after the
surgical procedure. They are:
• Blood Clots
• Swelling
• Infection – Please report any change in amount or drainage from incision
site, increase in pain, or temperature greater than 100 degrees Fahrenheit.
Treatment & Preventative Measures Treatment and preventative
measures for potential complications are:
• Ankle Pumps
• Blood thinners
• Hand washing
• Cover dressings
• Early mobility
• Fall precautions
DAILY SCHEDULE
DAY 1
• 5:30 – 7:00 AM – Blood work; Out of bed
and into recliner
• 7:30 - 8:30 AM – Breakfast
• 9:00 - 10:00 AM – Physical therapy
(1 on 1 session) in room, walking in hallways
• 11:45 - 12:45 PM – Lunch (in room)
• 1:00 - 2:00 PM – Group therapy session
• 2:00 - 3:00 PM – Group ADL class with
occupational therapist
• 3:00 - 5:00 PM – Relax in room or walk
with a physical therapist
• 4:30 - 5:30 PM – Dinner
*Nursingstaffwillbemakinghourlyroundsasneeded.

13. 13
DAY 2
• 5:30 – 7:00 AM – Blood work; Out of bed and into recliner
• 7:30 - 8:30 AM – Breakfast
• 9:00 - 10:00 AM – Group physical therapy
• 11:45 - 12:45 PM – Special lunch in Walkers Café
• 12:30 - 1:00 PM – Discharge class instructions during luncheon
• 1:00 - 2:00 PM – Final group therapy session
• 2:00 PM – Discharge from Joint Solutions Center to a more active
and pain-free lifestyle!*
*Unless dictated by clinical presentation or physician/physical therapy suggestion
**Nursing staff will be making hourly rounds and as needed

14. 14 PATIENT GUIDEBOOK
DISCHARGE
Going Home Someone responsible needs to drive you home. You
should receive written discharge instructions for medications,
home or outpatient physical therapy, returning to prior activities
of daily living, and how to change your dressings. We will make
arrangements for any equipment needs during your hospitalization.
Going to a Sub-Acute Rehab Facility The decision to go home or
to sub-acute rehab will be made collectively by you, the Joint
Care Coordinator, your discharge planner, your surgeon, physical
therapist, and your insurance company.
We will communicate to you prior to discharge if a family
member or someone responsible needs to drive you to a subacute
rehabilitation facility or the hospital can help you arrange for paid
transportation. Either your primary care physician or a physician
from sub-acute will be caring for you in consultation with your
surgeon. Expect to stay three to five days, based upon your
progress. Upon discharge home, instructions will be given to you by
the sub-acute rehab staff.

15. 15
You’ll be able to track your progress on our
Georgia Sightseers Tour as you walk our indoor circuit.
Enjoy the relaxing outside deck where you can take some time
away from your bed and room, and breathe in the fresh air.
Every Wednesday, you’ll receive a cooked-to-order meal in the Walkers’ Cafe.