Care pathway for an artificial joint replacement patient

Once your referral has been processed, you will be invited for an appointment with an orthopedic surgeon at the Joint Replacement Center's outpatient clinic at Peijas Hospital. The invitation will be sent to you by mail.

Before your appointment, you will receive a medical history form. Please fill this in with care. You can fill in the form in our online service, or you can fill it in on paper and mail it to us in the return envelope provided.

At the appointment, a physician and a nurse will review your medical history and medication with you and will enter your up-to-date details in the information system. 

An orthopedic specialist with expertise in artificial joint surgery will evaluate your joint at the outpatient clinic. The orthopedic surgeon needs to have X-rays of the affected joint in addition to the clinical examination in order to make a diagnosis. Sometimes other imaging, such as an MRI, is needed.
 
After the examinations, we will hold a customized consultation meeting with you. The purpose of this is to review your condition and your options for treatment, and to decide with your input on the policy for your treatment.

If your osteoarthritis is mild enough not to warrant surgical treatment, you will be referred to rehabilitative therapy. This mainly involves independent exercise and mobility, weight control, and possibly physiotherapy at your local health center. You will also be prescribed painkillers.  

If a surgical procedure is selected for your osteoarthritis, the consultation meeting will include discussion of the preparation for the operation, the progress of the operation itself, recovery on the ward, and further treatment at home.

You will be advised on your operation at the appointment, with a patient guide and with other advisory materials. An anesthesiologist may participate in the planning of your surgery at the preparation stage if necessary.

Before the operation, you should be in good physical shape, and any underlying conditions that you may have should be well managed.  

Any dental work required must also be completed. Please book an appointment with your dentist as soon as the decision to go ahead with surgery is made.

Please suspend or quit smoking at least 2 weeks before the operation and refrain from smoking for at least 3 to 4 weeks after it so as to ensure optimal healing of the wound. 

Weight control is important for osteoarthrosis patients, but a drastic weight loss before the operation itself is not recommended. Further information on weight control.

When the decision has been made on artificial joint surgery on your hip or knee, you will be referred to preoperative physiotherapy. During the advisory appointment, a physiotherapist will interview and examine you, estimate the need for assistive devices, and provide you with instructions and advice regarding the operation itself and postoperative rehabilitation.

You need to collect the assistive devices needed from the assistive device service in your municipality before coming in for your operation. 

While waiting for the operation, you should keep in shape and uphold your muscle strength if possible. These are factors in a speedier recovery.

A good general condition and muscle strength facilitate the operation and speed up recovery. Therefore, all osteoarthrosis patients are encouraged to exercise every day.

On the morning of the day of your operation you will arrive at Surgery Outpatient Clinic 3 at Peijas Hospital, where a nurse will prepare you for the operation. The nurse will check your health and the condition of your skin, have you change into surgical clothes, and give you the premedication.  

You will wait for your operation in the waiting room in Surgery Outpatient Clinic 3, and the operating room nurse will come to collect you.     

In the operating room, the first people you will meet are the operating room nurses and anesthesiologist who will be looking after you. At this point, your health details are checked one more time, and you can discuss any questions and requests related to anesthesia and pain management. 

An intravenous catheter (‘drip’) will be inserted in the back of your hand for administering fluids and medication. Sensors will be attached to your chest and upper arm for monitoring your heartbeat and blood pressure, etc. 

An artificial joint operation is performed under local anesthesia to the back or under general anesthesia. Both types of anesthesia are safe and allow for an optimal outcome. 

A knee or hip replacement operation generally lasts 1 to 2 hours. An artificial joint operation involves replacing damaged cartilage with an artificial joint. A partial replacement is also possible. 

In the evening after the operation, you may walk around and go to the restroom if you feel able and your pain level allows. You are also allowed to eat. Nurses will help you get up and support you in moving around and will help you in using assistive devices. 

If you can get mobile soon after the operation, you will have a better chance of a speedy recovery and less of a risk of blood clots. 

In the following days, nurses and physiotherapists will assist you to start moving independently while assisting you with everyday functions if necessary. 

While you are in inpatient care, your pain level and general condition will be monitored. You will be given painkillers regularly to alleviate the pain. Pain management is important particularly after artificial joint surgery. Excessive pain inhibits recovery and rehabilitation.  

The anesthesiologist and surgeon will plan the postoperative pain management regime. In addition to various non-medical pain management techniques (positioning, cold packs), local anesthetic and painkillers are used. 

Medication planning is informed by your underlying conditions and allergies, the extent of the operation, and your own requests and previous experiences of pain management. 

In many cases, preparations from several drug classes are used. On the ward, painkillers are usually administered by mouth. Painkillers are given regularly, with additional doses as and when required. 

Read more about pain management.

On the day after your operation, the physiotherapist will evaluate and provide individual guidance for your mobility and functional capacity. The goal is for you to be able to move as smoothly, safely, and independently as possible, using an assistive device. 

You will be encouraged and coached to use your operated joint as soon as possible, albeit within the limits of any restrictions imposed. Rehabilitation requires you to be active. 

After being discharged, you will need to exercise independently based on the instructions provided. If necessary, you can call the helpline of the physiotherapist on the ward, tel. 09 471 67841 (Mon to Wed, 12:30–13:00).

If necessary, your physician can write you a referral to physiotherapy in primary health care.

When you continue your rehabilitation at home, it is important to follow your physician’s instructions regarding pain management. Without sufficient pain medication, your rehabilitation may be unnecessarily prolonged. 

It is important that you follow instructions in caring for the surgical wound. 

You may need to use assistive devices for a period of 2 to 8 weeks after the operation. You can stop using them according to the instructions given by the hospital. 

If you have any questions after your surgery, please call the ward helpline: 
 
Ward K2, tel. 050 428 7371 (weekdays 12:30–13:30) 
Ward K3, tel. 09 471 67851 (weekdays 12:00–13:00) 

You will have your follow-up appointment at the Surgery Outpatient Clinic at Peijas Hospital 2 to 3 months after the operation.