Improving the Success of your Total Joint Replacement

Our total joint replacement program takes targeted steps to improve the success of your total joint replacement. Our program focuses on actively engaging patients prior to their surgical journey, and providing continued support.

Complete a pre-screening

Patients considering joint replacement surgery will undergo a rigorous exam to identify any risk-factors that could negatively impact the outcome of a joint replacement procedure, including:

• Smoking: Tobacco use increases the risk of infection and impairs healing and recovery. All patients who smoke are provided with smoking cessation resources and instructed to stop any tobacco use at least one month prior to and following surgery.
• Obesity: A patient who is morbidly obese is at risk for serious complications both during and after surgery. Doctors will encourage overweight patients to enroll in nutrition counseling and will consider postponing a joint replacement procedure if a patient’s BMI is > 40.
• Cardiovascular disease: Any history of cardiovascular requires medical clearance and extensive follow-up after a joint replacement procedure.
• Diabetes: Because diabetes is linked to an increased risk of morbidity and mortality following surgery, patients with previously undiagnosed or uncontrolled diabetes will be referred to a diabetes management clinic before undergoing joint replacement.
• Venous thromboembolic disease (VTE): VTE, which includes pulmonary embolism and deep vein thrombosis, occur frequently and can result in long-term complications. Identified patients are placed on a high-risk anti-coagulation protocol to avoid complications.
• Other co-morbidities: Issues such as inability to walk or cognitive deficits identified prior to surgery are addressed to optimize outcomes.

Receive support

A strong support system during a joint replacement procedure is essential. Our program provides each patient a dedicated registered nurse, called an outpatient case manager. Their case manager will guide them through their joint replacement journey from pre-surgery to home recovery, and will closely monitor their patient for any potential issues to avoid future complications. They can also help to coordinate services such as home health and skilled nursing, if needed. However, most patients are discharged directly to their homes. 

Patients are also asked to identify a "joint coach", which is typically a family member, friend or other individual, who will play an active role in their recovery. The joint coach will keep an eye out for potential problems and also facilitate and encourage home exercises and return to daily living activities.

Be educated about your joint replacement journey 

Patients and their joint coach will attend our joint replacement education class prior to surgery, where they will learn about their surgery, physical therapy, how to perform daily living activities after surgery and much more. The education and materials that joint coaches receive in class are available on our website, as well several online videos that can help coaches and patients during the recovery process.

View resources for current patients

Patients and their joint coach will also have the opportunity to meet their case managers in person at the joint replacement education class. At this time, patients should feel free to discuss any questions or concerns with their case manager.   

View the current joint class calendar

Get directions to joint class at Barnes-Jewish Hospital

Get moving quicker with rapid recovery protocols

Evidenced-based research has shown that the sooner a patient is mobile after joint replacement surgery, the better the outcome. Once your surgery is complete, physical therapy will start while still in the hospital, with the patient first moving to a chair and then walking. These rapid recovery practices allow our patients to return home sooner after surgery, often within one to one-and-a-half days after surgery, reducing the risk of a possible infection. 

Your case manager will check on you during your hospital stay, and go over any instructions with you after your discharge. They will also contact you after you return home for up to 3 months after your surgery, checking on progress and monitoring you for any potential issues that should be addressed by a physician.