Joint Replacement Surgery: Standard Protocol and Best Practices

Pre-operative Phase

Patient Assessment

• Complete medical history review
• Physical examination
• Radiographic imaging (X-rays, CT scans if needed)
• Laboratory tests
  • Complete blood count
  • Comprehensive metabolic panel
  • Coagulation profile
  • HbA1c for diabetic patients

Pre-operative Planning

1. Template Analysis

   • Digital or acetate templating
   • Implant size estimation
   • Anatomical considerations

2. Equipment Verification

   • Implant availability
   • Instrument sets
   • Special instruments for complex cases

Operative Phase

Patient Positioning

• Proper table positioning
• Padding of pressure points
• Surgical site preparation

Anesthesia Considerations

• General or regional anesthesia options
• Prophylactic antibiotics administration
• DVT prophylaxis

Surgical Technique

1. Approach

   • Standard incision guidelines
   • Soft tissue handling
   • Neurovascular protection

2. Bone Preparation

   • Precise cuts following manufacturer guidelines
   • Trial component placement
   • Final implant positioning

3. Closure

   • Layer-by-layer closure technique
   • Wound drainage considerations
   • Dressing application

Post-operative Phase

Immediate Post-op Care

• Pain management protocol
• Wound care guidelines
• Early mobilization plan

Rehabilitation Protocol

1. Phase I (0-3 weeks)

   • Protected weight-bearing
   • Range of motion exercises
   • Gait training

2. Phase II (3-6 weeks)

   • Progressive weight-bearing
   • Strengthening exercises
   • Activity modification

Follow-up Schedule

• 2 weeks: Wound check
• 6 weeks: X-rays and function assessment
• 3 months: Progress evaluation
• 1 year: Long-term follow-up

Complications Management

Early Complications

• Infection prevention and management
• DVT/PE monitoring
• Neurovascular injury assessment

Late Complications

• Implant loosening evaluation
• Wear assessment
• Periprosthetic fracture management