Care pathway for an artificial joint replacement patient

You may request a referral to the HUS Artificial Joint Center from a health center physician, an occupational healthcare physician, or a physician in private practice if you are diagnosed with symptomatic osteoarthritis.

Once your referral has been processed, you will be invited for an appointment with an orthopedic surgeon at the Artificial Joint Center outpatient clinic at Peijas Hospital. You may also be given a remote appointment. The invitation will be sent to you by mail.

You will be invited to an appointment or a remote appointment with the orthopedic surgeon for a treatment consultation at the Surgery Outpatient Clinic at HUS Peijas Hospital when your referral arrives. Your family members are welcome to attend the meeting too.

You can prepare for your upcoming visit through the Maisa portal. In Maisa, you can fill in the pre-information form and check your contact details, medications, allergies, etc.

You can view treatment of osteoarthrosis, joint replacement surgery and rehabilitation online on the digital treatment path in the Health Village. Log in to the digital path in MyPath.

At the appointment, a physician will review your medical history and medication with you and will enter your up-to-date details in the information system. A nurse will contact you after your physician’s appointment and will provide you with information about preparing for surgery in addition to reviewing your health information.

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 pain medication.  

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. See also the Joint Hub web pages at the Health Village.

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 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. 

Before surgery, you will be invited to group counseling with a physiotherapist for instructions and advice about the surgery itself and further rehabilitation, and about the assistive devices you will need afterwards.

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 maintain 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 4 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 if prescribed.

You will wait for your operation in the recovery room in Surgery Outpatient Clinic 4, 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 spinal anesthesia or 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 get up 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. 

Getting mobile soon after the operation protomoesrecovery and reduces the 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 pain medication 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 pain medication 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, various types of medicines are used. On the ward, pain medication is usually administered by mouth. You will receive pain medication regularly, with additional doses as and when required. 

Read more about pain management at the Health Village.

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 discharge, you will need to exercise independently as instructed. If necessary, you can call the helpline of the physiotherapist on the ward, 09 471 67841 (Mon to Wed 12.30–13.00).

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

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 surgery, please contact the ward at 09 471 73500.

To help your rehabilitation, see our instructional videos on climbing stairs and two-point alternate gait. 

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