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Requirements Before Surgery

Patients must complete these steps before having joint replacement surgery at CHA.

  1. Dental Clearance
    • Infections in your mouth can lead to higher risks during joint surgery.
    • You will need to visit a dentist to ensure you are not at risk for infection.
    • We will give you a clearance letter to be signed by your dentist.
    • You can turn this in at our front desk or at your next appointment with your surgeon or PA.
  2. Primary Care Clearance
    • Make an appointment for a pre-op physical to make sure you are healthy enough to have this surgery.
    • If you have other medical issues (i.e. heart conditions), you may need to see other providers for additional tests/clearance.

  3. Attend Total Joint Class
    • Attend one online or in-person class to learn about the total joint surgery process. You must sign up ahead of time.
      • Please note: Due to ongoing COVID-19 concerns, our total joint replacement class is currently being held virtually and individually.
      • Include family/friends who will be helping you after your surgery. Interpreters are available if English is not your primary language. Call 617-665-1566 and ask to speak with your surgeon’s staff to request an interpreter.
      • You need access to an email account to be able to participate in the online class.
      • If you do not have access to an email account, you will be scheduled for an in-person class at your orthopedic clinic.

  4. Physical Therapy Evaluation
    • Hips/Knees: Attend one appointment with physical therapy to evaluate your ability to walk. They will also show you how to use a walker after surgery.
    • Shoulders: Attend one appointment to prepare for using one arm after surgery.

  5. Get Medical Equipment
    • Hip Replacement: You need a walker and a raised toilet seat (or commode) in your home before you have surgery. Sock aids and reachers, etc. are optional.
    • Knee Replacement: You need a walker in your home before you have surgery. A raised toilet seat (or commode) is optional for knee support.
    • Ask For A Prescription
      • If your insurance does not cover these items, you can find them at pharmacies, home improvement stores, and online.
      • If you can’t afford to buy these items, you can go to the Mason’s Loan Program in Woburn. They loan out used hospital/medical equipment for free. Open on Saturday from 9 am to 12 pm at 500 West Cummings Park Suite 1150 in Woburn, MA

  6. Body Mass Index (BMI) Less Than 40
    • We will measure your BMI (based on your height and weight)
    • If your BMI is 40 or over, you will need to lose weight before surgery.
    • CHA Nutritionists are available to help with weight management.

  7. Quit All Nicotine Products (Cigarettes, Vape, Patches, Gum, etc.)
    • You must quit at least 1 month prior to surgery. A urine test will confirm this.
    • We can help you quit. Please ask us about this.

  8. If Diabetic, You Must Have Well-Controlled Blood Sugar Levels
    • Your Hemoglobin A1C (a blood test to check your glucose levels) must be less than 8.

  9. Nasopharyngeal Swab For COVID-19
    • The test must be performed within 96 hours prior to your scheduled surgery.
    • If the test is negative, you can proceed with your surgery as planned.
    • If positive, you will need to quarantine for 10 days before having your surgery.

  10. Nasal Swab For MRSA
    • This painless test will check for bacteria that have been linked to infection.
    • If your test is positive, we will prescribe a nasal ointment to use before surgery.

  11. Chlorhexidine Body Wipes
    • To use the night before surgery and the morning of surgery.
    • If your nasal swab is positive, you will need to use the wipes for 5 days.

  12. Pre-Admission Testing Appointment (PAT)
    • You will have a tele-visit with an anesthesia team member and have blood tests 1-2 weeks before your surgery.
    • You must attend this appointment or your surgery will be canceled.

  13. Telephone Call With Case Management
    • A nurse or social worker from the Case Management team will call you to discuss your insurance benefits and your plan of care after your surgery.

***Your total joint surgery cannot be done until you fulfill all requirements***

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