Hip & Knee Arthritis Surgical Assessment Program (ASAP)

As part of the surgical triage process for knee and hip osteoarthritis, you may see an ASAP advanced practice physiotherapist before you see an orthopedic surgeon. Your visit will take approximately 30 minutes. The purpose of your visit is to obtain your medical history, a complete medication and supplement list and a history of your painful joint. The therapist will also perform an assessment of your hip or knee joint. 

The APP will help you determine if speaking to a surgeon about joint replacement is right for you.  You may also discuss non-surgical treatment strategies for osteoarthritis or how to optimize yourself for potential joint replacement surgery.

Pre-Op Class for Knee and Hip Replacement Surgery

The ASAP physiotherapists teach the Vancouver Coastal Health Hip and Knee Pre-Op Class. This is a mandatory class for patients having hip or knee replacement surgery.  You will receive an invitation to attend a class one to five weeks before your surgery date. The class lasts about one hour and you may attend in person or virtually. There will be an opportunity to ask questions during or after your class.  If you have other questions or concerns, you may contact the ASAP clinic afterwards.

If you have not been contacted 2 weeks before your surgical date, please email ASAP at asap@vch.ca.

• Vancouver:  asapubc@vch.ca
• Richmond: rhasap@vch.ca
• North Vancouver: lghasap@vch.ca

Equipment

All of this information is covered in the Hip and Knee Pre-Op class. Your hospital stay after surgery will be short, so it is important to prepare your home and get any necessary equipment before your surgery.

Before Surgery:

1. Set up your home
Move any items that could make you trip (e.g. area rugs, cords) as you move through your home with your walking aid. Ensure that your stairs have railings. Prepare your meals in advance; stock up on instant, easy-to-prepare food, or arrange for meal delivery

2. Raise sitting surfaces to 2" above the height of your knee
For hip surgery patients with precautions, sitting on a higher surface is essential.
For people having knee surgery or hip surgery without precautions, a higher surface makes it easier for you to get up and down.

3. Get equipment one week before surgery
During the Hip and Knee Pre-Op class, you will learn about what equipment you need before your surgery.

Recommended Equipment for Walking:

• 2 wheeled walker (NO 4-wheeled walkers)
• Crutches

Recommended Bathroom Equipment:

• Raised toilet seat or commode
• Shower chair or tub transfer bench
• Non slip bath mat

Recommended Equipment for dressing (especially for those with hip precautions):

• Extra-firm cushion (4” x 16” x 18”)
• Long-handled shoe horn
• Long-handled reacher
• Sock aid

Recommended cold therapy for total knee replacements:

Ensure you have one of the following:  Crushed ice, gel packs, frozen peas or a Cryotherapy machine

4. Figure out how you will get home after surgery

Look at the following link if you are travelling out of town. If you are travelling from out of town learn more about travel and accommodations

5. Identify who will stay with you after surgery

If possible, arrange to live on one level and have a family member or friend stay with you for the first three days after surgery. This is especially important if you live somewhere that has multiple stairs.

6. Prepare for your hospital stay

Learn more about how to prepare for your hospital stay.

Where you can get equipment

• Borrow from family or friends.
• Rent or purchase from medical supply stores.
• You may be able to purchase walkers or crutches from the inpatient unit when you are in the hospital if you are unable to obtain them before your surgery.
• Canadian Red Cross (for individuals with financial need) –Please contact your family doctor or local ASAP for more details.

Sitting - Guidelines on sitting and appropriate seating after hip or knee surgery. Demonstrates the use of a foam cushion and how to sit and stand up from a chair after hip or knee surgery.

Chair height - Guidelines for seating height after hip or knee surgery. Demonstrates the use of a foam cushion and how to sit and stand up from a chair after hip or knee surgery.‎

Walking with a standard walker - Demonstrates how to walk with a standard walker after hip or knee surgery. Demonstrates how to adjust height of walker.

Walking with a two-wheeled walker - Demonstrates how to walk with a 2 wheeled walker after hip or knee surgery.

Walking with crutches - Demonstrates how to walk with crutches after hip or knee surgery. Demonstrates how to adjust crutch height.

Going up and down stairs with crutches - Demonstrates going up and down the stairs using crutches after hip or knee surgery.

Getting in and out of bed - Demonstrates how to get in and out of bed after hip or knee surgery.

Getting in and out of a car - Demonstrates how to get in and out of the car after having hip or knee surgery while maintaining hip precautions. Demonstrates how to set up seat in car using foam cushion.

Getting dressed using a long-handled reacher - Shows how to put on and take off pants while sitting after hip or knee surgery using a long handled reacher.

Using a sock aid - Demonstrates how to put on socks using a sock aid and how to take off socks using a long handle shoe horn.

Sitting on a toilet - Demonstrates using raised toilet seat with the option of either arm rests or a toilet safety frame. Demonstrates how to sit down and stand up from the toilet using the raised toilet seat after hip or knee surgery.

Bathing, using a tub transfer bench - Demonstrates the use of a tub transfer bench to get in and out of the bathtub after having hip or knee surgery.‎