Important: COVID-19, Vaccines, & Visitor Policy

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Orthopaedic - Enhanced Recovery Surgical Innovation

Before Surgery (At Home)

Register for your Pre-op Joint Replacement Class

Pickup your Pre-op Joint Replacement Supplies

  • Joint Replacement Guidebook
  • Preop Skin Prep: CHG Wash Kit
  • Incentive Spirometer

Enhanced Recovery – Surgical Innovation Patient Education Packet

Pre-Admission Testing

  • You will need to undergo a history and physical and have blood work completed in order to be cleared for surgery.
  • We highly recommended GBMC’s pre-admission testing department; otherwise, this can be done by your primary care physician.
  • Visit GBMC's Ambulatory Testing Center for your MSSA/MRSA Surveillance Nasal Swab Test and your COVID-19 test.


  • We recommend you increase your exercise by at least 10% prior to surgery. You can do this by simply walking 30 minutes a day.
  • Your doctor may refer you to a physical therapist or an exercise program depending on your diagnosis and procedure.
  • An in-home pre-surgical assessment should be completed by a physical therapist prior to your admission.
  • Visit ActiveLife website.


Nasal Swab

  • During your visit in the surgeon’s office, a nasal swab screening will be completed to determine if you are positive for s. aureus.
  • If the nasal swab is positive for s. aureus, you will be instructed to use povidone-iodine nasal swabs in both nostril twice a day for five days prior to surgery to reduce the likelihood of developing a surgical site infection.

CHG/Hibiclens Wash or Theraworx Wash

  • You will be instructed to shower using CHG/Hibiclens wash three days prior to surgery and up to seven days after surgery.
  • If you are allergic to CHG/Hibiclens wash, you will be instructed to use a product known as Theraworx.
  • The solution kills bacteria on the skin that could cause a wound infection after surgery.
  • CHG Instructions
  • Hibiclens Intsructions
  • Theraworx Instructions

Deep Breathing Exercise and/or Incentive Spirometry

Before Surgery (Pre-Operatively)

CHG/Hibiclens or Theraworx Wipes

  • You will be instructed to use CHG/Hibiclens wipes or Theraworx wipes (if allergic to CHG) at the hospital in pre-op before surgery.
  • The solution kills bacteria on the skin that could cause a wound infection after surgery.

Pain Management

  • Pain will be addressed using oral medications that target several different pain receptors.

Warming Gown

  • You will receive a purple warming gown to keep you comfortable and help maintain your temperature through the surgical process.

During Surgery

Antibiotic Prophylaxis

  • Will be given within one hour of incision.

Standardized Anesthesia Care

  • Evidence-based, best practice recommendations will be used throughout surgery.
  • These standardized anesthetics will be focused on non-narcotic pain medications, and often utilizes local anesthetic pain blocks for the best possible pain relief.

After Surgery

Post-operative Pain Management

  • Pain will be addressed using oral medications that target several different pain receptors.


  • You should be out of bed and walking the day after surgery.
  • Daily ambulation goals will be set by the medical team and their completion encouraged by nursing staff.

Eating and Drinking

  • The day after surgery, we will place you on a clear liquid diet and encourage gum chewing as well as high protein supplements.
  • We will advance your diet with solid food as tolerated. Proper nutrition will allow for improved recovery and reduce your risk for surgical infection.
  • The goal is to get your diet advanced to solid food as quickly as we can, once you are medically able to.

Education Materials

Our Team

Leroy M. Schmidt, MD
Leroy M. Schmidt, MD
Physician Champion
Dominick A. Lanzo, MD
Dominick A. Lanzo, MD
Physician Champion
John Kuchar, MD
John Kuchar, MD
Anesthesia Champion
Kara Douglas, CRNA
Kara Douglas, MSN, APN, CRNA
Program Director
Tanika Thompson, DNP, RN, NEA-BC, CPHQ
Tanika Thompson, DNP, RN, NEA-BC, CPHQ
Clinical Program Manager
  • James C. Johnston, MD
  • Stewart L. Koehler, MD
  • Todd M. Melegari, MD
  • Peter Jay, MD
  • David P. Buchalter, MD
  • James L. Huang, MD
  • Gurminder S. Ahuja, MD
  • April Asuncion Higgins, RN (Joint Program Manager)
  • Brittany Boyce (ECIP Program Manager)
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