At FWO, the surgeons typically follow-up with patients at 2-3 weeks post-op at the Grace Hospital Cast Clinic, then 2 months, 6 months, 1 yrs, 2 yrs and every 2 – 3 years after that with all appointments at the FWO Office.

The piece on the end of the femur is made out of Cobalt-Chrome, the piece in the top of the tibia is made out of Titanium, and the pieces in the middle and under the kneecap are made out of polyethylene.

The piece in the femur is made out of Titanium with a metal or a ceramic ball on it. The piece in the acetabulum is made out of Titanium with a polyethylene or ceramic liner inside of it.

Based on large international joint registry data, your total hip replacement has a 95% chance of lasting 15 years, and close to 90% chance of lasting 25 years. Based on the same data, your total knee replacement has a 90 – 92% chance of lasting 15 years, and approximately 80% chance of lasting 25 years.

All 5 of the FWO surgeons use hip restrictions on an as needed basis based on intra-operative assessment of the stability of your hip. Currently, hip restrictions are used on less 1% of our total hip replacements.

Currently the average length of stay for the 5 FWO surgeons is around 3 days for both total hip replacements and total knee replacements. However, a number of patients are going home the day of surgery, or on post-operative days 1 and 2. For this reason, we request patients have all arrangements in place in their home for an expected discharge date of post-op day 1 or 2.

The 5 surgeons of FWO routinely use Aspirin (ASA) for blood clot prevention following a total joint replacement. This is typically for 14 days following a total knee replacement and 35 days following a total hip replacement. If patients are a higher risk of blood clots, then patients will be given Xarelto in place of ASA.

Ideally dressings should be kept dry following your joint replacement unless your have a waterproof dressing which your nurse will indicate to you on discharge. Your dressing should be kept intact until you are seen for at your post-op appointment to have your staples removed or your wound assessed. Following your staple removal, you will be given a new dressing that you should keep dry for 48 hours, then remove it and you can then shower at that point.

All patients begin their physiotherapy while in hospital and following discharge. You will be given exercises to do once you are discharged. Most patients begin formal physiotherapy approximately 1 - 2 weeks following their surgery. This typically continues for 4 – 6 weeks post-op, or longer if needed. Within the WRHA, patients are required to pay for their own physiotherapy. Please ask your surgeon if you are looking for recommendations of a suitable physiotherapist.

All patients begin their physiotherapy while in hospital and following discharge. You will be given exercises to do once you are discharged. Many patients following a total hip arthroplasty are capable of recovering with no formal physiotherapy. However, if you feel as though you would benefit from this, then patients are invited to attend any physiotherapist they wish. Please ask your surgeon of you are looking for recommendations of a suitable physiotherapist.

Following most ankle fractures, patients are non-weight bearing for approximately 6 weeks in a backslab, cast or cast boot. If the x-ray at the 6 week mark shows not complications, then patients are typically weight bearing as tolerated in the cast boot for 4 weeks, then walking out of the boot at that point. Most patients following an ankle fracture do not require formal physiotherapy. This can be arranged if needed. Patients are typically discharged from care around the 10 week mark.

Following a shoulder fracture, most patients are treated in a collar and cuff for 3 – 4 weeks to allow the fracture to begin to heal. If the x-ray and exam at this point indicates the fracture is healing well, then patients typically begin physiotherapy then to work on range of motion and strengthening. At times, this may not begin until 6 – 8 weeks from the injury. Patients are typically discharged from care around the 12 week mark.

Following a distal femur or tibial plateau fracture, patients are typically non-weight bearing in a knee brace for at least 6 – 8 weeks. If the x-ray and exam at that point indicates no complications, the patients can typically begin range of motion and early weight bearing with physiotherapy. Patients are typically discharged from care around the 12 – 16 week mark.

Following a fracture of the foot, depending on the severity, patients are typically non-weight bearing, or weight bearing as tolerated in a cast boot or cast for a total of 6 weeks. If the patient had been non-weight bearing for 6 weeks, and the x-ray shows no concerning features, then the patient would usually be allowed to be weight bearing as tolerated in the cast boot for 4 weeks. If the patient was initially weight bearing in the cast boot for the first 6 weeks, and the x-ray shows the fracture healing, they the patient would typically be able to weight bear as tolerated in a normal shoe. Most patients are discharged from care around the 10 week mark.

Following a quadriceps or patellar tendon repair, patients are typically weight bearing as tolerated in a splint that keeps the knee out straight at all times, for at least 6 weeks. Flexion of the knee stresses the repair and runs the risk of stretching it out, or re-rupturing it. At the 6 week mark, patients typically begin physiotherapy to begin ROM and strengthening of the knee. Patients typically stay in their brace until physiotherapy is happy that the quads strength is sufficient to allow unprotected weight bearing. Patients are typically discharged from care around the 12 – 16 week mark.

Following an Achilles tendon injury, whether managed non-operatively or operatively, the surgeon of FWO follow well established Accelerated Rehabilitation Protocols. Patients are typically in a cast boot with heel wedges initially, for a total of 8 – 12 weeks, non-weight bearing initially and progressing gradually. The recovery is closely monitored by physiotherapy following closely a protocol provided by your treating surgeon. The total time in physiotherapy following an Achilles tendon injury is typically 4 -5 months. Patients are typically discharged from care around the 6 month mark.

Canadian Payers:

Manulife

Great West life

Sun Life

Sun Life Public

Desjardins

 Blue Cross (ON, BC, QC)

Equitable Life

The Co-Operators

Worker Compensation Board of Manitoba

Manitoba Public Insurance

If an insurer is not listed, this does not mean they do not offer coverage. This is a general guideline for major payers encountered on an average basis.

Coverage varies across plans.

Certain payers have limitations to coverage.