Musculoskeletal Sunnybrook Magazine Sunnybrook Magazine - Fall 2019

Behind the scenes: Preparing for hip/knee surgery

OR for hip and knee surgery

Every year, nearly 2,500 patients leave Sunnybrook’s Holland Bone and Joint Program with a new knee or hip replacement. This dedicated focus on joints makes the site one of Canada’s highest volume centres, requiring an extremely efficient system.

“Some people call us a well-oiled machine, but that seems very impersonal,” says operating room patient care manager Helen Vandoremalen. “I like to consider our team a well-tuned orchestra playing off the same page. The result is more harmonious as our goal is to provide excellent patient outcomes and high patient satisfaction.”

The team at the Holland Bone and Joint Program has implemented several innovative models of care. Most patients are spared a general anesthetic and given a regional instead. This helps reduce complications and gets patients back on their feet more quickly. A highly-skilled interprofessional team helps ensure smooth patient flow.

Recently, donor support has expanded and modernized the function of the operating rooms. “There is a continued high demand for knee and hip replacements, so having highly efficient spaces has increased our capacity and efficiency,” says Dr. John Murnaghan, orthopaedic surgeon and medical director of the Holland Centre.

Here, Holland Centre experts share what it takes to prepare a patient and operating room space for each procedure.


1. Each room is cleaned and prepared to meet strict aseptic (contamination-free) standards.

OR getting cleaned


2. A nurse checks the patient into the “block” area, where they meet with the anesthesiologist and the patient receives a regional anesthetic. This type of localized pain control reduces complications after surgery and allows patients to mobilize and go home more quickly.

A nurse checks the patient into the “block” area


3. The operating room is prepared. Between 8 to 13 instrument pans – each containing about 40 surgical instruments – are needed for each surgery.

Instrument pan in the OR


4. When the patient is brought into the operating room, the team reviews the surgical safety checklist together. Checking all the relevant details of each case is a critical step, reducing the risk of any adverse events. The patient is carefully positioned for surgery, which will take one to two hours to complete.

Patient in the OR


5. The surgical team verifies the size and type of components for the replacement joint, which is different for every patient. It’s one of many checks and balances that ensure safety and the best possible outcomes.

Team verifies replacement joints for patient in OR

About the author

Monica Matys

Monica Matys is a Communications Advisor at Sunnybrook.

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