top of page

Overview

FOR PROVIDERS

General Guidelines

     Exceptions may be made for below requirements in individual scenarios (based on surgeon approval)

​

  •    Hemoglobin A1c <8.0  (this goal may be higher in elderly/ fragile patients)

  •    SBPs<160s  DBP<100

  •    Stable kidney disease (unchanged creatinine over 6 months)

  •    Stable cardiopulmonary disease (no new dyspnea, cough, worsening exercise tolerance, weight      gain, edema, angina, syncope, brady- or tachyarrythmias…etc)

  •    No recent fever or infections (pneumonia, UTI, URI, cellulitis…etc.)

  •    BMI<40

  •    Sobriety from EtOH and illicit substances > 6 months

  •    Tobacco cessation > 4 weeks

  •    Social supports and stable housing  

​​

​

Illicit substances & Tobacco (heroin, non-prescribed opiates or benzodiazepines, methamphetamine, cocaine, excessive alcohol…etc.)    Use of illicit substances can make surgery and general anesthesia deadly.  Patients using these must be sober and clean for 6 months prior to surgery and have random monthly screening tests through PCP prior to surgery.

​

 

We ask that patients stop smoking at least 4 WEEKS prior to surgery.  Please reiterate the association of smoking with delayed wound healing, worse surgical outcomes and increased complications.  Because most our procedures are elective, this is a unique opportunity for patients to make the commitment to stop smoking.  We are happy to assist with finding local resources to achieve this. 

Other things to know:

  •  Patient should NOT drive self to surgery

  •  Patient must have an established and stable residence

  •  Opiates:  post-op opiates for pain will be prescribed/renewed by SFVA orthopedics for 90 days only. If patients require prolonged pain medication it will be at the discretion of their PCP or in consult with pain management. If patients are on opiates pre-operatively it will improve their outcomes and postoperative pain if they can decrease their opiate use prior to surgery.

 

Helpful tools to talk with your patient about surgical risk and how to prepare

bottom of page