Follow any restrictions or precautions your surgeon may have given to you. See your discharge instruction sheet and be sure to follow instructions regarding showering and dressing changes.

General post-op expectations

  • At home you should expect to mostly care for yourself, allowing family members and friends to handle caring for the home and driving duties.
  • Surgeons will clear you to drive, usually after a few weeks when you are no longer taking prescription pain medication and are consistently moving around much better.
  • It is normal to use a walker for one to two weeks following surgery, transitioning to a cane as decided by your therapist or walking program. (Do as your surgeon directs.) Formal therapy, if required, can last for six to eight weeks depending on individual patient recovery.
  • Use a cane for longer than you think you need to! It will assist with stability and balance.
  • Swelling and bruising can last for longer than you think it should (several weeks).
  • Muscle tenderness and soreness for several months is normal. It will remind you that your joint was replaced as you recover.
  • The greater majority of your physical function typically returns in the first month. Therefore, focusing on recovery in that first month is important! For an optimal recovery, it is important to follow both surgeon and therapy instructions.

Tips for sitting

  • Use a comfortable chair with armrests and a firm seat (soft and low are hard to get out of).
  • Do not sit for more than 45 minutes at a time.
  • Elevate your legs frequently.

Tips for walking/exercise

  • Get moving. Exercise prevents blood clotting, stiffness and swelling.
  • Walk frequently but not long distances.
  • Walk on flat surfaces and wear good shoes.

Tips for pain relief

  • Take pain medication 45 minutes before physical therapy (PT) sessions.
  • Use ice at least two to three times per day for the first two weeks to limit swelling.

Tips for lying down/sleeping

  • Consider lying down twice daily. Rest is important!
  • Be patient. Sleeping may be hard for a while after surgery.
  • Use a pillow between your legs when sleeping on your side. Remember: Do NOT sleep with a pillow underneath your knee.

Tips to prevent infection

DO

  • Sleep well, rest, eat a healthy diet and stay hydrated.
  • Take proper care of your incision. Keep clean, dry and protected.
  • Identify any open skin irritations, infections (urinary tract, respiratory, etc.) or fevers as early as possible.
  • Wipe down cell phones with alcohol. These high touch items can transmit a lot of bacteria from hand to hand, especially if the phone is used in the bathroom.
  • Practice good personal hygiene.
  • Keep your home environment clean (linens, sheets, bathrooms).

DO NOT

  • Do not use lotions or powder.
  • Do not touch your incision or skin without washing hands first.
  • Wear artificial nails. Artificial nails harbor bacteria and can spread infection.
  • Swim or get into a hot tub during the post-op period. Ask your doctor how long to wait before resuming these activities.
  • Do activities that increase risk of injury or falling.
  • Drink alcohol or take medications that may impair judgment or coordination.

Tips for being around pets

  • Keep pets clean.
  • Keep pets away from incision site.
  • Always wash hands after contact with pets.
  • Do not sleep with pets for four weeks during the post-op period.

Keep in mind that some domestic pets have organisms like MRSA which can be transmitted to humans.

Take a proactive approach to prevent infection

Notify your physicians and dentist. Let them know you’ve had a total joint(s) replacement and to update your medical history.

Take prophylactic (preventive) antibiotics prior to any invasive procedure, including teeth cleanings and colonoscopies. Your surgeon will give you more information regarding how long to continue taking the antibiotic.

The use of anticoagulants

Your surgeon will choose an anticoagulant (blood thinner) for you. Anticoagulants are safe and effective if taken according to your orthopedic surgeon’s instructions. However, if you fall, have a traumatic injury, or experience any of the following, call your orthopedic surgeon immediately.

  • Bleeding or oozing from your surgical site
  • Bleeding at the site of the injection
  • Nosebleed
  • Blood in your urine
  • Coughing or vomiting blood
  • Excessive bleeding when brushing your teeth
  • Spontaneous bruising (a bruise not caused by a blow or any apparent reason)
  • Pain or swelling in any part of your leg, foot or hip
  • Dizziness, numbness or tingling
  • Rapid or unusual heartbeat
  • Chest pain or shortness of breath
  • Vomiting, nausea or fever
  • Confusion

Things to avoid while on anticoagulants

Certain medications, food and activities can interact negatively with anticoagulants. Check with your primary care physician or orthopedic surgeon before taking any over-the-counter drugs like aspirin, aspirin-containing compounds, nonsteroidal medications and even vitamins.

You should also avoid or postpone:

  • Drinking alcohol
  • Using a straight-edge razor
  • Getting a procedure (such as dental work) that may cause bleeding*
  • Doing activities that may result in an injury that could break the skin (e.g., using power tools or sharp instruments/objects)

*If it is not possible to postpone a procedure, be sure that your dentist or physician is aware that you are taking anticoagulants and that you have had a recent joint replacement surgery.

Recognizing and preventing potential complications

Blood clots

Your chance of developing a blood clot is minimal if you follow your orthopedic surgeon’s instructions and take your anticoagulation medication as prescribed, wear compression stockings (if your surgeon prescribes them), and exercise as directed.

Be aware of these warning signs and call your surgeon right away if there is:

  • Increased swelling in your thigh, calf or ankle that does not go down when your feet are elevated above heart level
  • Pain and tenderness in the calf of either leg
  • Increased warmth or redness in either leg

Do not take a “wait and see” approach with the above symptoms. Call your surgeon immediately.

Pulmonary embolus

A pulmonary embolus (PE) occurs when a blood clot breaks off inside a vein and travels through the blood into the lungs.

Call 911 immediately if you experience:

  • Sudden chest pain
  • Difficult and/or rapid breathing
  • Shortness of breath
  • Sweating
  • Confusion

A PE can be life threatening. Do NOT take the time to call your orthopedic surgeon.

Call 911 immediately.

Infection

Infections, although rare, do sometimes occur after surgery. It is important to be aware of any of the following changes in your incision(s):

  • Increased swelling and redness
  • Increased drainage or discharge that changes color or has an odor
  • Surrounding skin that is hot to the touch
  • Increased pain in your knee, not associated with exercise
  • Night sweats or fever greater than 101 degrees

If you experience any signs and symptoms of blood clotting or infection, call your surgeon immediately.