At Home Tips for Joint Replacement
Preparing for joint replacement surgery
Follow restrictions or precautions your surgeon may have given to you. See your discharge instruction sheet and follow instructions regarding showering and dressing changes.
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.
Also keep in mind:
- 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.
- Much 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.
Postoperative patient information/education for hip and knee replacements
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.
- Follow your surgeon's recommendations on walking distances and frequency.
- Walk on flat surfaces and wear supportive shoes.
Tips for pain relief
- Take pain medication as needed 45 minutes before any home activity or exercise program.
- Use ice at least two to three times per day for the first two weeks to limit swelling and help with pain. Use ice for 15 to 20 minutes, then wait at least an hour before using again if needed.
Tips for nutrition (bowel function)
Eating well can help you feel better as you recover! Taking in enough water and natural fiber (fruits and veggies) can keep your bowels functioning properly. Continue to take same medication for constipation until you are no longer taking pain medication.
Tips for lying down/sleeping
- Consider lying down twice daily. Rest is important!
- Be patient. Sleeping may be hard for a while after surgery.
- Do NOT sleep with a pillow underneath your knee if you've had a knee replacement.
Tips for surgical incision care
Your incision may be closed with dissolvable stitches, staples or regular stitches. If you have visible stitches or staples, these will need to be removed in about 14 days after surgery, so be sure to make your follow-up appointment with your surgeon for this to happen.
While at the hospital, you'll wear a protective dressing. Once at home, follow surgeon's instruction if a dressing is needed. Do not apply any ointments or lotions to the incision area while it's healing.
YOU MAY NOT BATHE IN A TUB, SWIM OR USE A HOT TUB UNTIL YOUR INCISION IS FULLY HEALED.
If you:
- Notice any increased drainage, redness, or swelling
- Have a fever of 101 or greater
- Are unable to maintain your pain goal or have increasing pain, numbness or tingling, muscle weakness
- Have difficulty with swallowing or breathing
- Are unable to control your bowel or bladder
Please call your surgeon's office immediately or go to the emergency room.
Tips to prevent infection
Take a proactive approach to prevent infection
Notify your physicians and dentist. Let them know you've had hip or knee surgery and to update your medical history.
Take prophylactic (preventative) antibiotics prior to any invasive procedure, including teeth cleanings, if your surgeon recommends. Your surgeon will give you more information regarding how long to continue taking the antibiotic.
DO:
- Eat a healthy diet and stay hydrated.
- Keep your incision clean, dry and protected.
- Notify your doctor right away of open skin irritations, infections (urinary tract, respiratory) or fevers.
- Practice good hygiene, wipe down cell phones with alcohol, and keep your home clean (linens, bathroom).
- Keep pets clean and away from incision site, and wash hands after coming in contact with pets.
DO NOT:
- Use lotions or powder
- Touch your incision without washing hands first
- Wear artificial nails
- Swim or get into a hot tub
- Sleep with pets for four weeks after surgery
Be sure to ask your doctor when you can continue with these activities.
Tips for being around pets
- Keep pets clean and away from incision site.
- Always wash hands or use hand sanitizer after contact with pets.
- Do not sleep with pets during the post-op period. Some domestic pets have organisms like MRSA which can be transmitted to humans.
Use of anticoagulants
Your surgeon might prescribe a blood thinner (anticoagulant) to prevent blood clots. This can be an Aspirin or—as necessary—a stronger anticoagulant. While safe when taken as instructed, blood thinners can cause bleeding if you fall or have an injury.
Call your surgeon immediately if you experience bleeding from anywhere (e.g., urine, surgical site, nose, etc.) Please also notify your surgeon if you have the following:
- Oozing from the surgical site
- Painful swelling in your leg, foot or hip
- Dizziness, numbness or tingling
- Rapid or unusual heartbeat
- Chest pain or shortness of breath
- Vomiting, nausea, fever or confusion
Things to avoid while on anticoagulants
Over-the-counter drugs like aspirin-containing compounds, nonsteroidal medications (e.g., ibuprofen or Aleve) and vitamins can interact with anticoagulants and cause bleeding. Avoid these products while on a blood thinner.
For similar reasons, you should also avoid or postpone the following:
- Drinking alcohol
- Using a straight-edge razor
- Getting a procedure (e.g., dental work)*
*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 hip or knee surgery.
Recognizing and preventing potential complications
Blood clots
Do not take a "wait and see" approach. Call your surgeon immediately if you experience the following signs of a blood clot:
- 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
Wear compression stockings (ONLY if your surgeon prescribes them) and exercise as directed.
Infection
While rare, call your surgeon immediately if you notice the following signs of an infection:
- 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 incision, not associated with exercise
- Night sweats or fever greater than 101 degrees
Blood clot in lungs (pulmonary embolus or PE)
A pulmonary embolus is a blood clot that has traveled to your 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 orthopaedic surgeon.
Call 911 immediately.