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What to Expect With Joint Replacement Surgery

To better help prepare you with your upcoming joint replacement surgery, here is a list of common questions of what to expect before, during, and after surgery.

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What to Expect Before Joint Replacement Surgery

Should I exercise before the surgery?

Yes, you should consult your surgeon and physical therapist about the exercises appropriate for you.

What if I live alone?

Several options are usually available to you. You may return home and receive help from a relative or friend. You can have a home health nurse and physical therapist assist you at home, or you may also stay at a sub-acute facility following your hospital stay depending on your insurance.

Will I need a second opinion prior to the surgery?

The office secretary will contact your insurance company to pre-authorize your surgery. If a second opinion is required, you will be notified.

How do I make arrangements for surgery?

After your surgeon has scheduled your surgery, the Memorial Hermann Joint Center Coordinator will contact you. The Joint Center Coordinator will guide you through the program and make arrangements for both pre-op and post-op care.

Will I need physical therapy when I go home?

Yes, we will arrange for a physical therapist to provide therapy in an outpatient facility two to three times a week to assist in your rehabilitation. The length of time required for this type of therapy varies with each patient. Find a physical therapy clinic near you.

What to Expect the Day of Joint Replacement Surgery

Patients must fast before arriving at the hospital for their surgery.

We reserve approximately 2-2 1/2 hours for surgery. Some of this time is taken by the operating room staff to prepare for the surgery.

Pain Management

You may have a general anesthetic, which most people call "being put to sleep." But most patients prefer to have a spinal or epidural anesthetic, which numbs only your legs and does not require you to be asleep. The choice is between you, your surgeon and the anesthesiologist.

You will have discomfort following the surgery, but we will try to keep you as comfortable as possible with the appropriate medication. Generally most patients are able to stop very strong medication within one day.  ­

Surgeon

Your orthopedic surgeon will perform the surgery. An assistant often helps during the surgery, and you will be billed separately by that assistant. 

What to Expect After Total Hip Replacement Surgery

Recovery after total hip replacement is different for each patient. Please discuss your individual needs with your physician.

Answers to some commonly asked questions are below.

Will I need blood?

You may need blood after the surgery: You may donate your own blood if you are able, use the community blood supply or have your relatives donate for you. Bank blood is considered safe, but we understand if you want to use your own.      ­

How long will I be incapacitated?

Moving around early is important to your healing and avoiding complications.  You will be getting up out of bed the evening of surgery and start moving short distances.  The following days you can expect to sit in a chair or recliner and should be walking with a walker or crutches twice a day.

How long will I be in the hospital?

Most hip patients will be hospitalized for two days after their surgery. There are several goals that you must achieve before you can be discharged.

How long until I can drive and get back to normal?

The ability to drive depends on whether surgery was on your right hip or your left hip and the type of car you have. If the surgery was on your left hip and you have an automatic transmission, you could be driving at two weeks. If the surgery was on your right hip, your driving could be restricted as long as six weeks. Getting "back to normal" will depend somewhat on your progress. Consult with your surgeon or therapist for their advice on your activity.

When will I be able to get back to work?

We recommend that most people take at least one month off from work, unless their jobs are quite sedentary and they can return to work with crutches. An occupational therapist can make recommendations for joint protection and energy conservation on the job.

When can I have sexual intercourse?

The time to resume sexual intercourse should be discussed with your orthopedic physician.

How often will I need to be seen by my doctor following the surgery?

You will be seen by your surgeon for your first postoperative office visit 1-2 weeks after discharge. The frequency of follow-up visits will depend on your progress. Many patients are seen at six weeks, twelve weeks and then yearly.

Do you recommend any restrictions following this surgery?

Yes, high-impact activities, such as running, singles tennis and basketball, are not recommended. Injury-prone sports such as downhill skiing are also restricted. Hip patients will be restricted from crossing their legs, twisting operated leg, bending 90 degrees at the hip or twisting side-to-side.

What physical/recreational activities may I participate in after my surgery?

You are encouraged to participate in low-impact activities such as walking, dancing, golf, hiking, swimming, bowling and gardening.

Will I notice anything different about my hip?

In many cases, patients with hip replacements think that the new joint feels completely natural. However, we always recommend avoiding extreme position or high-impact physical activity. The leg with the new hip may be longer than it was before, either because of previous shortening due to the hip disease or because of a need to lengthen the hip to avoid dislocation. Most patients get used to this feeling in time or can use a small lift in the other shoe. Some patients have aching in the thigh on weight bearing for a few months after surgery.

Will I need a private nurse?

No, you do not need a private nurse, but if you want one, we can make these arrangements for you.

Will I need a walker, crutches or cane?

Yes, for about four to six weeks we do recommend that you use a walker, a cane or crutches. The Joint Center Coordinator can arrange for them if necessary.

Will I need any other equipment?

After hip replacement surgery, you will need a high toilet seat for about three months. We can arrange to have one delivered to you, or you may rent or borrow one. You will also be taught to use assistive devices to help you with lower body dressing and bathing. You may also benefit from a bath seat or grab bars in the bathroom, which can be discussed with your occupational therapist. Other equipment needs (with instructions for use) will be arranged by the  Joint Center Coordinator.

Where will go after discharge from the hospital?

Most patients are able to go home directly after discharge.

Will I need help at home?

Yes, the first several days or weeks, depending on your progress, you will need someone to assist you with meal preparation, etc. If you go directly home from the hospital, the Joint Center Coordinator will arrange for a home health care nurse to come to your house as needed. Family members or friends need to be available to help if possible. Preparing ahead of time. before your surgery, can minimize the amount of help required. Having the laundry done, house cleaned, yard work completed, clean linens put on the bed and single portion frozen meals will reduce the need for extra help.

What to Expect After Total Knee Replacement

Recovery after total knee replacement is different for each patient. Please discuss your individual needs with your physician.

Answers to some commonly asked questions are below.

How long will my knee continue to hurt and swell?

The pain after joint replacement will usually decrease rapidly during the first month. Sometimes there is a dull ache after long walks; this may occur for up to 12 months. "Start-up" pain (pain with the first few steps after standing up) may be present for a while. This improves without treatment and does not mean that the implants are loosening or failing. "Noisy knees" are not usually a problem.

The swelling usually increases during the first few days home from the hospital. This is improved by spending one hour in the morning and one hour in the evening with the feet elevated above the heart each day. Swelling is generally worse in the evenings and is increased by exercise.

How much exercise should I do, and how can I tell if I have done too much?

Mild or moderate exercise is beneficial. Thirty to forty minutes, two times daily, should be devoted to straightening and bending the knee. It is important to put ice on the knee after these exercise sessions.

When should I drive?

Driving is an individual matter. Some people regain their coordination and reflexes quickly and others take several weeks. It is usually safe to drive short distances about a month after surgery, but an automatic transmission is required if the left knee was replaced. Driving should NOT be considered if you are still taking pain medication.

When can I take a shower?

Check with your surgeon to see how soon you can shower and what you should do to protect the wound.  Do not scrub the incision.  Do not soak the wound in a bath. Just let water run over the area and blot the incision dry.

Should I put lotion on my incision?

NO! Not until instructed by your doctor to do so.

What kind of shoes should I wear?

High heels should be avoided for the first three months. A well fitting, closed-toe, tie shoe is safest. A good example would be tennis shoes.

Should I wear support hose?

Surgical support stockings (TED hose) should be worn for six weeks after surgery.

Should I use a heating pad or ice packs?

Ice can be used to help relieve pain, but can be harmful if left on too long (more than 20 minutes). The use of heat is not recommended for six weeks after surgery.

How long should I continue taking my medications after surgery?

Blood thinning medications (Coumadin) should be taken for 4-5 weeks. All pain medications may be taken as directed for pain. If you have any questions about your medications, consult your doctor.

How much bend can I expect from my knee?

The average flexion is about 125°. However, there is nothing wrong if 125° is not achieved. Some people achieve more than average and some less.

Why does my new knee click?

This is normal and nothing to worry about. Approximately 70% of patients with new knees experience some kind of sound when they bend their knees.

How long will my knee feel hot?

Total knee patients can expect to feel warmth for 3-4 months after surgery. The heat is the body's indicator that healing is occurring.

How long will exercise therapy last?

This is dependent on your healing process but typically can include 3-4 weeks of physical therapy in the outpatient setting. Please discuss with your physician.

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