Answers about joint replacement

We've compiled some answers to questions you may have regarding your total joint replacement surgery and recovery. We are, of course, always happy to address any other questions or concerns you have about your specific case.

What is the recovery time for total knee and hip replacement surgery?

Everyone heals from total joint replacement surgery at a different pace. In most cases, however, you will likely use a walker for 2 weeks after your operation. You will then advance to a cane and wean to no assistive device at all. You will gradually return to normal function without any assistive devices. In general, most patients are close to full recovery after 3 months.

When can I shower (get incision wet) after joint replacement surgery?

You may shower 3 days after your operation. If no drainage is present at the incision, no protection of the wound is required. If there is drainage from the incision, try to keep it covered and dry while showering.

How long will I be on pain medication after total joint replacement surgery?

You will likely require some form of pain medication after your hospital stay. Initially, you will be on a strong oral pain medication (such as a narcotic). Most people are able to wean off of their strong pain medication after 1 to 2 months and are able to switch to an over-the-counter pain medication (such as Tylenol or ibuprofen). If you are on Coumadin (warfarin), Plavix, or other blood thinner, avoid taking any NSAIDs (e.g., aspirin, ibuprofen, Advil, Motrin, Aleve, Naprosyn) without first consulting your internist.

How long will I be in the hospital after total knee replacement surgery?

The length of time spent in the hospital varies from patient to patient. Average length of stay for a total knee or hip replacement is 1 to 2 days after surgery.

Will I go to rehabilitation or home after total joint replacement surgery?

It depends. Many people are able to go home after their operation. However, you may go to a rehabilitation hospital in order to gain the skills you need to safely return home. Many factors will be considered in this decision. These include availability of family or friends to assist with daily activities, home environment, safety considerations, post-operative functional status as evaluated by a physical therapist in the hospital, and overall evaluation by your hospital team. This decision is made at the hospital and “reservations” cannot be made ahead of time.

Do I need a CPM (continuous passive motion) machine after total knee replacement surgery?

You will likely use a CPM machine in the hospital. You will continue to use the CPM machine after you are discharged from the hospital for approximately 3 weeks or until you start outpatient therapy.

How long will I be on a “blood thinner” after total joint replacement surgery?

Typically, you will be on a blood thinner up to 1 month. The exact type and duration will be determined by your physician based on your specific medical history and risk. Of note, if you are on Coumadin (warfarin), it is extremely important to have your blood thinner level checked regularly and your Coumadin dose adjusted accordingly. This will be done by the home health nurse and relayed to Dr. Lux for adjustments in dose as needed.

I am constipated after total joint replacement surgery. What should I do?

It is very common to have constipation post-operatively. This may be due to a variety of factors, but it is especially common when taking narcotic pain medication. A simple over-the-counter stool softener (such as Colace) is the best prevention for this problem. In rare instances, you may require a suppository or enema.

When can I drive after total knee replacement surgery?

If you had surgery on your right knee, you should not drive for at least 1 month. After 1 month, you may return to driving as you feel comfortable. If you had surgery on your left knee, you may return to driving when you feel comfortable as long as you have an automatic transmission. DO NOT DRIVE IF TAKING NARCOTICS. Most important, do not take chances, and only resume driving if you are confident in yourself. It is recommended that you test your driving ability prior to driving in traffic.

When can I return to work after total joint replacement surgery?

When you can return to work after total knee replacement surgery depends on your profession. If your work is sedentary, you may return as early as 2 to 4 weeks post-operatively. If your work is more rigorous, you may require up to 3 months before you can return to full duty. In some cases, more time may be necessary.

Will I set off the machines at airport security after total knee replacement surgery? Do I need a doctor’s note about my surgery?

You may set off the machines at airport security, depending on the type of hip implant you have and the sensitivity of the security checkpoint equipment. A wallet card or letter is not helpful or required to travel.

Do I need antibiotics before dental work or an invasive procedure after total joint replacement surgery?

Yes. Antibiotic prophylaxis is recommendation for two years after your joint replacement surgery. Avoid any dental cleaning or non-urgent procedures for 6 weeks post-operatively.

I feel depressed after total joint replacement surgery. Is this normal?

It is not uncommon to have feelings of depression after your knee replacement. This may be due to a variety of factors, such as limited mobility, discomfort, increased dependency on others, and/or medication side effects. Feelings of depression will typically fade as you begin to return to your regular activities. If your feelings of depression persist, consult your internist.

What is a dislocation of the hip?

A dislocation of the hip occurs when the femoral head (ball) comes out of the acetabulum (socket). While this risk is very small, typically less than 2%, you are given dislocation precautions to help avoid this happening.

What are the dislocation precautions for my hip (positions I should avoid)?

You should avoid flexing (bending) at the hip more than 90°. Avoid low chairs and furniture because they require too much bending at the hip in order to get up. If you must reach to the floor when seated, always reach between your legs, not to the outside. Use an elevated toilet seat to avoid excessive bending of the hip. If possible, use a chair that has arms. The arms provide leverage for you to push up to a standing position. When sitting, position your legs so that you can see your inner thigh, calf, and foot (not the outside).

Who should I call with questions after total knee replacement surgery?

In the case of an emergency, call 911. For all other inquiries, call the office at 314-336-2555. After business hours, listen to the recording and follow the instructions. Calls will be returned as soon as possible.

NORMAL things about your new knee or hip:

  • Clicking noise with motion
  • Skin numbness on the outer (lateral) part of your knee
  • Swelling around knee or hip and/or lower leg
  • Warmth around knee or hip
  • "Pins and needles" feeling at or near incision
  • Dark or red incision line. This will gradually fade to a lighter color.
  • Bumps under the skin along the incision. Occasionally, the sutures used to close the wound can be felt
  • Bruising

ABNORMAL things about your new knee or hip:

Call the office immediately if you experience any of these:

  • Increasing redness, particularly spreading from incision
  • Increasing pain and swelling
  • Fever (>101° F)
  • Persistent drainage from your wound
  • Calf swelling or pain, particularly associated with ankle motion
  • Ankle swelling that does not decrease or resolve overnight
  • Bleeding gums or blood in urine/stool

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