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A Patient's Guide to Hip and Knee Replacement Surgery

Being prepared for what to expect before, during, and after joint replacement surgery will help make it a less intimidating experience. The following is an overview of what to expect and tips to prepare yourself for surgery, as well as your home for a successful recovery.

Preparing Your Home

  • If you live in a multi-story home, make sure everything you need is easy to get to and on the same floor where you will spend most of your time. If there is not a bathroom on that floor, make arrangements to have a portable toilet.
  • Make sure your bed is low enough so your feet touch the floor when you sit on the edge of the bed.
  • Place items you will need within reach without having to stand on your tiptoes or bending low.
  • Make sure you can easily get to or reach your phone.
  • Make sure you have a reliable thermometer.
  • For at least the first week, you will need help standing, using stairs, bathing, dressing, and other household chores. It is recommended that a friend, family member, or someone from a home health service be available to help you when you go home from the hospital.
  • Since you will not be able to drive, make arrangements for someone to help with your grocery shopping and other errands.
  • The following items may be useful to have when you go home from the hospital: a long-handled shower sponge; crutches or a walker; a long-handled "grabber" to help you reach things; and handle bars in the bathroom to help you steady yourself. Also, make sure that your bathtub or shower has a nonslip mat or decals.
  • Remove throw rugs, which can be tripping hazards.

One Week Before Surgery

  • Visit your primary care physician for a preoperative exam and clearance, including blood work, an EKG, chest x-ray, and urine analysis.
  • Go to your pre-op appointment with your orthopedic surgeon, who will review the details of your procedure with you. Be ready with any questions you may have about your surgery and recovery process.
  • Discontinue any blood-thinning medications and/or any nonsteroidal, anti-inflammatory drugs (NSAIDS) 10 days before surgery.

Day of Surgery

  • Do not eat or drink anything after midnight.
  • When you get to the hospital, an IV will be started by a nurse when you are in the pre-operative holding area. You will also be given pain medication.
  • You will be given antibiotics one hour before surgery.
  • You will meet your anesthesiologist, who will ask you some questions and talk to you about the type of anesthesia to be used during your procedure.

After Surgery

  • Your hospital stay will typically last 2 to 3 days. You will receive physical therapy each day.
  • You will be given antibiotics for 24 hours after surgery.
  • Pain medication will be available to help keep you comfortable.
  • If you had knee surgery, you should wear your knee immobilizer at night for the first few days, or when walking until you are able to perform a straight leg raise. Most patients are able to discontinue use of the immobilizer in about a week.
  • Your bandage will be changed daily for about a week.
  • You will be given a blood thinner, and compression devices will be placed around your lower legs to help prevent blood clots.

After Hospital Discharge

  • Although most patients go home after 2 to 3 days, some patients will be advised to go to a rehabilitation facility for 7 to 10 days.
  • You will receive physical therapy at home.
  • If you had knee surgery, ice your knee 3 to 4 times a day; keep the ice on your knee for 20 minutes each time.
  • Continue to take your blood thinning medication for several weeks after surgery.
  • If you are prescribed a blood-thinning medication such as warfarin, a home health nurse will visit you twice a week to draw your blood and monitor the warfarin level.

When to Call the Doctor

Call the Hip & Knee Institute if you experience any of the following:

  • Fever greater than 101.5 degrees Fahrenheit
  • A sudden increase in pain
  • Excessive drainage from your incision
  • Unusual redness, warmth, or swelling around the incision
  • Calf pain and marked swelling in the leg
  • Chest pain or shortness of breath

Precautions for Patients Who Have Undergone a Posterior Hip Replacement

  • Do not bend over too far when standing — no more than a right angle (90 degrees).
  • Do not raise your legs or thighs more than 90 degrees.
  • Do not raise your hip more than 90 degrees, even when sitting or lying down.
  • Do not roll your leg inward, especially when turning on your side or turning in bed

Antibiotics and Dental Work after Joint Replacement Surgery

  • Amoxicillin (2 grams) should be taken 1 hour before any dental work
  • If you are allergic to penicillin, an alternative antibiotic will be prescribed
  • Avoid any dental cleaning and non-urgent dental work for 6 weeks after surgery

Follow-Up Appointments

It is very important that patients attend all of their follow-up appointments with their orthopaedic surgeon after surgery. Appointments should be made at the following times:

  • 10 to 14 days after surgery
  • 6 weeks after surgery
  • 3 months after surgery
  • 6 months after surgery
  • 1 year after surgery
  • Once a year thereafter

Questions? Call us at 818.708.9090