Before Admission
Dental exam
Why do I need a dental exam before surgery?
Your mouth has a lot of bacteria. As the dentist is working on your mouth that bacteria gets into the blood stream. Then it likes to travel to the new joint implants. This puts you at higher risk for infection.
Dental work includes:
- Abscesses
- Root canals
- Tooth extractions
- Planning or scaling
- Periodontal disease
Any dental concerns your dentist has need to be taken care of before your pre-op appointment for your planned surgery. After Surgery, do not go to the dentist for a routine checkup or have a colonoscopy for 12 weeks.
During Recovery
General questions
New joints often last 10 to 20 years. This is based on your age, weight, and activity level. Loosening is the major long-term problem. You may need surgery to fix this.
If you have external staples or sutures, they will be removed at your 2-3 week follow up visit if the site is well healed.
You will take blood thinners as prescribed by your surgeon. This is often for 4 weeks after surgery. If you were taking blood thinner before surgery, you will restart your previous medicine.
Some people have a clicking or a clunking sound after their total knee replacement. Your replaced joint is made from plastic and metal. The parts moving against each other make the sound you are hearing. This should go away within 1 year.
If you follow the guidelines and restrictions, there is no concern for hurting it.
Numbness on the inside and outside of the knee is normal. It will get better with time. If you have numbness after 1 year, it will likely be forever.
No.
Activity
Your hip or knee should feel better quickly, even after just a few days. The first 6 weeks, progress your activity as tolerated. The only exercise should be walking and what your care team teaches you.
Hips. Walking is the best exercise Listen to your hip, especially in the first 12 weeks. Do not do activities that cause pain. Your care team will show you a list of guidelines to lessen the risk of dislocation. After your 12-week visit you should be able to do all normal activities.
Knees. Your knee will be sore. It takes time to strengthen. Listen to your knee. Progress with walking and range of motion as tolerated for the first 6 weeks. After your 12-week visit you should be able to do all normal activities. Most people say it is hard to kneel after a knee replacement. See the kneeling protocol in your discharge instructions.
6 weeks after surgery if you follow precautions.
No bike or exercise machines until after your follow-up visit.
Most people can do normal activities within 6 weeks after surgery. Other sports you may enjoy are:
- Biking
- Dancing
- Elliptical
- Fishing
- Gardening
- Low impact aerobics
- Tennis
- Walking
- Water aerobics
Acceptable | Do Not Do |
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Occupational and physical therapy
Occupational therapy will teach you how to use a sock aide, shoehorn, and reacher (grabber). These will help you in your recovery. Most insurance companies do not pay for these. They will be an out-of-pocket expense.
Rest and let your body heal the first couple of weeks. Do about 5 minutes of activity each hour. This includes walking and pumping your ankles. Listen to your body. Progress as able but be patient. If your hip or knee is swollen or painful you likely overdid it. Do not worry. Lessen swelling and pain with icing, positioning, elevation, and medicines. Then slowly progress walking and exercises.
Walk and do an exercise to straighten and bend your knee each hour you are awake. Start with 5 minutes of walking and exercise each hour the first week. Try to walk farther each day until you reach a goal of 1 mile over the entire day.
If you have an anterior hip replacement, there are no restrictions. If you have a posterior hip replacement, you have restrictions. When bending forward, keep your hands between knees. Do not twist at your waist to reach outside the knees with your hands.
The Kinex person will deliver and teach you how to use it. They are often in the hospital between 9 and 10 a.m. Try to have a support person with you to also hear these instructions.
Surgical dressing
It often stays on 2 weeks. Follow your discharge instructions on how to remove the dressing. Some providers have you remove it at home. Others will remove it at your 2-week follow-up visit.
During the first week, before the PICO battery is removed, you have 2 choices.
- Pause it by pushing the large orange button on box. Release the box and tubing using the luer lock. Put the tubing near the white dressing. Wrap both the dressing and tubing in Press N Seal® or Saran wrap. Reattach the PICO box after your shower. Then, press the orange button to restart vac therapy. The box will vibrate while it removes extra air from the tubing and dressing.
- Take a bath from the sink for the 1 week.
Antibiotic
Bacteria likes to travel to the new joint. Tell your providers you had a joint replacement before any invasive procedures. Take an antibiotic 1 hour before any:
- Dental work
- Surgery
- Treatment
You will be given a prescription with refills for 1 year at a time. This is for the rest of your life.
Constipation
It can be caused by:
- Inactivity
- Narcotics
- Drinking less fluids than normal
You should have a bowel movement every 3 days. To help:
- Take a stool softener or laxative daily.
- Drink plenty of water.
- Eat foods high in fiber.
Stop taking the stool softener or laxative when you have normal bowel movements.
Driving and parking
It can help having a parking pass (handicap sticker) for the first few weeks. However, you need to walk as much as possible during your recovery. Let your care team know if you feel you need a handicap parking pass. Your provider will write a letter you can take to the Department of Motor Vehicles. This is a temporary pass for up to 3 months.
Showering and dressing
You may shower when you feel able. This is often when you are home. Use Glad Press N Seal® or Saran® wrap to cover your dressing or incision. Do not soak your incision in a bathtub, hot tub, pool, or body of water for 6 weeks.
Sleeping
Knees: It is best to sleep on your back with a pillow under the heel of the surgical leg to keep your knee straight. You can lay on your side with a pillow between your knees if needed. If you have trouble sleeping in a bed, a chair is okay. The first few days at home, sleep on the same level as the bathroom. It is okay to use stairs.
Hips: It is best to sleep on your back or the side opposite your hip replacement. Do not lie on the incision for 1 month. If you have trouble sleeping in a bed, a chair is okay. The first few days at home, sleep on the same level as the bathroom. It is okay to use stairs.