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 your bloodstream and travels to the new joint implants. This puts you at a higher risk of infection
Dental work includes:
- Abscesses
- Root canals
- Tooth extractions
- Planning or scaling
- Periodontal disease
Any dental concerns need to be taken care of before your pre-operative visit for your planned surgery. After surgery, do not go to the dentist for a routine checkup for 12 weeks.
During recovery
Antibiotics
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.
Activity
Your hip or knee should feel better quickly, even after just a few days. For 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 lower 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. Keep progressing 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. Follow the kneeling protocol in your discharge instructions.
You can start 6 weeks after surgery if you follow your precautions,
Do not bike, including stationary bicycle machines, until 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
People can do most of their normal activities 3 to 6 months after surgery. There are some your care steam still does not want you to do, such as:
- Contact sports
- Combat sports
- Jogging
- Running
Constipation
It can be caused by:
- Inactivity
- Narcotic pain medication
- Drinking less fluids than normal
You should have a bowel movement every 3 days. To help:
- Take a stool softener or laxative every day.
- 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 to have 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 for a temporary pass that lasts up to 3 months.
General questions
New joints often last 20 to 30 years. This is based on your age, weight, and activity level. Loosening of the joint can happen over time and may need surgery to fix.
If you have staples or sutures, they will be taken out at your 2 or 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 thinners before surgery, you will restart your normal medicine.
Some people have a clicking or 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.
If you follow the guidelines and restrictions, there is no concern about hurting it.
- Knee: Numbness on the inside and outside of the knee is normal and gets better with time.
- Hip: If you had a direct anterior hip replacement, you may have numbness on the front or side of the thigh. If you had a posterior hip replacement, you may have numbness along the incision line. \
If you have numbness after 1 year, it may last forever.
No.
No, these are meant for single use. The clinic has a disposal area for the vacs if needed.
Most patients get a walker as part of the cost of surgery. Some insurance companies may not cover the cost of a walker.
Before your surgery, we can set up a meeting with a social worker. They can talk with you about places you might want to go after surgery, like a rehab center or nursing facility. The final decision cannot be made until after surgery.
After surgery, our therapy team will evaluate you and see if you qualify for placement. If you do qualify, our hospital social work team will make referrals to the facilities you prefer that are covered by your insurance plan.
Occupational and physical therapy
Occupational therapy will teach you how to use a sock aid, shoehorn, and reacher (grabber). These will help you in your recovery. Most insurance companies do not pay for these.
Rest and let your body heal for the first couple of weeks. Do about 5 minutes of activity each hour, like walking or pumping your ankles. Listen to your body and be patient. If your hip or knee is swollen or painful you likely overdid it. You can lessen swelling and pain with icing, positioning, elevation, and medicine. Then, you can slowly progress your walking and exercises.
Walk and do exercises to straighten and bend your knee each hour you are awake. Start with 5 minutes of walking and exercise each hour for the first week. Try to walk farther each day until you reach a goal of 1 mile over the entire day. This often happens around 6 weeks after surgery.
- If you have an anterior hip replacement, there are no restrictions.
- If you have a posterior hip replacement, you will have restrictions. Follow your discharge instructions.
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
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. For the first few days at home, sleep on the
same level as the bathroom. It is okay to use stairs.
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 as needed. If you have trouble sleeping in a bed, a chair is okay. For the first few days at home, sleep on the same level as the bathroom. It is okay to use stairs.
Surgical dressing
Most dressings stay on for 2 weeks. Follow your discharge instructions on when and how to remove the dressing.
You can either:
- Pause it by pushing the large orange button on the pump box. Untwist the tubing connectors that join the pump to the dressing. Put the tubing near the white dressing and wrap both in Press N Seal® or Saran® wrap. Reattach
the PICO pump after your shower. Then, press the orange button to restart it. Make sure you see the green light flash. The box will vibrate while it removes extra air from the tubing and dressing.
OR - Take a bath from the sink for 1 week.