Frequently Asked Questions About Total Joint Replacement

This information should serve as a guide for you. As this is general information, your orthopaedic surgeon, based on the specific nature of your surgery and general overall health, may modify your own care after surgery.

 

Introduction to Total Joint Replacement

What is total joint replacement?
Joint replacement is an operative procedure where the surgeon removes or resurfaces both sides of a joint and replaces it with an artificial implant (prostheses) that is attached to the bone. Joint replacement is performed to alleviate pain and stiffness in the joint and restore quality of life. back to list

Why do some people need joint replacement?
In osteoarthritis, the soft cartilage at the ends of the joint bones breaks down and wears away over time. Eventually the bones rub together and pain occurs. In rheumatoid arthritis, changes occur in the joint fluid that destroys the cartilage. Trauma to the joint can cause the bone and cartilage in the joint to not heal properly and the surfaces can rub together causing pain and stiffness. Joint replacement may be recommended when other treatment no longer provides relief. back to list

How do I know when I will need joint replacement?
This will be a decision only you can make, with the help of your orthopaedic surgeon’s evaluation of your pain and its effects on your quality of life. It may be recommended to not only relieve your pain but also prevent the disability it can cause you. back to list

Before Surgery

Once I decide to have joint replacement surgery, what will I need to do before surgery?
A surgical scheduler at our office will lead you through the process.

You will see your medical doctor to get surgery clearance and/or have a history and physical at our office. You will have an appointment with the hospital to have a health assessment and preoperative tests, such as blood work and electrocardiogram (EKG). You will be asked to stop certain medications such as aspirin or other blood thinners at least one week in advance of your surgery. back to list

How can I get more information on my surgery?
We offer a free group class at our office that you can attend that will educate you about joint replacement surgery and allow you the opportunity to ask questions. Patients have found it to be helpful in preparing them for surgery. Contact the surgical scheduler if you are interested in signing up for the class or click here to e-mail us about your interest. back to list

Your Hospital Stay

What can I expect during my hospital stay?
The hospital recovery period is typically 3-4 days depending on how you are progressing. Surgery takes about 2-3 hours and then you will be in the recovery room for a couple of hours. Most of your recovery will be on the orthopaedic floor. Physical and occupational therapy will begin the day after surgery. A discharge planner will work with you and your family to determine your specific needs after discharge. You will be started on a blood thinner, Coumadin or aspirin, that will continue for a period of time after your discharge. This will aid in the prevention of blood clots. back to list

How ambulatory will I be in the hospital?
In most cases you will be able to bear weight on your operative leg with the assistance of a walker or crutches. Stair climbing will be a part of your therapy while in the hospital. back to list

Recovery at Home

What can I expect once I am discharged?
You shouldn’t be surprised if you feel a little shaky and uncertain for a few days after you are discharged to home. Soon you will get a routine going and gain confidence in your new joint. It is our recommendation that someone stay with you for the first 24-72 hours to offer you some assistance. In addition a home care nurse may be set up to check in on you. back to list

What about pain medicine and physical therapy?
You will be discharged with a prescription for pain medication. Most patients do require a short-term course of pain medicine. Expect to be on some type of pain medication for several weeks after discharge, especially at night or before therapy sessions. In most cases you will be set up to have a physical therapist come to your home to aid in your recovery with your new joint. You will be encouraged to work on your exercises daily and walk as much as you can. back to list

Will I be on a blood thinner?
You will be started on a blood thinner medication of aspirin or Coumadin while you are in the hospital and it will be continued for 3-6 weeks by your doctor. In addition to activity, the blood thinner will work to prevent blood clots from forming. If you are on Coumadin, you will have a home care nurse draw your blood twice a week to determine the best dose for you. Important: If you don't receive a call from our office by the following day after your blood is drawn, please contact our office. You will need to avoid vitamins containing vitamin K or large amounts of vitamin E or vitamin C. Large amounts of food high in vitamin K can change the way the Coumadin works. Foods rich in vitamin K include green tea, beef liver, soy oil, broccoli, brussel sprouts, cabbage, cauliflower, chickpeas, kale, lettuce, turnip greens, and spinach. back to list

What should I be concerned about after my surgery?
You need to call the office if you note any new redness, swelling or drainage from your incision, or a fever that persists above 101 degrees and is accompanied by chills, sweats, or increased pain. Swelling is normal in the operative leg. Normal swelling is reduced in the morning and gradually accumulates throughout the day. Any activity that leaves your feet on the floor, such as sitting in a chair, standing, or walking can lead to swelling. If the swelling is severe in the morning when first arising or if accompanied by leg pain or redness, call our office. It is best to elevate your legs when you are sitting. back to list

What precautions do I need to follow if I had a hip replacement?
The positioning of your hip after your surgery is very important to avoid dislocation. The greatest risk of dislocation is within the first 6 weeks. Avoid excessive flexion (greater than 90 degrees), crossing your legs, or rotating your operative leg inward. You will need an elevated toilet seat to limit your flexion. You will need to use a pillow between your legs to help maintain the proper position and to keep your legs apart. Your therapist will help you to modify your activities to help you follow these restrictions. Discuss with your orthopaedic surgeon when you can return to more normal activities. back to list

How often do I follow-up after my surgery?
You will be seen in the office for your follow-up appointment 10-14 days after your surgery. You will then be seen periodically during the first year to evaluate your progress and allow the opportunity to ask questions. Then it is recommended you follow-up yearly for new x-rays and to monitor the progress of your new prosthesis. back to list

When can I shower and swim?
Your staples or stitches will be removed about 10-14 days after surgery. At that time if you have no wound problems, you will be permitted to get your incision wet. back to list

How long do I have to wear my white stockings?
They must be worn until you have your first visit to the orthopaedic office. If you are active then most people are permitted to stop wearing them at that time. back to list

When may I resume driving?
The side of surgery (left vs. right let) and your overall health play a role in this decision. Mostly it is when you feel comfortable getting in and out of the car and are no longer taking narcotic pain medication. It is recommended you go with someone and practice in a quiet place before you go alone. back to list

When can I participate in activities?
People are encouraged to walk as part of their recovery and general cardiovascular fitness. Swimming, walking distances, bicycle riding, golfing, and other low impact sports activities can be tried after a few weeks. High impact activities such as jogging, singles tennis, basketball, etc. are not recommended. You may do lower extremity weight lifting activities, however, it is recommended to keep the weights relatively low and do higher repetition. back to list

When will I be able to return to work?
This varies with the type of work you do. In general, people who work a desk job may return in 4-6 weeks or sooner if they can do safely. People with jobs that require standing and lifting may need 8-12 weeks for their recovery period. This should be discussed with your orthopaedic surgeon so the best decision can be made for your individual situation. back to list

Can I obtain a handicap-parking permit?
Yes. Our office will give you a form that you will need to complete and take to your town hall who will then issue the permit. back to list

Ongoing Questions After Your Joint Replacement

Will I set off the metal detectors at the airport?
Most likely the current technology will detect your joint replacement. We do offer cards to notify officials of your implanted metallic device. However, these cards are easily duplicated so most officials will use the metal detecting wand over the site of your implant and pat the area to ensure there is no other metallic device. back to list

Do I need to take antibiotics before dental and other procedures for the remainder of my life?
Yes, you will need to take antibiotics prior to any invasive procedure which would include dental work (even routine cleanings), urological, gastrointestinal, or surgical procedures. This will protect the joint replacement from infection. The antibiotic is given by your doctor or orthopaedic surgeon and will be taken about 1 hour prior to your procedure. back to list

Is it normal to have numbness along the outer or lateral aspect of my incision?
With knee and certain types of hip incisions, it is common to develop some numbness or change in sensation over the outer aspect of the incision or down the thigh. The incisions cut across the nerves that run down the leg. Generally, after four to six months much of the skin sensation will return. However, in some people, there is always a reduced degree of sensation, usually of little significance to you. back to list

Is it normal for my knee to be warm after surgery and to have occasional clicking?
It is normal for knee replacements to be warm for the first four to six months after surgery. There is extensive surgery underneath the skin which can cause warmth and stiffness, especially with activities. It is also common for the knee to look larger in relation to your natural knee due to the knee prosthesis. Your knee may also click on occasion due to the fact that there is a small degree of flexibility left into the knee so it can move and function well. Otherwise if the knee is too tight, you may have limited motion. However, if the clicking is painful, you should notify our office. back to list