you are discharged from the hospital or rehab facility you
will have a period of 4-6 weeks until you are seen again
by your surgeon. This time is important in your rehabilitation
and in the long term results from your surgery. Listed below
are specific as well as general tips to help you accomplish
the maximum benefits from this portion of your surgical
experience. We hope that this information provides useful
and timely information to you regarding this phase of your
joint replacement surgery.
First 48 Hours -
matter how much you have prepared for your homecoming,
this time is always one of adjustment. You may experience
a slight period of anxiety and even wonder if you have
come home too early. Relax and remember, this is a normal
feeling. Give yourself a little time to become accustomed
to your routine at home and you'll be well on your way.
Be aware that many times well-meaning friends and relatives
stop by to visit on the day you come home. Remember,
this is your first day home and you have had a major
operation - don't overdo! Get the rest you need to continue
your recuperation period.
Continue your exercise program - Once home, the major
focus for you will be to regain strength and function.
Don't skip exercise sessions - the only one to suffer
will be you when you don't reach your maximum potential.
Keep in mind that once your surgeon has completed your
surgery the rest is up to you.
Manager Follow-up Call
Expect a call from the case manager or physicians assistant
in your surgeons office. This post discharge phone call
is made to maintain contact between the surgeon and
you. Report any problems, and ask any questions, no
matter how minor you may believe them to be. It is much
more beneficial to ask questions and report problems
rather than to worry about them. Remember, it is "always
better to be safe than sorry."
Expect a call from the physical therapist or home care
nurse within 48 hours of discharge to arrange for continued
home care if necessary.
1-6 After Discharge
Is A Phone Call Away -
Remember that the health team members in the office
are available to assist you. The secretaries, clinic
staff, physicians assistants and residents are available
5 days a week during normal business hours. In addition,
resident coverage is available 24 hours a day 7 days
a week in the event of a problem. This availability
allows for you or a family member to call and receive
answers to general questions as well as instructions
in the event of an emergency.
The Common Sense Approach -
As you continue to recuperate at home you may encounter
a problem or may have questions that you would like
to ask. Do not hesitate to call the office if this is
the case. Keep in mind also that even if your home care
provider says that everything is allright, but you still
feel you need to speak with someone in the office, you
should do so rather than worrying about your progress.
To Report -
In general, patients do very well after discharge. However,
you should contact the office if any of the following
have increasing pain in the operative site
is redness or warmth which is new or increased since
is drainage from your incision which is new or increased
operative site is increasingly swollen
calf becomes swollen, tender, warm, or reddened
have a temperature above 100.4 for more than 24
the case of total knee replacement, your knee feels
as if it is decreasing in flexion (bending) rather
than increasing or at least staying the same as
Your Activity -
During the first 6 weeks after discharge you should
find yourself making progress week by week. Most patients
returning at 6 weeks for their follow-up appointments
are eager to report their progress and ready to move
on to the next level in their recuperation. Listed here
are activities that most patients can expect to accomplish
during their first 6 weeks after total joint replacement.
independently on a level surface with the use of
your walker or crutches
stairs at least once a day
into and out of bed independently
into and out of a chair or care independently
using a tub bench once your staples are removed
provided there is no problem with the incision
resume your activities of daily living including
cooking, light house cleaning, walking more, and
going outside the home. You should certainly be
up and about all or most of the day.
4-6 weeks after your surgery
some cases return to work prior to your 6 week check-up.
This is allowed on an individual basis and should
be discussed with your surgeon.
sexual activity when you are comfortable in doing
so. In total hip patients this can be done by following
the Sexual Precautions Do's
After Total Hip Replacement.
stated above, your first post-operative visit is approximately
6 weeks after your surgery. We hope that the information
which is presented here acts as a helpful guide to make
these first few weeks at home as comfortable as possible.
Please remember that you are encouraged to call your physician's
office if you have any questions or problems during
6-12 After Discharge
- The 6-12 week period after your
joint replacement is a time of continued progression.
You will probably notice an increase in your energy,
a desire to do more activities the better you feel,
and a noticeable improvement in the strength of your
operated leg. Please keep in mind that every patient
is different and will progress at different levels.
If you feel that you are not progressing satisfactorily,
please contact your physician's office to discuss your
Once you are seen for your 6 week check-up you will
most likely advance to using a cane for ambulation.
Remember to use the cane until you return for your 12
week follow-up. You may walk with the cane as much as
you want as long as you are comfortable.
To Work -
Most patients return to their work after being seen
for their 6 week visit. Tips to remember for returning
to work are:
heavy lifting (over 25 pounds)
prolonged standing or sitting
activities such as climbing stairs frequently or
any positions which would call for extremes in terms
of range of motion, i.e. kneeling, stooping, bending
a period of adjustment - Most people return to work
with minimal problems. However, you may find the
first several days very tiring. Remember to give
yourself time to adjust to work again and gradually
this should improve.
Your Exercise Program -
Keep up with your exercises to keep up your progress!
Many patients do not need to work with a physical therapist
during this time, but remember that your exercises are
the one most important activity to help increase your
strength and give you an optimal surgical result.
Any Restrictions -
While you may feel like you can do anything, if your
surgeon has restricted your activities or body positions
in any way, you need to realize this is done to protect
your operative hip or knee while it continues to heal.
If you want to achieve the best possible surgical result,
be patient and follow your physician's instructions
3 months to Forever After -
Once you have reached the 3 month period after surgery,
you will see your physician for another follow-up visit.
This visit usually marks the time when you may go without
any assistive device for walking and without any restrictions
on your weight bearing.
- You are encouraged at this point to resume your
normal activities both inside and outside of the
home. Keep in mind as you continue to return to
your activities to use the common sense approach.
Some tips for doing this are:
Realistic - Pace yourself and resume activities
gradually. Increase your walking distance or
activities such as bowling, tennis, biking,
or dancing over a period of time, not all at
a cane in the trunk of your car. If you are
travelling for any distance, sight seeing on
an extended trip, or out during winter conditions,
this may come in handy if you start to tire,
experience discomfort, or face uneven or icy
the benefits of your total joint. Keep in mind
that your joint replacement was done to relieve
pain and help you resume your normal activities.
By the time you have reached the first year
after your surgery, you should be doing all
that you would like to do.
to call with any questions or concerns. Our
staff is always available to assist you and
will be happy to find answers to any questions
you may have.
the Total Joint Patient Forever
- Your schedule for further follow-up appointments
from this time on is 6 months after your surgery
and then annually unless directed otherwise. These
appointments are important to keep for several reasons.
The most important reason for these appointments
is you. By following your condition both you and
your surgeon will have an accurate picture of your
status at any given time. You also will have a chance
to discuss any concerns regarding your total joint
replacement or other joints which may develop symptoms.
In addition, the x-rays and physical exams done
at each visit may alert you and your surgeon to
any problems with your total joint which sometimes
can be seen on x-ray or physical exam before
any symptoms are felt by the patient. This in particular
is the primary reason we encourage patients to return
for appointments even when they may feel they are
doing well and don't need to see their surgeon.
Remember, your total joint replacement is a permanent
part of you and your follow-up appointments should
be considered a part of this also.
conclusion, we hope the information presented here has been
helpful. While each patient is certainly viewed as an individual,
we have offered this information as a result of following
our patients for over 20 years. If after reviewing this
information you have any questions or concerns, please feel
free to contact our office.