What You Need to Know
Early Post-Operative Experience
Early Post-Operative Experience
Injections
Discharge to 7 Days Post-op
What to Expect
It is normal to experience swelling and bruising after total joint replacement.
- You may experience swelling and bruising around the knee or hip and down into the lower leg after your total joint replacement.
- Bruising may last for up to 6 – 8 weeks and this is part of the normal healing process.
- Swelling of the leg and down into the foot can sometimes last for 2 or 3 months.
- Being on the blood thinner after surgery can contribute to this bruising too.
This medication is especially important so please continue to use as you were directed.
You can do the following to minimize the swelling and bruising:
- Elevate the leg when you are not doing your exercises or when you are resting.
- For the first two to three weeks after surgery, ice your knee or hip for 20 minutes every hour and after exercising. This will help to minimize both the swelling and the bruising. After a total knee replacement, using your CPM (Continuous Passive Motion) will improve your range of motion, make your knee feel better, and reduce swelling.
Coaches’ Role
48 hrs after post-op, you may need assistance from your coach with the following:
- Personal care: bathing, dressing
- Physical therapy exercises and walking
- Help manage medications and schedule
- Pain management: pain medication, ice, CPM
- Wound checks and dressing changes
- Meals and grocery shopping
- Providing transportation to outpatient therapy if needed
- Care of other family members and pets if needed
- House cleaning
- Being available in the event of an emergency
You can do the following to minimize the swelling and bruising:
- Elevate the leg when you are not doing your exercises or when you are resting.
- For the first two to three weeks after surgery, ice your knee or hip for 20 minutes every hour and after exercising. This will help to minimize both the swelling and the bruising. After a total knee replacement, using your CPM (Continuous Passive Motion) will improve your range of motion, make your knee feel better, and reduce swelling.
Changing Your Dressing
Home Physical Therapy and Schedule
Following your inpatient stay, you will receive home health PT for 5 – 7 days, and thereafter you will complete a course of outpatient PT. Some patients however will be able to exercise on their own or go directly to outpatient PT. Outpatient PT can last anywhere from several weeks to several months based on your progress. We will provide you with an exercise program in the hospital that you can share with your next PT, so that they can see what you have already been accomplishing and help progress you in your recovery.
Post Discharge Call
A physician assistant (PA) or a nurse practitioner (NP) will call you within 1 week of being discharged.
Reminder
You do not have limits on your activities or on how fast you resume your activities. The speed of your recovery depends very much on you and your confidence level.
1 to 4 Weeks Post-op
CPM and Ice Therapy After Knee Replacement
In the hospital, you will be provided an ice pack and a Continuous Passive Motion (CPM) Machine for TKR patients to help with pain relief. We encourage you to continue these when you get home.
We encourage you to ice as often as able postoperatively, but specifically after any home health or outpatient PT session, or after you have done any activity like walking for exercise or completing your exercises at home.
We encourage you to ice as often as able postoperatively, but specifically after any home health or outpatient PT session, or after you have done any activity like walking for exercise or completing your exercises at home.
No Restrictions
You do not have limits on your activities or on how fast you resume your activities. The speed of your recovery depends very much on you and your confidence level.
You are permitted to put as much weight as possible on your operative leg and proceed as quickly as you feel comfortable.
You are permitted to put as much weight as possible on your operative leg and proceed as quickly as you feel comfortable.
Bruising and Swelling
Constipation
Drinking fluids, moving, and taking a stool softener will help with constipation.
One Month Office Visit
When you come in for your one month office visit, you will have x-rays of your joint replacement(s). You will then be evaluated by your surgeon, physician assistant or nurse practitioner. Your surgeon will review all your x-rays as well. If special instructions are necessary, the instructions will be provided at this appointment.
1 - 3 Months Post-op
Proceed at your own pace. You are permitted to put as much weight as possible on your operative leg and proceed as quickly as you feel comfortable.
Dental Work Post Joint Replacement
Following any total joint replacement or revision, any dental work or cleaning is allowed starting one month after the surgery.
Antibiotic prophylaxis is required following any total joint replacement.
Antibiotic prophylaxis is required following any total joint replacement.
Cleanings Within 3 Months Post-Op
- For cleanings that are scheduled within 3 months after their surgery date, patients need to pre-medicate with Cephalexin 500mg, (4 tabs) 1 hour before cleaning.
- If allergic to Cephalexin, alternative is either Clindamycin 300mg or Azithromycin 250mg (both 2 tabs) 1 hour before cleaning.
- After 3 months, no treatment is needed before cleaning.
Invasive Dental Work Within 2 Years Post-Op
- For any invasive work (cavities, extraction, root canals etc.) that are scheduled within 2 years since the surgery date, same pre-medication procedure applies.
Pre-medicate with Cephalexin 500mg, (4 tabs) 1 hour before cleaning). - If allergic to Cephalexin, alternative is either Clindamycin 300mg or Azithromycin 250mg (both 2 tabs) 1 hour before cleaning.
- After 2 years, no treatment is needed before invasive work.
If someone has a history of joint infection, we have them pre-medicate prior to any cleaning or dental work for the rest of their life.
When you need to contact the office or follow-up sooner
After Hip replacement
- Persistent groin or thigh pain
- Feelings of looseness
After Knee replacement
- Persistent knee pain or swelling
- Grating sensation
- Increase in clicking (occasional clicking without pain is normal!)
Never hesitate to call with any questions or concerns!
