Recovering From a Hip & Knee Replacement
Being an informed and active participant in your own care gives you an advantage in returning to your everyday life with a newly replaced joint.
Knowing what to expect after surgery may help lead to a smoother recovery. Use the patient guide below to help you understand your recovery from a joint replacement procedure.
After Your Surgery
Our goal is to do all we can to make sure that you have a successful surgery and recovery. The following information will help you know what to expect after surgery and what you can do to help yourself heal more quickly and prevent problems.
- While in the recovery room, nurses will take care of you to make sure you are recovering well.
- With some types of anesthesia, your legs may feel numb as you wake up. This is a normal part of the anesthesia and will begin to wear off in the recovery room.
- With other types of anesthesia, you may have a sore throat, nausea and pain. Your nurse will give you medications to help.
- If your coach or family member cannot visit you while you are in the recovery room, your surgeon and/or nurse will contact them to let them know how the surgery went.
- Visitation policies for friends and family may be different than described on this page.
- Some patients go home the same day of surgery and some stay overnight. Your surgeon will let you know if you should plan on an overnight stay in the hospital after your surgery.
- If you are going home the same day, you will likely recover in the Outpatient Surgery Stay Unit in the Pavilion.
- Wherever you recover from your surgery, we will discharge you from the hospital when it is medically safe to do so.
Your Nursing Staff
- Your nursing team will visit you at least once every hour.
- Your nursing team will give you medications prescribed by your care team.
- Your vital signs will be continuously monitored for the first few hours after surgery and then every four hours.
- The nurses will check circulation, movement and sensation in your legs.
- It is normal for you to feel tired for a few hours after your surgery.
- You will have a dressing (bandage) covering your surgical site.
- You may have a tube to drain fluid away from the incision (cut in skin).
- If you are tolerating liquids by mouth, your IV fluids will be discontinued.
- If you have a drain in your bladder called a catheter to measure your urine (pee), it will be removed soon after surgery to reduce the risk of an infection.
- Most people will have compression sleeves or foot pumps on their legs to help prevent blood clots while in the hospital. You may also be given medications to help prevent blood clots after surgery.
- If you have a hip surgery, you may wake up with a pillow between your legs to keep you from crossing your legs.
- You may also have a drain that removes excess bloody drainage from your surgical site. This is usually removed by your surgeon or PA the day after surgery.
Time to Start Moving—Usually Sooner Than You Expect!
- Do not get up on your own. Always get help from a nurse, clinical partner or therapist to get out of bed or walk.
- Your surgeon wants you to start moving the day of your surgery.
- Nursing staff or therapists will get you moving within a few hours after you have awakened from surgery.
- You will start moving by sitting on the side of the bed for a few minutes and then standing in place.
- Once it is safe to do so, you will be expected to start walking. Most people can walk the day of their surgery using a front-wheeled walker.
- Plan to eat all your meals out of bed in a chair, just like you do at home.
- If you are walking, you will use the bathroom. If not, the nursing team will help you stand and pivot to a bedside commode to relieve yourself.
- Falls can be very dangerous. Do not get out of bed without help while you are in the hospital.
- Call us when you need to get up or go to the bathroom. A member of the care team will help you.
- If you try to get up by yourself, a bed alarm may go off to remind you to stay in bed and wait for one of the staff members to help you.
- While you are in the hospital, please do not ask your coach, family members or friends to help you get out of bed or walk. They are not trained to prevent falls.
It is normal to feel some pain after surgery and while you are healing, even when you are taking pain medication. Your doctor or surgeon will prescribe medications for mild, moderate and severe pain. Your nurse will check with you on your pain level and provide you with the right medication. The goal is to control your pain well enough so that you can fully take part in your recovery and get better quickly. This is called functional pain control.
The Best Ways to Treat Pain After Your Surgery
- Anticipate that you will not be pain-free, even with pain medication.
- Tell your nurse about your pain so she can help you keep it under control.
- Use ice on your leg to reduce swelling and pain after surgery.
- If you are having pain that is getting worse and your pain medication is not helping, tell your nurse so that your doctor or surgeon can help.
- Pain medications can cause constipation (hard bowel movements). Drink plenty of fluids and take the bowel medication your doctor has prescribed.
- Ask for pain medication before your therapy session so you are comfortable enough to perform all the exercises.
- Most people who take opioid pain medication (narcotics) do not become addicted, because they only need it for a short time. Talk to your team if you still have concerns about taking strong pain medication.
- Do not stay in bed. Instead, ask to be helped to a chair and to walk around. This will help your body get back to normal more quickly and prevent your muscles from feeling stiff.
- The more you move, the faster you will get better, so we will encourage you to be out of bed and walking as much as possible.
- Sit up in a chair to eat all of your meals and spend time with visitors.
- Plan to be out of bed at least three times a day, walking with assistance and sitting in a chair.
- Work with the physical therapist to learn how to safely walk with a walker or cane.
- You will have pain, but it should be controlled enough so you can sleep at night, work with physical therapy and spend most of your day out of bed and moving around.
- Take all your medications as ordered by your medical doctor and surgeon.
- If you stopped taking any medications before your surgery, ask your surgeon or medical doctor when it is safe to start taking them again.
- Drink plenty of liquids to help your body recover from surgery.
- Eat plenty of healthy foods to help you heal and get strong again.
- Do your deep breathing exercises every hour (the nurses will show you how).
- Use the compression sleeves and foot pumps as directed by your care team.
- Prepare for discharge home.
Going From Hospital to Home
Once you can walk safely, do your exercises and your surgeon says you are ready, it will be time to go home.
If you no longer need hospital care but it isn't safe for you to go home, your case manager will work with your surgeon to help you find a place to recover. One such place is called a skilled nursing facility (SNF). Cedars-Sinai collaborates with a select number of SNFs. These facilities will follow the care plan developed by your surgeon and will give daily updates to your care team. While you may choose any SNF that is convenient for you and your family, we encourage you to consider one of these facilities to get the best possible coordination of care. You should also select more than one facility in case your first choice is not available. You will receive a list of SNFs during your hospital stay.
Acute/inpatient rehabilitation care is reserved for those very few patients who meet strict clinical criteria. This type of care is typically covered by insurance only if you cannot recover in a less intensive setting. The criteria include having a health condition that requires acute medical supervision, intensive rehabilitation and multiple types of therapies. You also must be able to take part in and benefit from at least three hours of daily therapy for up to five or six days each week of your stay.
As an additional service for seniors, Cedars-Sinai also offers an Ambulatory Care Manager to assist with special needs after surgery.
One of our Clinical Joint Surgery Managers will contact you about one week after your surgery to check in with you, discuss any concerns you may have and answer your questions.
- You are responsible for arranging transportation to take you home. These arrangements should be made prior to your surgery. Most patients have their coach, family member or friend drive them home.
- Many patients return to their home the same day they have surgery.
- If you do not leave the hospital on your day of surgery, plan on being discharged before 11 a.m. on the next day, unless you have been told otherwise.
- You may not drive before your first postoperative (after surgery) visit. The decision about when to safely drive your vehicle is made with your surgeon.
- If you stay overnight, your coach should be at the hospital by 9 a.m. on the day of discharge so they can be with you to hear your discharge instructions.
- Before you leave, your case manager will discuss your discharge plans with you. The case manager will also help to organize home-care nursing services if you require them.
- Your nurse will talk with you and your coach about your home-care instructions. Make sure that you understand the instructions. Ask as many questions as you need. The instructions will tell you:
- How to take care of your incision
- When it is OK to shower
- How and when to take your medications
- When and where to return for your post-op visit
- How to reach us if you are concerned or have questions
- Your physical and occupational therapists will talk with you about equipment that you will need at home. Your nurse will order equipment to be delivered to your room based on the therapists’ recommendations.
- You may get a 3-in-1 commode that you can use as a shower chair, and to elevate the level of your toilet seat at home. See section on “Frequently Used Medical Equipment.”
- You may get a 3-in-1 commode that you can use as a shower chair, and to elevate the level of your toilet seat at home. See section on “Frequently Used Medical Equipment.”
- Most pain medication will be limited to 90 days after surgery. After 90 days, if you still need prescription pain medication, you may need to be referred to pain management. If you are under the care of a pain management doctor, please continue to get your pain medications from that doctor.
- Pain medications can cause constipation (hard bowel movements). Drink plenty of fluids and eat foods that are high in fiber to help prevent this problem. Your medical doctor may also tell you to take a stool softener, which you can buy at any drugstore.
- Some of the medications that you were taking before your surgery may change how your body heals. Talk to your surgeon before you start taking any of these medications again.
- If you have not already obtained your discharge medications, talk to your nurse about our discharge prescription service or call the Cedars-Sinai Outpatient Pharmacy at 310-423-1400 (dial 3-1400 from your bedside phone). We accept most insurance plans and will bill your insurance for you.
You may think that your new joint is very fragile or needs to heal before using it. Nothing could be further from the truth! Sitting too long is not good for you. Try not to sit for more than two hours at a time. You should alternate between sitting, short walks and resting. Activity is good for you and your new joint.
- Make sure your coach is with you at home and is ready to help you move safely.
- Your new joint and leg will feel uncomfortable when you first return home from the hospital. It is normal to feel pain and stiffness as your body heals from surgery, especially if you are working hard on your recovery.
- You will need to walk with a walker or a cane for up to six weeks. Your surgeon or physical therapist will help guide you to know when you are ready to walk without assistance.
- Use an adjustable commode seat for toileting and sitting in the shower, if needed.
- You should climb stairs with support. Climb one step at a time. Always hold on to a railing. It is best to go up by leading with the limb that has not had surgery. Going down, lead with the limb that has had surgery.
- Remember, you may not drive until your surgeon tells you it is safe for you to do so. Talk to your surgeon about driving during your post-op visit.
Your surgeon will decide the best dressing (bandage) for your incision and will tell you how to care for your incision as it heals. Before discharge from the hospital, your nurse will review how to care for your incision and make sure you understand your surgeon’s instructions. The instructions are included in the discharge paperwork you will be given when you leave the hospital. General tips for incision care and hygiene include:
- Make sure to keep your dressing dry. Follow your surgeon’s instructions on how and when it is safe to shower.
- If you need to change your dressing or touch your incision, make sure you wash your hands well before and after doing so.
- Wear loose clothing that does not rub against your incision and irritate it.
- If your incision was closed with staples, the staples may be removed during your post-op visit with your surgeon. The surgeon may instead schedule a home-care nurse to remove your surgical staples.
- See the section on “When to Call Your Surgeon” for concerns regarding your incision.
Swelling and bruising on the leg that was operated on is normal after your surgery.
- You can keep the swelling down by putting ice packs on the swollen area.
- Put a clean cloth between the ice pack and your skin. Do not put the ice pack on your bare skin.
- Lying flat and elevating your limb a few times a day with your foot above your knee and your knee above your hip and heart will help reduce the swelling in your leg.
You will need to do some basic exercises after your surgery. Sometimes your surgeon will want you to have physical therapy after your surgery. In some cases, physical therapists will come to your home to help you with your exercises. In other cases, you may go to an outpatient physical therapy office and do the exercises there.
Be patient while you are healing. It often takes about three to six weeks to get back your strength. It is normal to feel weak and tired after surgery. Make sure you focus on your recovery from surgery. Do not rush the healing process by going back to work or starting your normal activities too soon.
Walking is an important way to help your body heal. It is your main exercise after surgery and helps you to gradually increase your endurance. Walking helps your blood flow better, which is good for your whole body. Every day walk a little bit farther and a little longer than the day before. This will help you get your strength back.
It is normal to have some bruising, tightness, swelling, pain and redness at the incision site. But if you have any of the symptoms in the list below, call your surgeon or a Clinical Joint Surgery Manager. You can also call one of the Clinical Joint Surgery Managers with any other questions or concerns you may have.
- A fever above 101.5 degrees
- A fever and chills together
- A mild fever (less than 101.5 degrees) that lasts more than five days
- Redness that gets larger and spreads from your surgery site
- If the wound oozes fluid and soaks the dressing or bandage
- Your incision site smells bad
- Any part of your incision is open
- Severe pain that does not get better when you take pain medications
- Any changes in feeling or numbness in your toes
- Toes suddenly look purple or very pale
- Any sudden changes including increased pain, redness, heat and swelling in either leg
The amount of insurance coverage for medical equipment varies and is determined by your health plan. While some of the described equipment may be covered by your insurance, some may incur an out-of-pocket cost to you. We recommend that you check with your health plan to confirm what coverage you have before your surgery.
You will go home from the hospital with a walker or a cane. Sometimes a bedside commode is recommended. Some of this equipment may be available for purchase at the hospital prior to discharge.
- Front-wheeled walker
- Shower chair
- Bedside commode
- Long-handled shoehorn
- Long-handled bath sponge
- Long-handled reacher
It is recommended that you use the front seat when riding as a passenger.
- Have the front seat moved all the way back.
- Recline the backrest as far as possible.
- Back up to the car seat with the walker. Sit down as you would in a chair, keeping your operated leg out straight. Be careful not to hit your head as you sit down in the seat.
- Slide back into the seat far enough to bring your operated leg into the car while leaning back.
- Sit semi-reclined or at a position of comfort.
- For getting out of the car, reverse these instructions.
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