Common Post-Op Questions
After surgery and your hospital stay you may be tired and drowsy. Rest and elevate the leg. Advance your diet as tolerated. Be sure to take your medications as directed. Try to get a restful sleep and begin more normal activities as tolerated. Begin Physical Therapy as directed as soon as possible after you return home.
The Aquacel dressing stays in place for a week and then you may remove it. After the dressing is off you may continue to shower. Call the office and you will be given a follow-up appointment. Unless there is a problem, your appointment will be about 6 weeks from the time of your surgery.
After joint replacement surgery, it is important to remember that performing daily activities like walking around, going up and down stairs, carrying light groceries, performing desk work and most non-strenuous work tasks will not cause any damage to your joint. Returning to normal activities will actually improve your recovery, by using your joint in a functional manner.
Ice and elevation helps reduce pain and swelling. Ice therapy often works better than oral pain medication and that is why we recommend the ice therapy machine. Apply ice therapy as often as possible while you are awake and especially after activities such as Physical Therapy and exercising. Using cold therapy is recommended several times a day for 20 minutes at a time. Discontinue the ice therapy when it no longer reduces discomfort.
It is normal to have some swelling after surgery. It gradually subsides but may be present for several weeks. Elevation and icing will help to reduce the swelling more rapidly. It is not unusual to have some redness around the wound and some clear, yellow or blood-tinged drainage. Bruising (black and blue) about the incision or the upper or lower leg is normal. Occasionally blisters may develop. If so, a dressing and a special cream may be recommended. Despite great care, any wound may become infected. The signs of infection are increasing pain, a lot of drainage or pus coming from the wound, with redness and fever. If infection is suspected, please call the office or go to your nearest hospital or the emergency department at Mount Sinai Beth Israel.
All medications prescribed should be taken as directed. All medications can have side effects such as bleeding, stomach upset, headaches, dizziness, constipation, etc. If you have any major problem or allergic reaction, stop the medication and call the office. We usually prescribe a codeine type painkiller. If you are allergic to codeine, please inform us and we will prescribe a different drug. If you have only a little pain, you may simply take Tylenol or nothing at all. If you have had a hip replacement be sure to take the Indomethacin prescribed for you.
You may return to an office-type job whenever you feel comfortable enough. The only restriction would be your own motivation and pain tolerance. If your job requires vigorous activities, or if you have to use public transportation (like the bus or subway), then you must be the judge as to when you feel capable to return.
As a general rule, you may resume driving as soon as you are comfortable and fully alert and off narcotic pain medications. This is usually anywhere from 2-4 weeks after surgery. Remember that the hip or knee will not be damaged, but if you are at the wheel, you must be comfortable enough not to put yourself or others at risk. You may take the train or bus or ride in a car as soon as you are comfortable. Air travel is allowed as soon as you feel capable. If you are flying within 6 weeks after surgery make sure you continue with your blood thinners and perform range of motion exercises of the legs and feet during the flight. Get up and walk around frequently.
I recommend Physical Therapy for all my patients after joint replacement and a prescription is provided for you. In the first 6 weeks after knee replacement, all therapy should be directed to increasing your range of motion. Most patients have 120º of flexion (bending) by that time. You must have at least 90º or else manipulation of the knee will be recommended. If you had a hip replacement, you may do isometric and range of motion exercises. Abduction exercises should not be started until 6 weeks after surgery and you must use a cane or crutches for 6 weeks after surgery to allow proper healing of the hip. You may return to normal activities as soon as you are comfortable. Walking, sitting, standing, getting up from and into a chair or the toilet is part of your rehabilitation program. After knee replacement using a stationary bicycle will help improve your range of motion.
Swimming: If you have access to a pool, you can swim as long as the wound has no drainage and is fully healed. Swim for 5-10 minutes and then dry the incision. Do not swim in water over your head until certain of your capability. If it is a public pool, do not swim or get your incision wet for at least 3 weeks.Do not do any other type of exercising without checking with me.
-Steven F. Harwin, MD, FACS