How to Recover from Joint Replacement Surgery
The most common joint replacement surgeries involve the hip, the knee, and the shoulder. If you have recently undergone joint replacement surgery (or if you have an upcoming surgery planned), it is key to understand how to properly recover, so that you can maximize the function of your new joint moving forwards and minimize any complications.
Healing Initially In Hospital
Start your initial recovery in the hospital.When the general anesthesia following your joint replacement surgery wears off, you will find yourself in a place called the "recovery room," also known as the post anesthesia care unit, or PACU. This is where patients stay until they wake up, and even a few hours after that to ensure that the initial recovery from surgery is going well. There is supervision from nurses in the recovery room, and your surgeon may come in to check on you to ensure that you are doing well following the procedure.
- After a few hours in the recovery room, you will be transferred to a hospital bed where you will be spending anywhere from one to five nights.
- It depends upon the type of joint replacement surgery you had (which joint was operated on), as well as the severity and degree of repairs needed.
- Your doctor will inform you of how many nights you need to stay in hospital, and she, or he, will check in on you daily, in addition to the rest of your healthcare team (nurses, physiotherapists, etc).
Have your pain managed with medication.After the numbing effects of the anesthesia (used during surgery) wear off, you will need to be put on pain medication to ease the pain following surgery. Your doctor will prescribe these and the nurses will administer them. You will most likely be receiving pain medications orally (in pill form), and the dose will continually decrease as your body heals following surgery.
- Keep your surgeon and the nurses looking after you informed about how well the pain medication is working for you.
- If the dosage prescribed by your doctor is insufficient to control the pain, let the staff know so that they can offer you additional strategies for pain control.
Work with a physiotherapist.You can expect to receive a visit from the hospital physiotherapist the day following your joint replacement surgery to begin a rehabilitation program. In the initial stages following surgery, the movements suggested by your physiotherapist will be small and minimal. The goal in the initial stages is to keep the circulation flowing to the affected joint (the one that was operated on), while not moving too much so as not to disrupt the alignment of the joint or interfere with joint healing in any way.
- The extent of the physiotherapy exercises will increase in the weeks following surgery, after initial healing has taken place.
- While in hospital, you can expect to see a physiotherapist one or two times per day.
Monitor for any post-surgical complications.Another reason that it is important to stay in the hospital following your joint replacement surgery is so that the nurses and doctors can monitor for any post-surgical complications, and handle these immediately should they arise (they occur in approximately 2% of patients).Things your doctor will be looking for include proper wound healing with no signs of infection, as well as preventing the formation of blood clots (both by monitoring you as well as providing blood thinning medications and sometimes compression stockings).
- The risk of blood clots following surgery is heightened due to your relative immobility during the initial recovery phase as well as the surgical site is in proximity to the veins.
Recovering After Hospital Discharge
Plan your next steps after discharge from the hospital.You will most likely be working with a PT (a physical therapist therapist) and a discharge planning nurse to organize your next steps after you leave the hospital. After receiving joint replacement surgery, some people (particularly elderly patients) go on to spend a few days to a few weeks in what is called an "intermediate care facility" or "rehabilitation facility." This is a place where they can receive additional care that is not at the level of a hospital, but that is much more helpful than trying to cope alone at home.
- If you have people who can help you in the initial recovery stages at home, an intermediate care facility may not be needed.
- Also, if your surgery was more minor and will not interfere with your ability to function day-to-day around the home, you may be able to manage returning home immediately after you leave the hospital.
- These decisions will be made on a case-by-case basis in conjunction with the expertise of your healthcare team.
Continue with regular physiotherapy.After being discharged from the hospital, people who have received a joint replacement surgery are generally advised to continue with physiotherapy 3 to 4 times per week. This is one of the mainstays of treatment following surgery, and will be a key factor playing into how well you recover (better adherence with physiotherapy correlates with a better recovery).
- You may also receive a mobility aid, such as a walker, a wheelchair, or crutches, depending upon the type of surgery you have had. If it is surgery involving your shoulder joint, you will likely be given a sling.
Recruit help from family and friends.If you are returning home and are not yet capable of completing all living tasks on your own, now is the time to reach out and ask for help from family and friends. For instance, they may be able to give you a hand with cleaning, shopping, and other errands during the first couple weeks following surgery. They may also be able to help by driving you places, if the joint you received surgery on prevents you from being able to drive on your own.
- In more severe cases, you may also need help with bathing, dressing, cooking, and with other day-to-day tasks.
- You may be comfortable asking a family member to help you with these things.
- Alternatively, you can hire nursing support, either for a few hours per day or as a 24 hour live-in support, to help you in the initial stages as you recover from your surgery.
- You can also ask family and friends to help move furniture so that your home is set up in a way that poses the least hassle to you for ambulation.
- If possible, you may ask that things be arranged so that you can stay on one floor of the house (as opposed to having to climb stairs, if this is a challenge for you following joint replacement surgery). Check with your surgeon if you are restricted from using stairs and for how long.
- You may also need assistance getting in and out of the car, or changing positions in general, if you are severely set back following surgery. Your surgeon can provide advice on this if it is an issue for you.
Contact your employer and discuss your return to work.Depending upon which joint you received surgery on, as well as the nature of the job you do, you may need to take a short leave of absence from work as you recover. Another option, if you cannot do certain physical aspects of your job after surgery, is to ask your boss about giving you alternate duties at the workplace.
- If you need to take time off work to recover, look into employee insurance and any other benefits you may have to help cover healthcare costs.
Recovering Long Term
Ensure that your surgical incision is healing well.You will want to keep an eye on your surgical wound as the weeks go by to ensure that it is healing properly. You will most likely be returning to your surgeon approximately 14 days after surgery to have the staples removed - staples are what tend to be used these days to hold the edges of your wound together after surgery. At this time, your surgeon can also provide his or her opinion on your wound healing to date.
- You can use an ice pack for 10 to 15 minutes as needed to help with pain and/or swelling around your incision.
- Avoid using creams, lotions, or ointments over the incision as these may interfere with proper healing.
- Your surgeon will have instructed you about the dose and type of pain medication you are advised to take to control any pain at the incision point and in the joint itself following your joint replacement surgery.
- Contact your doctor if you notice unusual redness and heat around your incision (this may be a sign of infection), if there is any drainage from the wound, or if the pain is progressively getting worse rather than better.
Attend all scheduled follow-up visits.Following a joint replacement surgery, follow-up visits are generally scheduled with your surgeon at the 3 week mark, the 6 week mark, the 3 month mark, the 6 month mark, and the 12 month mark. After that, you can expect to receive annual check-up to assess your implant and to ensure that it is still functioning well. In order to set yourself up for optimum recovery and the best health moving forwards, it is key that you attend all follow-up visits. You can also bring up any additional concerns or questions with your doctor at this time.
Return to physical activity as directed.An essential part of a good recovery is returning to physical activity as recommended by your physiotherapist and healthcare team. If you remain sedentary after a joint replacement surgery, or do minimal activity, your chances of developing a strong and optimally mobile new joint are much smaller than if you adhere to the physical activity recommendations.
- While it is important to be physically active, it is also wise to avoid hazardous activities that could potentially re-injure your joint. Practice caution and moderation as you recover.
- Physical activity recommendations may include a gradual return to walking, followed by more complex activities like climbing the stairs (for joint replacement surgeries that are severe enough to have set you back in your basic day-to-day functioning).
- For more minor joint replacement surgeries, and/or for younger individuals who normally play sports, your return to physical activity will include recommendations as to how to get back into your sport of interest in the safest way possible (often starting with non-contact drills and proceeding to more intense play once your joint is fully recovered).
Video: Hip Replacement: A Patient Guide
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