I just had a joint replacement surgery, what happens next?
Most people spend a night or two in the hospital, after which they are discharged.
Many patient’s return to home with a home-healthcare service. This depends on your overall health prior to surgery, the support from family and friends that you have as you recover, how many stairs or obstacles are in your house, and other factors.
Some patients may discharge to a skilled nursing facility to recover for 7 to 10 days – for example, if you live on a second-floor apartment without an elevator, or if you live alone, it may be difficult to care for yourself for the first week or two.
You will be sent home with a handful of medications, typically these are all electronically prescribed and will be waiting for your when you discharge from the hospital. Make sure the hospital has your correct pharmacy the day you check in for your surgery.
I usually prescribe Vitamin D3, Vitamin C, an NSAID (usually Meloxicam), Docusate (a stool softener, important while taking narcotic medications), a pain-relieving medication (typically a narcotic such as Oxycodone or Hydrocodone), and finally a blood thinner (Deep Venous Thrombosis prophylaxis).
In 2015, the AAOS (American Academy of Orthopaedic Surgery) and ACCP (American College of Chest Physicians) released a recommendation to use Aspirin as a means of DVT prophylaxis in the post-operative period. Most patients are given Aspirin 81mg twice daily for 30 days, but exceptions exist.
I also like to send people home with a walker, an elevated commode seat, and a shower chair. These prescriptions will be provided in paper form and we either have them ready when you leave, or a home healthcare service will assist you with obtaining them.
For the first two weeks, a home healthcare provider may assist you with certain daily activities, but they are really there to help with therapy.
Physical therapy is very important, you will perform exercises at home for the first two weeks following surgery, and in an outpatient setting after that.
The post-operative bandage (a silver-impregnated island dressing) should be left on for 7 days from the date of surgery. You should remove it after 7 days, because sometimes it can cause a rash if it’s on for too long.
You can shower in the hospital and once you return home, but I ask you to cover either the island dressing or the incision itself with a strip of plastic cling wrap.
Your incision is typically closed with sutures placed under the skin that dissolve on their own, plus glue and steri-strips. Typically, there are no staples or stitches to remove in clinic.
After two weeks, the incision is usually well-healed enough that you can shower and lightly wash the incision with warm, soapy water.
After six weeks, the incision is typically healed enough that you can soak it in a tub or pool.
You will begin outpatient physical therapy in one of Layton’s many good outpatient facilities beginning two weeks after surgery. Physical therapy is extremely important to assist in returning to full and pain free function! Expect to go two times per week for 4 to 8 weeks following surgery.
Expect to take a break from driving for 3 to 4 weeks following surgery.
Anticipate time off from work – usually 6 to 8 weeks following a hip replacement, or 10 to 12 weeks following a knee replacement. Everyone’s job is different, an office-type job may return sooner, if you work a very physical job expect the full time off.
This is an elective procedure – schedule a time that works well for you and your family. Consider when you have slow months at work, when your family or friends are available, and when you don’t have any exciting trips or obligations coming up.