Life After Replacement

The goal of joint replacement is to restore function of the joint and eliminate pain. Slowly, you will be able to resume most daily activities. However, these activities may need to be altered to ensure a successful outcome.

When you return home, you must ensure the wound heals completely and without infection. Keep the area clean and dry and follow the instruction from the hospital on changing the dressing. At 2 to 3 weeks post-operative, you will revisit your surgeon for removal of sutures and follow-up X-rays. Avoid showering or bathing, using only a sponge bath to keep clean. If the wound appears red or begins to drain, notify your doctor. Swelling is common during the first 3 to 6 months after surgery. It can be reduced by elevating the leg slightly and applying an ice pack for 15 to 20 minutes at a time. Monitor your temperature twice daily and notify your doctor if it exceeds 100.5F. If you notice any calf pain, chest pain or shortness of breath, contact your doctor immediately. These are signs of a possible blood clot.

Follow your doctor's guidelines on taking medications. You may be given a blood thinner to prevent blood clot formation. Blood clots that travel to your lungs can result in a pulmonary embolism, a potentially fatal condition.

With a prosthetic joint you must prevent any bacterial infections from settling in your implant. As a precaution, take antibiotics whenever there is the possibility of a bacterial infection, such as before dental work. Inform your dentist of your joint implant and notify your primary care doctor about upcoming extractions, periodontal work, dental implant, or root canal work.

Diet

Upon returning home, you should resume a normal, healthy diet with the addition of a vitamin supplement. Drink plenty of fluids and avoid excessive intake of vitamin K (found in broccoli, cauliflower, Brussels sprouts, liver, green beans, garbanzo beans, lentils, soybeans, soybean oil, spinach, kale, lettuce, turnip greens, cabbage and onions) as it may interfere with blood thinner medication. Limit your coffee consumption and avoid alcohol. Watch your weight to avoid putting more stress on the joint.

Resuming normal activities

Once you get home, stay active within your new limits. With proper rehabilitation, you will notice a gradual improvement and ability to return to your normal activity.

Review weightbearing guidelines with your physician and physical therapist. These guidelines will vary depending on the type of implant used and your physical health. Recovery from a revision surgery (replacing a previously implanted prosthesis) generally requires an extended period of time with protective weightbearing on the leg.

You can begin driving an automatic shift car in 4 to 6 weeks as long as you have stopped taking narcotic pain medication. The physical therapist will show you techniques, such as placing a plastic bag on the site, to help in entering and leaving a car. Try sleeping on your back with your legs apart or on your side with a pillow between your knees. Use a pillow between your knees for at least 6 weeks, or until cleared by your doctor.

Use a chair with arms to aid in sitting down and rising up for at least the first 3 months. Avoid low chairs, low stools, or reclining chairs and never cross your legs. Your physical therapist will show you how to sit and stand from a chair, keeping your operated leg out in front of you. Move around on a regular basis, at least once every hour to ensure good blood circulation. Stair climbing is the activity that puts the most strain on your new implant, and should be avoided during healing. When forced to climb stairs, step up with the unaffected leg first. Then bring the affected leg up, followed by your crutches or canes. Going down stairs, reverse the process. Put your crutches or canes on the lower step. Then, bring the affected leg forward. Finally step down on the unaffected leg.

Depending on the type of work activities you perform, it may be 2 to 4 months before you can return. Once your doctor clears you, walk as much as you like in addition to your prescribed exercises. Swimming is a good non-weight bearing activity once the wound is healed. Other good activities include dancing, golfing (with spikeless shoes and a cart), and bicycling (on level surfaces). Avoid activities that put excessive stress on the joint such as singles tennis and contact sports (football, basketball), or jogging. Avoid heavy lifting (more than 40 pounds) or weight lifting.