Joint Replacement Patients

• When you are cleared to do so by your surgeon or physical therapist.
• When you are no longer taking narcotic pain medication.
• A good self-test would be if you can crush an empty pop can under your foot with your operative side.
• When you can walk 100 feet without a cane or walker.
• When you are confident you can safely manipulate the brake and gas pedal in an emergency situation.

• Notify your dentist or other doctor/surgeon in advance if you are having dental work or other invasive procedures.
• You will need to be on antibiotics for an amount of time determined by your surgeon preventively for any surgical, dental, endoscopy, or colonoscopy procedure.
• Postpone any procedures that may cause bleeding such as dental work, minor or major surgical procedures, etc. If it is not possible to postpone, be sure that the dentist or doctor is aware of the fact that you are taking blood thinners and that you have had a recent joint replacement.

• Your joint replacement is made of metal alloy and may or may not be detected when going through some security devices. Inform the security agent you have a metal implant. The agent will direct you on the security screening procedure.

When traveling, stop and change positions frequently to prevent your joint from getting stiff.

Having trouble sleeping since your surgery? You are certainly not alone. Many people complain of difficulty sleeping from the lingering effects of anesthesia, the body’s stress response to the surgery, as well as changes in your daily routine. Here are a few tips for a better night’s sleep:

• Avoid day-time naps, try to remain active, and exercise throughout the day.
• Avoid caffeine in the evenings (coffee, tea, chocolate, and colas).
• Listen to relaxing music in the evenings.
• Take a nice warm shower, if permitted.

Your normal sleeping patterns should return within a few weeks, but please notify your doctor if:

• You notice changes in your behavior.
• A lack of sleep is causing problems in your life.
• Normal sleeping patterns do not return within two to three weeks.

After surgery, it is not unusual for your appetite to “disappear” for a while. Your favorite foods may not taste as good as usual, or you are just not hungry. Here are a few suggestions to try until your appetite returns:

• Eat 5-6 small meals a day. Rather than 3 larger meals, try eating smaller meals and snacks to make sure you get enough nutrition. Good snacks include cheese and crackers, glass of milk, cottage cheese, peanut butter on crackers or celery, or some of the protein shakes that are available.
• Some foods that may taste good during your recovery may not be the most nutritious. Try replacing them with foods that are higher in protein, vitamins and minerals.
• If you are experiencing taste changes, try a variety of foods to find out what works best for you. For example, you may find that cold foods with little odor work best. Cottage cheese, cereals, macaroni and cheese and chicken salad may be tastier than beef.

The swelling will be at its worst the first month or two after surgery. However, swelling can last from six months to a year after surgery to some extent. For total knees, the size of your knee will always be slightly bigger than the original one.

Generally, a hip or knee replacement should last around 20 years. Some of the more recent research has shown a possibility of lasting upwards of 30 years.

Yes, walking and dancing activities will depend on how active you were prior to surgery and how hard and dedicated you are to rehabilitation after surgery. Prolonged running, jogging, jumping, or high impact activities are never recommended after a total hip or knee replacement.

• Please schedule your post-op physical therapy appointments prior to surgery to get an appointment time that works for you.
• You will need a driver to and from P.T. until you have discontinued your narcotic pain medication and you are cleared to drive.
• Your P.T. order will be given to you when you are discharged.
• Hoffman’s patients will begin physical therapy the Monday following their surgery.
• Mendel’s patients will begin physical therapy the Friday following their surgery.

Knees:

• For the first 3-4 weeks → Physical therapy will be at least 3 times a week
• For the next 1-3 weeks → Physical therapy will be at least 2 times a week

Hips:

• For the first 2 weeks → Physical therapy will be at least 3 times a week
• For the next 2-3 weeks → Physical therapy will be at least 2 times a week

This depends. The initial goal after surgery is at least getting to what you had preoperatively. The hope is that from the replacement and a full physical therapy program, is that your ROM is increased by a total of 10-15 degrees.

Typical ROM

The typical ROM for a total knee replacement is 120 degrees of flexion (or knee bend) and zero degrees of extension (or knee straightening). Again, this also depends on your ROM prior to surgery. Hip replacements can get full extension, however, are limited to 90 degrees of hip flexion or bend initially.

Total hip precautions are very important for a while after surgery. However, a combination of any of the precautions can be hazardous for many years after the surgery.