Joint Replacement Patients

• Swelling and stiffness is normal and expected. Swelling normally peaks 5-7 days after surgery.  Your operative leg potentially could double in size.  Please follow instructions for icing, elevation, and activities in your discharge folder to help with swelling.

Knee Replacement Patients: A tourniquet was placed on your upper thigh to reduce blood loss during surgery.  Bruising from the tourniquet is normal and expected.

Changes in daily routine, short-term reductions in appetite and mobility, as well as narcotic pain medication can contribute to an increased risk for constipation.

• Take stool softeners and/or laxatives as prescribed.
• Drink plenty of water to add fluid to the colon making bowel movements easier to pass.
• Eat fiber rich foods like whole grains, fresh fruits, and vegetables to help keep your digestive system moving.
• Avoid caffeine – coffee, tea and colas. Caffeine flushes your colon of fluids and causes dehydration making stools dryer and harder to pass.
• Avoid alcohol – it also causes dehydration.
• Keep up with your exercises – daily walks help to keep things moving.
• Wean yourself from narcotic pain medications as soon as possible.

Follow your surgeon’s instructions for constipation management and prevention.

Call your surgeon if you haven’t had a bowel movement for 3 days. 

Although risks are low for postoperative infections, the risk remains. A prosthetic joint could possibly attract bacteria from an infection located in another part of your body.

If you sustain an injury such as a deep cut or puncture wound, you should clean it as best you can, put a dressing or adhesive bandage on it, and notify your doctor.  The closer the injury is to your prosthesis, the greater the concern.

Occasionally, antibiotics may be needed. Superficial scratches may be treated with topical antibiotic ointment. Notify your doctor if any area is painful or red.

Signs to notify your physician of:

• Excessive swelling, heat, drainage or redness from the incision site
• Fever greater than 101.5 degrees that is not relieved by taking Tylenol

Prevention

• Take proper care of your incision. Wash your hands frequently, especially after using the bathroom and after contact with pets.
• Notify your other doctors and dentist that you have a joint replacement.

A pulmonary embolism is an unrecognized blood clot that could break away from the vein and travel to the lungs.  This is an emergency CALL 911.

Signs

• Sudden chest pain
• Difficult and/or rapid breathing
• Shortness of breath
• Sweating
• Confusion

Follow the guidelines in the next section below to prevent blood clots from forming.

Surgery may cause the blood to slow and clot in veins of the legs. If a clot occurs, you may need to be admitted to the hospital to receive blood thinning medication. Blood clots can form in either of your legs.

Signs to notify your physician of:

• Pain, heat, and tenderness in your calf.

Prevention

Blood clots after surgery can cause serious problems. However, there are steps that can be taken to help prevent them:

• Follow your daily exercise routine and perform ankle pumps.
• Walk several times a day as instructed.
• Wear white compression stockings and grey compression wraps provided to you on surgery day, as directed by your surgeon. Inspect your skin daily.
• Take your anticoagulant or blood thinning medication as prescribed if ordered by your surgeon.

Report any anticoagulant-related side effects such as large amount of bleeding immediately!

There are many different types of blood thinning medications. Some are oral (by mouth) while others require injections. Your doctor will select the type of medication that is best for you.

When taken according to your surgeon’s instructions, blood thinners are generally safe and effective. However, in some cases, there may be warning signs that prompt treatment is needed.

If you fall, have a traumatic injury, or if you experience any of the following, call your surgeon immediately. DO NOT WAIT AND HOPE THE SYMPTOMS GO AWAY.

• Bleeding or oozing from the surgical wound
• Bleeding at the site of the injection, if taking an injectable blood thinner
• Nosebleeds
• Blood in your urine
• Coughing or vomiting blood
• Spontaneous bruising anywhere other than your operative leg (a bruise not caused by a blow or any apparent reason)
• Dizziness, numbness or tingling
• Uncontrolled vomiting, nausea or fever of 101.5 that persists after taking Tylenol
• Confusion
• Call 911 if you are experiencing rapid or unusual heartbeat, chest pain, or shortness of breath.

Things to Avoid While on Blood Thinners

Certain medications, foods and activities can interact negatively and interfere with blood thinners. It is important to take proper steps to avoid any potential complications.

• Check with your surgeon before taking any over-the-counter drugs like aspirin, aspirin containing compounds, non-steroidal medications and even vitamins, except those prescribed by your surgeon. Your surgeon will provide additional information based on the specific blood thinner you will be taking.
• Be consistent in the amount of dark green leafy vegetables you eat each day – they are high in Vitamin K and this can counteract the action of some blood thinners.
• Avoid drinking alcohol while on blood thinners.
• 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 knows you are taking blood thinners and that you have had a recent joint replacement.
• Avoid any activity that may result in injury such as hobbies that use power-tools or sharp instruments.