I'm Recovering From Surgery

Recovery from surgery is not the same for every patient. Recovery is very individualized. It takes, in general, about three months for the joint to recover to a point where you are back to full activity. Obviously, some patients recover faster than others, depending upon age, health status, personal motivation and response to rehabilitation. Recovery also depends on on the condition of your joint BEFORE surgery. Some patients will have more stiffness, deformity or weakness than others.

Be patient during your recovery since your progress will be gradual. Recovery is not an overnight process. You should notice positive progression each week. During the recovery phase it is not unusual to have a set-back. It is OK to have a few bad days mixed in with good progress. This is how a patient naturally recovers. Not every day will be better than the next.

Recovering from Primary (First-time) Hip Replacement

Recovering from Knee Replacement Surgery

Recovering from Arthroscopy Surgery

RECOVERING FROM PRIMARY (FIRST-TIME) HIP REPLACEMENT

For other information please review the HIP BOOKLET and the section on "Recovery"

  1. Keep white compression stockings ( TED® hose) on your legs to maintain good circulation and prevent blood clots. These stocking should be worn for a total of 4 weeks and can be taken off at night.
  2. ANTICOAGULANTS : This is a medication that can help prevent clots from forming in the blood. The medication taken is usually in the form of an oral pill (Coumadin®) or an injection under the skin (Lovenox®). An embolus (a blood clot that has broken away and traveled to another part of the body) can cause strokes, heart attacks, and death. Some side effects of taking a blood thinner include, easier bruising, easier to bleed if cut and increased wound drainage. If you are at low risk for developing a blood clot, then the use of these type of medications in usually less than one month following surgery, but again this is very individualized.
  3. Following discharge from the hospital, most patients will take oral pain medications--usually Hydrocodone, or Tylenol #3, for up to 6weeks after the procedure, mainly to help with physical therapy and home exercises for the knee. You should progressively be decreasing the amount of pain medication as you recover. It may be helpful to take an anti-inflammatory medication such as Aleve® or Motrin® to help decrease the the amount of pan and swelling. Remember, before starting any new medication, it is best to contact your family doctor to make sure there are no drug interactions side effects that may be unique to your medical history.

    Patients should not drive while taking these kinds of medications.

    IF YOU NEED A REFILL, please contact your pharmacy where you had the medication filled and they can help facilitate this process. Pain medication refills will be refilled M-F form 8AM to 5PM. Please plan accordingly. On weekends and after hour prescription refills, may require you to go to an emergency room.
  4. Make yourself as comfortable as possible by taking pain medication. Do not over-use or under-use them. Take your pain medications a half-hour before exercising so they will effectively control the pain. Remember, it is not likely to get addicted to a pain medication if used as directed. Most patients only need pain medication for the first 6-8 weeks and in this short time period, it is unlikely to become addicted.
  5. Because swelling causes pain, we try to minimize the swelling. However it is a natural process to have swelling around an area after surgery. This swelling can last up to 6 months. To help with pain after surgery we recommend the use of ICE. The easiest way to apply ice to a surgical area is with a frozen pack of vegetables or fruit. This can be re-used. Place 2-3 bags around the hip and surgical area, and leave in place for approximately one hour. Repeat every 4 hours. It is especially important to use ice 4 times a day in the first 2 weeks after surgery and after your therapy sessions. Decreasing swelling, decreases pain, and improves motion in your joint and speeds up the recovery process.
  6. Walk with crutches/cane and /or a walker as permitted by your physical therapist or Dr. Matthys
  7. Very few patients after surgery have hip precautions or restrictions. If Dr. Matthys has ordered any restrictions please follow the instructions
  8. How Your New Joint Is Different

    You may feel some numbness in the skin around your incision. It is not uncommon after Hip replacement to have some numbness or burning/prickling feeling around the outer thigh and above the knee. This will generally get better, but may take a year. You also may feel some stiffness, particularly with excessive bending. These differences often diminish with time, and most patients find these are minor compared with the pain and limited function they experienced prior to surgery. It may be common to have some clicking and popping sensation in the new joint. Remember this is a mechanical device and is made of metal. As the parts move on one another, it is normal to make a little sound. As the scar tissue matures, this will improve.
  9. Patients are usually discharged 3 days after hip replacement surgery. It is important that discharged patients be able to safely get in their homes and perform regular activities, such as getting to the bathroom and preparing food. During your hospital stay you will learn to walk with a walker or crutches and go up and down stairs and get in and out of a car.

    If patients are not progressing to the point that they can safely return to their home environment, in-patient rehabilitation may be recommended. This allows for further work with the therapists and 24-hour support services.
  10. EXERCISES: You should have been given a list of basic exercises. Do your exercises 2 times per day so you can regain as much strength and motion as possible. If you have been scheduled to see a therapist, follow their recommendations. Therapy is critical in getting the most out of your surgery. ***omedix---please put link to handout: regaining your knee motion.
  11. RETURN TO WORK: Return to work depends on the activity that you have to do at your job. Patients who work in a seated position, with limited walking, can plan on returning within about 4-6 weeks from the time of surgery.

    Patients who are more active at work may need more time until they can return to full duties. Laborers should consider their work obligations before undergoing hip replacement. For example, patients may not be able to return to activities such as roofing after hip replacement.

  12. RETURN TO DRIVING: Return to driving depends on a number of factors, including the side of your operation and the type of vehicle you have (standard or automatic). Patients need to be able to safely and quickly operate the gas and brake pedals. Under no circumstances should patients drive when taking narcotic pain medications.
  13. WOUND CARE:

    • Keep the incision dry.
    • Keep the incision covered with a light dry dressing until the staples are removed, usually 14 days after the surgery. If the wound is not draining, then a dressing may not be needed.
    • Notify Dr. Matthys' office if there is increased drainage, redness, pain or odor. Bruising around the wound and up and down the leg is not uncommon for up to 3 weeks after the surgery.
    • Take the patient's temperature if he or she feels warm or sick.
    • You may shower, but keep the surgical area clean and dry with an occlusive gauze. Do NOT soak or bathe the wound.
    • Do not apply any special creams, lotion or peroxide to the wound. Vitamin E lotion will be o.k. only after the wound has completely healed (1 month).
    • To improve scar healing and cosmetics, keep the surgical wound away form sunlight for up to a year.
  14. Do not deviate from the post-op regimen outlined by your doctor, nurse, and therapists
  15. CALL IMMEDIATELY IF THERE ARE ANY DANGER SIGNS:

SIGNS OF AN INFECTION:

  • Increased swelling and redness at the incision site. A little bit of warmth around the surgical area is common.
  • Drainage from the wound 10 days after the surgery
  • Increasing amount of discharge.
  • Smell or odorous discharge
  • Fever greater than 101.0º F . It may be common to have a temperature of up to 101 within the first week after surgery. This can usually be treated with tylenol®. Beyond 7 days, you should contact the office.

SIGNS OF A BLOOD CLOT IN THE LEGS

  • Swelling in thigh, calf or ankle that does not go down with elevation
  • Pain, heat and tenderness in calf, back of knee or groin area. NOTE: blood clots can form in either leg.

SIGNS OF AN EMBOLUS ( this is an emergency and you should call 911)

  • Sudden chest or arm pain
  • Difficulty breathing
  • Rapid breathing
  • Sweating
  • Confusion

RECOVERING FROM KNEE REPLACEMENT SURGERY:

For other information please review the KNEE BOOKLET and the section on "Recovery"

  1. Keep white compression stockings ( TED® hose) on your legs to maintain good circulation and prevent blood clots. These stocking should be worn for a total of 4 weeks and can be taken off at night.
  2. ANTICOAGULANTS : This is a medication that can help prevent clots from forming in the blood. The medication taken is usually in the form of an oral pill (Coumadin®) or an injection under the skin (Lovenox®). An embolus ( a blood clot that has broken away and traveled to another part of the body) can cause strokes, heart attacks, and death. Some side effects of taking a blood thinner include, easier bruising, easier to bleed if cut and increased wound drainage. If you are at low risk for developing a blood clot, then the use of these type of medications in usually less than one month following surgery, but again this is very individualized.
  3. Following discharge from the hospital, most patients will take oral pain medications--usually hydrocodone, or Tylenol #3, for up to 6weeks after the procedure, mainly to help with physical therapy and home exercises for the knee. You should progressively be decreasing the amount of pain medication as you recover. It may be helpful to take an anti-inflammatory medication such as Aleve® or Motrin® to help decrease the the amount of pan and swelling. Remember, before starting any new medication, it is best to contact your family doctor to make sure there are no drug interactions side effects that may be unique to your medical history. Patients should not drive while taking these kinds of medications. IF YOU NEED A REFILL, please contact your pharmacy where you had the medication filled and they can help facilitate this process. Pain medication refills will be refilled M-F form 8AM to 5PM. Please plan accordingly. On weekends and after hour prescription refills, may require you to go to an emergency room.
  4. Make yourself as comfortable as possible by taking pain medication. Do not over-use or under-use them. Take your pain medications a half-hour before exercising so they will effectively control the pain. Remember, it is not likely to get addicted to a pain medication if used as directed. Most patients only need pain medication for the first 6-8 weeks and in this short time period, it is unlikely to become addicted.
  5. Because swelling causes pain, we try to minimize the swelling. However it is a natural process to have swelling around an area after surgery. This swelling can last up to 6 months. To help with pain after surgery we recommend the use of ICE. The easiest way to apply ice to a surgical area is with a frozen pack of vegetables or fruit. This can be re-used. Place 2-3 bags around the hip and surgical area, and leave in place for approximately one hour. Repeat every 4 hours. It is especially important to use ice 4 times a day in the first 2 weeks after surgery and after your therapy sessions. Decreasing swelling, decreases pain, and improves motion in your joint and speeds up the recovery process.
  6. Walk with crutches/cane and /or a walker as permitted by your physical therapist or Dr. Matthys
  7. Very few patients after surgery have hip precautions or restrictions. If Dr. Matthys has ordered any restrictions please follow the instructions
  8. How Your New Joint Is Different You may feel some numbness in the skin around your incision. It is not uncommon after Hip replacement to have some numbness or burning/prickling feeling around the outer thigh and above the knee. This will generally get better, but may take a year. You also may feel some stiffness, particularly with excessive bending. These differences often diminish with time, and most patients find these are minor compared with the pain and limited function they experienced prior to surgery. It may be common to have some clicking and popping sensation in the new joint. Remember this is a mechanical device and is made of metal. As the parts move on one another, it is normal to make a little sound. As the scar tissue matures, this will improve.
  9. Patients are usually discharged 3 days after hip replacement surgery. It is important that discharged patients be able to safely get in their homes and perform regular activities, such as getting to the bathroom and preparing food. During your hospital stay you will learn to walk with a walker or crutches and go up and down stairs and get in and out of a car. If patients are not progressing to the point that they can safely return to their home environment, in-patient rehabilitation may be recommended. This allows for further work with the therapists and 24-hour support services.
  10. EXERCISES: You should have been given a list of basic exercises. Do your exercises 2 times per day so you can regain as much strength and motion as possible. If you have been scheduled to see a therapist, follow their recommendations. Therapy is critical in getting the most out of your surgery. ***omedix---please put link to handout: regaining your knee motion.
  11. RETURN TO WORK: Return to work depends on the activity that you have to do at your job. Patients who work in a seated position, with limited walking, can plan on returning within about 4-6 weeks from the time of surgery. Patients who are more active at work may need more time until they can return to full duties. Laborers should consider their work obligations before undergoing hip replacement. For example, patients may not be able to return to activities such as roofing after hip replacement.
  12. RETURN TO DRIVING: Return to driving depends on a number of factors, including the side of your operation and the type of vehicle you have (standard or automatic). Patients need to be able to safely and quickly operate the gas and brake pedals. Under no circumstances should patients drive when taking narcotic pain medications.
  13. WOUND CARE:
    • Keep the incision dry.
    • Keep the incision covered with a light dry dressing until the staples are removed, usually 14 days after the surgery. If the wound is not draining, then a dressing may not be needed.
    • Notify Dr. Matthys' office if there is increased drainage, redness, pain or odor. Bruising around the wound and up and down the leg is not uncommon for up to 3 weeks after the surgery.
    • Take the patient's temperature if he or she feels warm or sick.
    • You may shower, but keep the surgical area clean and dry with an occlusive gauze. Do NOT soak or bathe the wound.
    • Do not apply any special creams, lotion or peroxide to the wound. Vitamin E lotion will be o.k. only after the wound has completely healed (1 month).
    • To improve scar healing and cosmetics, keep the surgical wound away form sunlight for up to a year.
  14. Do not deviate from the post-op regimen outlined by your doctor, nurse, and therapists
  15. CALL IMMEDIATELY IF THERE ARE ANY DANGER SIGNS:

SIGNS OF AN INFECTION:

  • Increased swelling and redness at the incision site. A little bit of warmth around the surgical area is common.
  • Drainage from the wound 10 days after the surgery
  • Increasing amount of discharge.
  • Smell or odorous discharge
  • Fever greater than 101.0º F . It may be common to have a temperature of up to 101 within the first week after surgery. This can usually be treated with tylenol®. Beyond 7 days, you should contact the office.

SIGNS OF A BLOOD CLOT IN THE LEGS

  • Swelling in thigh, calf or ankle that does not go down with elevation
  • Pain, heat and tenderness in calf, back of knee or groin area. NOTE: blood clots can form in either leg.

SIGNS OF AN EMBOLUS ( this is an emergency and you should call 911)

  • Sudden chest or arm pain
  • Difficulty breathing
  • Rapid breathing
  • Sweating
  • Confusion

For other information please review the KNEE BOOKLET and the section on "Recovery" and handout on "Getting your Motion Back"

RECOVERING FROM ARTHROSCOPY SURGERY:

For the first couple of days, the leg should be rested and elevated as much as possible. Simple painkillers and cold packs may be used as required.

Dressings

The large bandage around the knee is normally removed 24-48 hours after arthroscopic knee surgery. The are stitches will be removed at 10-14 days after surgery and the wounds should be kept clean and dry until they have completely healed. A small dressing can be placed on these wounds for a few days following arthroscopic knee surgery.

Bathing and showering: The wounds should be kept clean and dry until at least four days following arthroscopic knee surgery when, providing the wound has sealed, bathing or showering is permitted.

Rehabilitation

In the first few days following arthroscopic knee surgery, simple rehabilitation exercises including straight leg raising, knee and ankle movements and tensioning of the quadriceps [thigh] muscles should be undertaken as recommended Dr. Matthys.

Physical Therapy (PT): Some patients require PT following arthroscopic knee surgery. This may take place either before or after the first post-operative check-up depending on individual need.

Return to activity

Generally, a return to activities takes between two and six weeks following arthroscopic knee surgery. Recovery, however, depends on the extent of damage found within the knee, the treatment performed, the type of activities to which the patient wishes to return and the general fitness of the patient. Approximate recovery times following simple arthroscopic surgery are:

  • Sedentary (office type) work 2-5 days
  • Physical work 1-3 weeks
  • Light training 3 weeks
  • Return to full impact activities 4-6 weeks
  • Driving 2-4 days (must be off Narcotics)

Wounds

The small wounds can remain tender and thickened for a few weeks following arthroscopic knee surgery. Occasionally, a lump remains under one or other of the puncture holes for several weeks , this will slowly resolve.

Ongoing problems

Knee arthroscopy is not itself damaging to the knee joint. Any ongoing symptoms following arthroscopic knee surgery are usually the result of the problem within the knee joint for which the surgery was recommended and not as a result of the arthroscopy itself. Patients who have had a microfracture may experience discomfort, pain and swelling for 6-9 months.