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Hip or knee replacement - in the hospital after

Hip replacement surgery - after - self-care; Knee replacement surgery - after - self-care

You will stay in the hospital for 2 to 3 days after having hip or knee joint replacement surgery. During that time you will recover from your anesthesia and the surgery.

Right After Surgery

Even though the surgeon may talk to family or friends right after surgery is done, you will still spend 1 to 2 hours after surgery in a recovery room before going to your room. You will likely wake up tired and groggy.

You will have a large dressing (bandage) over your incision (cut) and part of your leg. A small drainage tube may be placed during surgery to help drain blood that collects in your joint after surgery.

Back in Your Room

You will have an IV (a catheter, or tube, that is inserted into a vein, most often in your arm). You will receive fluids through the IV until you are able to drink on your own. You will slowly resume a normal diet.

You may have a Foley catheter inserted into your bladder to drain urine. Most of the time, it is removed the day after surgery. You may have some trouble passing your urine after the tube is removed. Make sure you tell the nurse if you feel that your bladder is full. It is helpful if you can walk to the bathroom and urinate in the normal fashion. You may need to have the tube put back in to help drain the bladder if you can't urinate for a while.

Your health care provider will show you how to prevent blood clots.

  • You may wear special compression stockings on your legs. These stockings improve blood flow and reduce your risk of getting blood clots.
  • Most people will also receive blood-thinning medicine to further reduce the risk of blood clots. These medicines can make you bruise more easily.
  • When you are in bed, move your ankles up and down. You will also be taught other leg exercises to do while you are in bed to prevent blood clots. It is important to do these exercises.

You may be taught how to use a device called a spirometer and do deep breathing and coughing exercises. Doing these exercises will help prevent pneumonia.

Your provider will prescribe pain medicines to control your pain.

  • You can expect to have some amount of discomfort after surgery. The amount of pain varies from person to person.
  • You may receive pain medicine through a machine that you can use to control when and how much medicine you receive. You will receive the medicine through an IV, oral pills, or a special tube placed into your back during surgery.
  • You may also have a nerve block placed during surgery, which may be continued after surgery. Your leg may feel numb and you may not be able to move your toes and ankle. Make sure you talk with your provider before and after surgery to make sure that your sensation is normal.

You may also be prescribed antibiotics to prevent infection. In most cases you will get these drugs through an IV while you are still in the hospital.

You Will be Encouraged to Start Moving and Walking

Your providers will encourage you to start moving and walking.

You will be helped out of bed to a chair on the day of surgery. You may even try to walk if you feel up to it.

You will work with specialists to get moving again and to learn to take care of yourself.

  • A physical therapist will teach you exercises and how to use a walker or crutches.
  • An occupational therapist will teach people who have had hip replacement how to safely perform daily activities.

All of this takes a lot of hard work on your part. But the effort will pay off in the form of a faster recovery and better results.

By the second day after surgery, you will be encouraged to do as much as you can by yourself. This includes going to the bathroom and taking walks in the hallways with help.

After knee replacement, some surgeons recommend using a continuous passive motion machine (CPM) while you are in bed. The CPM bends your knee for you. Over time, the rate and amount of bending will increase. If you are using this machine, always keep your leg in the CPM when you are in bed. It may help speed your recovery and reduce pain, bleeding, and risk of infection.

You will learn the proper positions for your legs and knees. Make sure you follow these guidelines. Improper positioning can injure your new hip or knee joint.

Getting Ready to go Home

Before you go home, you will need to:

  • Be able to move or transfer in and out of bed, in and out of chairs, and off and on the toilet without help and safely
  • Bend your knees almost to a right angle or 90° (after knee replacement)
  • Walk on a level surface with crutches or a walker, without any other help
  • Walk up and down some steps with help

Some people need a short stay in a rehabilitation center or a skilled nursing facility after they leave the hospital and before they go home. During the time you spend here, you will learn how to safely do your daily activities on your own. You will also have time to build strength while you recover from your surgery.

References

Harkess JW, Crockarell JR. Arthroplasty of the hip. In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 3.

Mihalko WM. Arthroplasty of the knee. In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 7.

  • Hip joint replacement

    Animation

  •  

    Hip joint replacement - Animation

    Your hip is hurting so bad, you can't sleep. It's hard to bathe, to clean, make it to the mailbox or shop at the mall. You may have severe arthritis in your hip, and there's a good chance you need a hip replacement. Hip replacements are usually done in people age 60 and older. If you need one, you probably have severe arthritis that limits your daily life, or perhaps have a hip fracture. Your hip joint is made up of two parts, the hip socket and the upper end of the thigh bone. One or both parts may be replaced during surgery. Your new hip will probably have a socket made of strong metal, a liner that fits inside the socket, usually plastic, a metal or ceramic ball to replace the round head of your thigh bone, and a metal stem attached to the thigh bone to make your joint more stable. So, how is the hip replacement procedure done? Well you won't not feel any pain during surgery because you will have medicine to make you fall asleep. The surgeon will cut and remove the head of your thigh bone and clean out your hip socket, removing cartilage and damaged or arthritic bone. The surgeon will put the new hip socket in place, insert the metal stem into your thigh bone, and place the ball for a new joint. Cement will probably hold the new joint in place. The surgery can take several hours. After the surgery, you will probably stay in the hospital for three to five days. As soon as the first day after surgery, you will be asked to start moving and walking around with a walker, crutches, or a cane. You will need physical therapy to strengthen your new joint for up to several weeks after your operation. Some people need a short stay in a rehabilitation center after they leave the hospital. At the rehab center, you will learn how to safely do your daily activities on your own. Your new hip should allow you to resume your daily activities once you've learned to move around on your own. In the long run, over 20 years or so, the joint may need to be placed again. But, in the short run, most or all of your pain should go away. The stiffness should go away. Your doctor should be able to monitor any problems and you should enjoy your new joint.

  • Knee joint replacement

    Animation

  •  

    Knee joint replacement - Animation

    Your knee has been hurting for a while, and it hurts bad. You've had trouble sleeping. It may be hard to bathe, to do normal chores like wash the car, or even be comfortable on the job. You may have severe arthritis in your knee, and if so there's a good chance you need a knee replacement. So, what is a knee replacement? Knee replacements are usually done in people age 60 and older. If you need one, you probably have severe arthritis that limits your daily life. During knee joint replacement, your surgeon will remove damaged cartilage and bone from the knee joint. The surgeon then puts man-made pieces, called prostheses, in their place. The lower end of the thigh bone, also called the femur, is usually replaced with a metal part. The part that replaces the upper end of the shin bone, the tibia, is usually made from metal and a strong plastic. The piece that replaces the back side of your kneecap, or patella, is usually made from a strong plastic. You shouldn't feel any pain during surgery because you will have medicine to make you fall asleep. The surgeon will make a cut over your knee to open it up. The cut is usually eight to ten inches long. Your surgeon will move your kneecap out of the way, then cut the ends of your thigh bone and shin bone to fit the replacement part. The surgeon will then cut the underside of your kneecap and prepare it for the new pieces that will attach there. The surgeon then fastens the two parts of the prosthesis to your bones, the upper end of the shin bone and the lower end of the thigh bone. Then the parts are attached to the underside of your kneecap using a special cement. The surgery usually takes a couple hours. After surgery, you will probably stay in the hospital for three to five days. As soon as the first day after surgery, you will be asked to start moving and walking around with a walker, crutches, or a cane. You will likely need physical therapy to strengthen your new joint after your operation. Some people need a short stay in a rehabilitation center after they leave the hospital. At the rehab center, you will learn how to safely do your daily activities on your own. Full recovery can take three months to a year. Your new knee should last for 15 years or maybe even 20. And in the mean time, your new knee should allow you to resume your daily activities once you have learned to move around. Most or all of your pain and stiffness should go away.

  • Hip joint replacement

    Animation

  •  

    Hip joint replacement - Animation

    Your hip is hurting so bad, you can't sleep. It's hard to bathe, to clean, make it to the mailbox or shop at the mall. You may have severe arthritis in your hip, and there's a good chance you need a hip replacement. Hip replacements are usually done in people age 60 and older. If you need one, you probably have severe arthritis that limits your daily life, or perhaps have a hip fracture. Your hip joint is made up of two parts, the hip socket and the upper end of the thigh bone. One or both parts may be replaced during surgery. Your new hip will probably have a socket made of strong metal, a liner that fits inside the socket, usually plastic, a metal or ceramic ball to replace the round head of your thigh bone, and a metal stem attached to the thigh bone to make your joint more stable. So, how is the hip replacement procedure done? Well you won't not feel any pain during surgery because you will have medicine to make you fall asleep. The surgeon will cut and remove the head of your thigh bone and clean out your hip socket, removing cartilage and damaged or arthritic bone. The surgeon will put the new hip socket in place, insert the metal stem into your thigh bone, and place the ball for a new joint. Cement will probably hold the new joint in place. The surgery can take several hours. After the surgery, you will probably stay in the hospital for three to five days. As soon as the first day after surgery, you will be asked to start moving and walking around with a walker, crutches, or a cane. You will need physical therapy to strengthen your new joint for up to several weeks after your operation. Some people need a short stay in a rehabilitation center after they leave the hospital. At the rehab center, you will learn how to safely do your daily activities on your own. Your new hip should allow you to resume your daily activities once you've learned to move around on your own. In the long run, over 20 years or so, the joint may need to be placed again. But, in the short run, most or all of your pain should go away. The stiffness should go away. Your doctor should be able to monitor any problems and you should enjoy your new joint.

  • Knee joint replacement

    Animation

  •  

    Knee joint replacement - Animation

    Your knee has been hurting for a while, and it hurts bad. You've had trouble sleeping. It may be hard to bathe, to do normal chores like wash the car, or even be comfortable on the job. You may have severe arthritis in your knee, and if so there's a good chance you need a knee replacement. So, what is a knee replacement? Knee replacements are usually done in people age 60 and older. If you need one, you probably have severe arthritis that limits your daily life. During knee joint replacement, your surgeon will remove damaged cartilage and bone from the knee joint. The surgeon then puts man-made pieces, called prostheses, in their place. The lower end of the thigh bone, also called the femur, is usually replaced with a metal part. The part that replaces the upper end of the shin bone, the tibia, is usually made from metal and a strong plastic. The piece that replaces the back side of your kneecap, or patella, is usually made from a strong plastic. You shouldn't feel any pain during surgery because you will have medicine to make you fall asleep. The surgeon will make a cut over your knee to open it up. The cut is usually eight to ten inches long. Your surgeon will move your kneecap out of the way, then cut the ends of your thigh bone and shin bone to fit the replacement part. The surgeon will then cut the underside of your kneecap and prepare it for the new pieces that will attach there. The surgeon then fastens the two parts of the prosthesis to your bones, the upper end of the shin bone and the lower end of the thigh bone. Then the parts are attached to the underside of your kneecap using a special cement. The surgery usually takes a couple hours. After surgery, you will probably stay in the hospital for three to five days. As soon as the first day after surgery, you will be asked to start moving and walking around with a walker, crutches, or a cane. You will likely need physical therapy to strengthen your new joint after your operation. Some people need a short stay in a rehabilitation center after they leave the hospital. At the rehab center, you will learn how to safely do your daily activities on your own. Full recovery can take three months to a year. Your new knee should last for 15 years or maybe even 20. And in the mean time, your new knee should allow you to resume your daily activities once you have learned to move around. Most or all of your pain and stiffness should go away.

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    Review Date: 7/7/2019

    Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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