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Newton, MA 02462
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For the first few days you may take a strong pain medicine, such as a narcotic. Most people taper off narcotics and change to Tylenol within the first few weeks. If you are taking Coumadin (warfarin) or any blood thinner, you should talk with your primary care physician before making any changes in your pain medicine. You may take Tylenol while you are taking Coumadin.
Yes. For some procedures they will want to give you antibiotics to prevent infection of your new joint. We prefer that you not have dental appointments the week before your surgery and in the three months following surgery.
You will be on a blood thinner to help prevent blood clots. You may be on aspirin, Coumadin, or other blood thinner that you take by mouth, or you may receive Lovenox, which is given in a shot. Your doctor will let you know when you can stop taking your blood thinner. Your nurse will review your instructions for blood thinners at the time of discharge.
Four weeks is usually enough time to build up blood after surgery.
It is very common to have constipation after surgery, especially when taking narcotic pain medicine. A simple over-the-counter stool softener (such as Colace) is the best way to prevent this problem. Increasing fruits and vegetables in your diet will also help. In rare instances, you may require something stronger, so check with your doctor’s office.
Alcohol use is not advised until you have stopped your narcotic pain medicine and are walking steadily. Alcohol is also not advised if you are taking Coumadin.
It is common to have feelings of depression or trouble sleeping after surgery. This may be due to a variety of factors such as difficulty getting around, discomfort, or increased dependency on others. These feelings will typically fade as you begin to return to your regular activities. If they continue, consult your primary care doctor.
Most patients are able to go home after surgery. Your health care team will evaluate your discharge needs post-operatively. If an extended-care facility is determined to be medically necessary, the team will discuss this with you. Many factors will be considered in this decision. Your case manager will assist you with discharge planning.
Yes! Therapy plays a very important role in your recovery. Your care team will provide guidelines for physical and occupational therapy while you are in the hospital and for when you return home or go to an extended-care facility.
Everyone heals from surgery at a different pace. The average recovery time is 3 to 6 months; your recovery may take less time or more.
Specific instructions will be reviewed with you before you leave the hospital. You may continue to wear a bandage to protect your incision from the irritation of clothing.
Some surgeons will want you to wear elastic stockings after surgery. These can be used for the first two weeks to help reduce swelling and improve circulation. You may remove stockings at night and put them back on in the morning. You may wear them longer, especially if you find that your ankles swell without them.
Ice should be used for the first several days, particularly if you have a lot of swelling or discomfort. Many patients benefit from ice during the first few weeks.
In most cases, you will need to use a walker or crutches for two to four weeks after surgery. You may be advised to use a cane after you have stopped using crutches. Most patients use an assistive device (walker or crutches) until they can walk without a limp.
Follow-up appointments are usually made after surgery anywhere from 2 to 5 weeks, at 12 weeks, and then yearly after that. Check with your surgeon.
You may sleep on your side with a pillow between your legs whenever you feel comfortable.
If your stitches are absorbable, they do not need to be removed. If your stitches are not absorbable or you have skin staples, they’re removed after 10 to 14 days. The steri-strips can be kept in place until they fall off on their own. They will help keep the skin edges together. If they have not fallen off by three weeks, it is okay to peel them off.
Confirm with your physician, but you can usually do this about 6 weeks after surgery.
This varies from patient to patient. For each year after your surgery, you have a one percent chance of requiring additional surgery. So, for example, at 10 years after surgery there is a 90% success rate.
Each patient's range of motion varies and depends on individual factors. Your potential will be determined at the time of your surgery. In most cases, you will have enough motion to put on socks and tie your shoes. Clipping toenails may be difficult.
After hip surgery, it is common to feel as though your leg lengths are different. At surgery, leg lengths are checked very carefully and every attempt is made to make them as equal as possible, but surgeons cannot guarantee absolute leg equality. If you feel a discrepancy, do not worry. This sensation of “feeling long” resolves in almost every patient within 6 weeks. The body and its muscles take time to adjust to a new joint. In some cases, a shoe lift may be prescribed for a true difference in leg lengths. However, in most cases, no treatment is necessary.
A dislocation of the hip occurs when the femoral head (ball) comes out of the acetabulum (socket). While this risk is very small, there are things you can do to prevent dislocation, depending on the approach used for surgery.
In general, you will want to avoid bending too much at the hip.
If you have a posterior-lateral approach, until your follow-up visit:
If you have an anterior approach, until your follow-up visit:
Your surgeon may also give you more specific instructions. Be sure to ask your surgeon about the approach used for your surgery and the precautions that are specific to you.
You should spend some time each day working on straightening your knee (extension) as well as bending your knee (flexion). Avoid using a pillow or towel roll behind the knee for any length of time. Please refer to exercise guidelines given to you by your therapist.
After six weeks, you can try. Touch down with your operative knee or leg first. To get up, use your non-operative leg to take the weight off your operative knee or leg. Although this may be uncomfortable at first, the knee will not be injured. Most people find the more you kneel, the easier it gets. Again, be sure to talk with your therapist or surgeon if you are worried about this.
Your doctor will let you know when it is okay to shower. The dressing on your incision is waterproof and does not need to be covered. Once that dressing is removed, you will receive additional instructions on showering and wound care. Do not soak in a bath or hot tub.
Yes. You will be taught to walk stairs during your hospital stay. Initially, you will lead with your non-operated leg when going up stairs and lead with your operated leg when going down stairs. You can use the phrase, “up with the good, down with bad” to help you remember. You will need to use crutches or a cane in one hand and hold the handrail with the other.
You may return to most activities when you feel up to it. Your surgeon may have specific restrictions that will be discussed with you.
Your weight-bearing status will be explained to you before you leave the hospital. Most patients are allowed to bear as much weight on their operative leg as is comfortable.
You will be instructed by your physical therapist on appropriate exercises and given a list to follow. Be sure to talk with your surgeon and your therapists about when you can begin new activities.
Generally, we do not advise using weights for at least the first two months. However, each patient’s strength is different. Talk with your doctor about when would be the right time to start using weights.
For the most part, you can gradually resume sexual activity when you are comfortable. Speak with your physician and/or therapist.
You should not drive until you are no longer taking narcotics and have good strength and leg control. Safety is the main priority.
This depends on the type of work you do. You may be able to return to a sedentary work after about 3 to 4 weeks. If your work is more rigorous, you may need up to 3 months before you can return to full work. In some cases, more time may be needed.
You may travel as soon as you feel comfortable, but avoid long-distance travel for 4 to 6 weeks or until after seeing your surgeon. We advise you to get up to stretch or walk at least once an hour when taking long trips. This is important to help prevent blood clots.
The increasing sensitivity of security detectors at airports and public buildings may cause your prosthesis to trigger an alert. We recommend you tell airport security that you have had a hip replacement. In some situations, security guards may also move a wand up and down your leg to locate your joint replacement. They may also pat you down on the area that triggers the wand.
We recommend that you visit the American Academy of Orthopedic Surgeons website at www.orthoinfo.aaos.org. Under “Treatment,” select “Joint Replacement.”
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