Joint Surgery FAQs

What does a total knee replacement involve?

The tibia and the bottom of the femur are shaved down surgically. A metal implant is then secured into the femur above the knee and a plastic spacer is inserted in the tibia below the knee. Your kneecap is resurfaced with a plastic kneecap. All these parts glide smoothly across each other.

What does a total hip replacement involve?

A total hip replacement involves the following: the arthritic ball of the thigh bone (femur) is removed and replaced with a metal ball that is fixed solidly inside of the femur by a shaft attached to the ball. The hip socket is replaced with a plastic or metal liner that is fixed inside of a metal cup. The new parts move freely and smoothly against each other.

What can I expect after my total knee replacement?

No two patients experience identical symptoms/levels of discomfort prior to knee surgery. Similarly, no two patients will relate identical recovery/results after a knee replacement. The constant and critical concept with a knee replacement is adherence to your surgeon’s guidelines for restoring motion in your knee. You will have discomfort after you surgery, consisting mostly of stiffness and soreness.

Am I too old for joint surgery?

As long as you are in reasonable health and you desire to put time and effort into the rehabilitation process, you are a candidate for joint surgery.

How long will my new joint last and can a second joint replacement be done?

A number of factors will affect how successful your new implant is. Thus, there is no guarantee for a specific length of time for your implant to last. Factors that are under the control of the patient that can affect the longevity of your new joint include weight, activity, and medical condition stability. It is important to remember that an implant is a medical device subject to wear that could lead to mechanical failure. Statistically, loosening or wear rates requiring repeat surgery are about 1% per year. In other words, about 90% of replacements will last about 10 years and about 80%, 20 years.

How long will I be in bed after joint surgery?

You will be assisted to stand the evening of your surgery. We have found that the quicker patients get back up and on their feet, the quicker the body’s hemodynamics (appropriate balance in blood pressure, pulse, hemoglobin level, and fluid volume) stabilize. Your first several times out of bed will require one or two staff to assist you. We will assist you up for breakfast the morning after your surgery, and you will be up for all further meals. We do not use bedpans so you will be assisted to a bedside commode when needed. Please keep in mind that our staff are specifically trained in the proper techniques of getting patients with new joints out of bed safely. Listen to and use their tips.

How long will I be at the Joint Center?

The average number of days for a joint replacement is three; however, with the advent of Total Joint Centers, shorter stays are becoming more common.

How painful is a joint replacement?

You will have discomfort after your surgery. The initial eight – ten hours out of recovery prove to be the most painful. The staff on the Total Joint Center are specifically trained for post-operative pain management. Your RN will work closely with you to insure that you are as comfortable as possible. You will initially require IV narcotic pain medication. Most patients are able to stop using IV narcotics and take pain pills with breakfast the day after surgery. It is important to keep in mind that extended use of IV narcotics has proven to slow the body’s ability to hemodynamically stabilize. IV narcotics slow digestion, which increases the risk for nausea and poor appetite. They also decrease your ability to participate and make decisions in your care. It is a misconception that IV narcotics are the best way to handle surgical discomfort. We often find that many of our patients experience fewer complications and mobilize much safer with the use oral pain meds.

What is a femoral block?

Your anesthesia provider may administer what is called a “femoral block” prior to your surgery. The femoral nerve block has proven to be very helpful in regards to post-operative pain control. The sensory effects (transmission of impulses through nerves) of the femoral nerve block last from eight to ten hours, while the motor effects (ability to move as usual) last four to six hours. Since the use of femoral nerve blocks has become commonplace, the amount and frequency of post-operative pain medication has shown a marked decrease.

Will I need help at home following joint surgery?

You will need some assistance and supervision with activities of daily living for a short amount of time. This amount of time varies with each patient. Some surgeries require a daily dressing change to your incision, which you will probably need help with. You should not need someone with you full-time at home. Your occupational therapist will teach you how to handle daily activities prior to discharge. Preparing things before surgery can reduce the amount of assistance you need after surgery. Having laundry done, house cleaned, several meals prepared ahead of time, and clean linens on your bed will benefit you once you return home.

Will I need physical therapy once I return home from a knee replacement?

Total knee replacement requires consistent exercise and stretching to loosen tight ligaments and prohibit stiffness and swelling. Your surgeon will discuss with you the frequency and duration of your outpatient physical therapy. It is very common to go to outpatient physical therapy two to three times a week for 1-2 months. Unless your insurance company specifies where you need to go, you have several options for your therapy provider. You will need to have transportation arrangements made for your outpatient therapy needs.

Will I need physical therapy once I return home from a hip replacement?

Normally, hip replacements will not require outpatient physical therapy. You will be taught exercises to perform twice a day once you get home. It is important that you understand and perform these exercises on a daily basis.

How long until I can drive again after surgery?

Your surgeon will instruct you on this prior to discharge.

When can I return to work after surgery?

Overall, the recommendation is not to return to work for one month. There may be exceptions to this, largely dependent on what you do for a living. If you have specific questions about how to perform your job tasks once you return to work, please ask our occupational therapist during your evaluation and treatment while in the hospital.

What activities are encouraged/permitted after a knee replacement?

Cycling, walking, dancing, golfing, swimming, bowling and gardening are all activities that one can perform without risking jolting or impact of force on a new knee replacement. If you wonder about further specific activities, please ask your surgeon.

What activities are encouraged/permitted after a hip replacement?

Cycling, walking, dancing, golfing, swimming, bowling, and gardening are all activities that one can perform without risking jolting or impact of force on a new hip replacement. If you wonder about further specific activities, please consult your surgeon. Often patients report that their new hip feels “normal” to them. The leg with the new hip may be slightly longer than it was before. Most patients get used to this feeling, some require use of a small lift in the shoe of the non-operated leg. Patients report a range from no pain to an aching type of discomfort in the operative leg for a few months after surgery.

What are the major risks with a hip replacement?

Infection and blood clots are two serious complications with any surgery. To avoid complications, we start antibiotics just prior to your surgery, and give 3 additional doses through your IV after surgery. We also use early mobility, mechanical stockings (called SCD’s) and blood thinners to minimize the risk of blood clots.

Should I exercise prior to joint surgery?

Yes, your surgeon can give you recommended exercises and you will also be taught specific exercises by a physical therapist at your pre-operative education class. It is important to build up the muscle groups that you can prior to surgery as you will have soreness and stiffness after your surgery that will require more effort for you to get up and around.

Will I need blood?

A marked decrease in post-surgical blood transfusions has occurred over the last two years. This is due largely in part to vast improvements in surgical techniques with orthopedic surgeries. An average of five to ten percent of patients require a blood transfusion after surgery.

Should I give my own blood prior to joint surgery?

This is an option that you should have discussed with your medical doctor. This process is called Autologous donation. It is recommended that this process be initiated well before any intended surgery, a minimum of 35-40 days prior. The “shelf life” of blood is 42 days. This process also has certain criteria that must be met in order to qualify to give your own blood. There is also a fee associated with this process.

What if I live alone?

Most all of our patients can return home with help from a relative or friend. You will be encouraged to select a “coach” to go through your hospital stay with you, learning the proper ways to assist you once home and remind you of any limitations you might have (i.e. hip precautions).

When do I see the surgeon after I return home?

Your first appointment will be in the surgeon’s office within 10 to 14 days to check your incision. You will see your surgeon at intervals determined by your surgeon depending on your progress.

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