Hip or knee replacement - in the hospital after

Right After Surgery

Even though the surgeon may talk to family or friends right after surgery is done, you will still spend 1 - 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 knee joint after surgery.

Back in Your Room

You will have an IV (a catheter, or tube, that is inserted into a vein, usually 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. Usually it is removed 1 - 2 days after surgery. You may have some difficulty passing your urine after the tube is removed. Make sure you tell the nurse if you feel bloated.

Your nurse will show you how to prevent blood clots:

• You will 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 reduce the risk of blood clots more.
• 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 doctor will prescribe pain medicines to control your pain.

• Everyone has pain and discomfort after surgery, but people feel pain differently.
• You may receive pain medicine through a machine where you can control when and how much medicine you receive -- at least to a point. You will receive the medicine through an IV or a special tube placed into your back during surgery.

Your doctor may also prescribe antibiotics to prevent infection.

You Will Be Encouraged to Start Moving and Walking

You will be encouraged to start moving and walking

You will be helped out of bed to a chair on the first day after surgery. You may even be asked to try to walk.

The following people will help you learn how to get moving again and take care of yourself:

• A physical therapist will teach you exercises and how to use a walker or crutches.
• An occupational therapist will teach you 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 a faster recovery and better results.

You will be encouraged to do as much as you can for yourself by the second day. This includes going to the bathroom and taking walks in the hallways, always with someone helping you.

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 will 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 instructions, as bad positions can cause injury to your new knee joint

Getting Ready to Go Home

Before you go home, you will need to meet these goals:

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

Some people need a short stay in a rehabilitation center after they leave the hospital and before they go home. At a rehab center, you will learn how to safely do your daily activities on your own.

For more detail, see also:

• Taking care of your new knee
• Hip replacement discharge
• Knee replacement - discharge

Alternate Names

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

References

Crockarell JR, Guyton JL. Arthroplasty of the knee. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 6.

Eikelboom JW, Karthikeyan G, Fagel N, Hirsh J. American Association of Orthopaedic Surgeons and American College of Chest Physicians guidelines for venous thromboembolism prevention in hip and knee arthroplasty differ: what are the implications for clinicians and patients? Chest. 2009;135:513-520.

Harkess JW. Arthroplasty of the hip. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 7.

Jones CA. Total joint arthroplasties: current concepts of patient outcomes after surgery. Rheum Dis Clin North Am. 2007;33(1):71-86.

Update Date: 8/12/2011

Updated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, and Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.