The Joint Replacement Center After Surgery

Have your joint coach at your side any time of day and for every activity. Your coach will learn a lot, which will help make your recovery at home faster and easier. Your friends and family are welcome any time at the Joint Replacement Center as well.

What to Expect When You First Arrive

  • Your nurse will welcome you and your family to the Joint Replacement Center and will help you settle into your room, which will be equipped to help you get up and moving.
  • You may have oxygen overnight and will have a monitor to track your oxygen level, heart rate and rhythm.
  • Your vital signs (blood pressure, heart rate and temperature) will be checked often at first and then every four hours while you’re at the Joint Replacement Center.
  • You’ll have fluids going through your IV following surgery.
  • A catheter will drain your urine for the first night after surgery, and will be removed in the morning.
  • You’ll have a large dressing over your incision, which might feel bulky.
  • Swelling is very common after surgery. Using ice or cold therapy will help keep the swelling and pain under control.
  • When you feel more alert and awake the evening of your surgery, your physical therapist will help you get out of bed. After the first time out of bed, your nursing staff can help you to move around.

Fall Prevention During Your Stay

You are at a higher risk for falling after your surgery because of medications and anesthesia, equipment and limited mobility.

  • Your safety is very important to us. Remember to ALWAYS call for help anytime you feel that you need to get up.
  • Only the Orthopedic staff can help you get up. DO NOT get up out of bed alone or with family or friends during your stay.

Pain Management

The pain you’ll experience after surgery is usually different from the arthritic pain that you felt before. To gain full use of your new joint, you’ll need to follow the accelerated therapy plan that we’ve custom designed for you. So during your therapy, you’ll often be asked to rate your pain on a scale of 0 to 10 (please see the chart). Above all, we want you to be as comfortable as possible while you recover. So, let us know if your pain medication is doing its job, or if we need to adjust it: please communicate with our nursing staff about your pain level.

  • Multi-Modal Pain Medicine Therapy - We will provide you with both scheduled pain medicine and medicine as needed to control your pain. The different types of pain medicine work together for better pain control. Your nurse will check on your pain level often. 
  • Ice Packs - Ice packs on the incision area can help relieve pain and swelling. We will provide you with an ice pack in the hospital that you can take home with you after your stay.
  • Repositioning - Changing positions can help with pain control. Your nursing staff will help you to move from the bed to a chair and back. Please be sure to wait for our staff to help you before getting up!

Activity

  • Start moving with help from staff as soon as possible after surgery, which helps your breathing and digestion and will help you heal faster. It may hurt to move, but moving and being active will help lessen pain over time.
  • Actively participate in your accelerated therapy course. Research shows that when you move as soon as possible after surgery, you’ll recover faster and your new joint will work better.
  • On the night of surgery, your Joint Replacement Center team will help you sit up or get out of bed; be sure you wait for your nurse’s help.
  • Your Joint Replacement Center team will get you up and moving very early during your stay in the Joint Replacement Center. 

Preventing Complications After Surgery

To help minimize the risk of developing a blood clot or pneumonia, your nurse or therapist will help you sit on the side of your bed the evening of your surgery. Every day, you’ll be encouraged to get out of bed and move around. This will increase the range of motion of your new joint.

Preventing Blood Clots

Your surgeon and entire team will determine what treatments to use to help prevent blood clots, which are a serious condition:

  • After surgery and until your discharge from the Joint Replacement Center, you’ll take blood thinning medication.
  • Additional preventive measures may include an intermittent massaging compression device on your feet or calves to help keep the blood flowing.
  • The nursing staff will encourage you to paddle your feet and ankles, perform foot circles and move your legs to keep the blood flowing.

Preventing Pneumonia

  • You’ll receive an incentive spirometer to help prevent the risk of pneumonia. It’s a device that will help us assess the amount of air you use with each breath, and you’ll need to use it at least 10 times every hour while you’re awake.
  • It’s important to be out of bed and be active every day. This helps you take deeper breaths and decreases your risk for pneumonia.

Your Nutritional Needs

Your digestive system will need to ‘wake up’ after surgery, so you’ll be on a restricted diet of clear liquids at first. Your nurse will help you decide how quickly you can start eating normally to avoid the nausea that sometimes comes after anesthesia or pain medication.

Shortly after you’re admitted to the Joint Replacement Center, your nurse will introduce you to the diet recommended by your doctor and our menu selections. You will be able to place your meal order by telephone or through your nurse, and our dietary associates will help you select foods within the guidelines of any special restrictions made by your doctor.

It may take a few days before you have a bowel movement, because anesthesia, pain medication and not moving around can cause constipation. Please be sure to drink plenty of fluids (water is always best) and eat whole grains, fruits and vegetables. Your surgeon prescribes a stool softener or laxative as well.

Physical Therapy

After surgery, your physical therapy team will instruct you in exercises to improve your range of motion and strength and help you walk. Some of these exercises will be familiar to you from the Physical Therapy Assessment Screening and some will be new. The team will also assist you with walking short distances and progress your therapy plan on an individual basis to help you achieve your therapy goals.

  • Protecting your new joint is very important, so we’ll tell you about any precautions or restrictions that will help reduce soreness, while strengthening your muscles around the joint.
  • When you leave the Joint Replacement Center, you should be able to:
    • Walk safely with your walker and supervision.
    • Get safely in and out of bed without assistance.
    • Get safely in and out of a chair without assistance.
    • Get safely in and out of a vehicle.
    • Understand how to protect your new joint.
    • Perform exercises as instructed by your therapist to increase strength, mobility and balance
    • Move safely at home
    • Climb up and down stairs.

Occupational Therapy

The morning after surgery, you’ll meet with your Occupational Therapist (OT) to learn how to become independent again. Your Occupational Therapist will get you up and moving to the toilet and assess potential equipment needs. When you leave the hospital, you should understand:

  • How to get dressed
  • How to safely get on/off of the toilet
  • How to safely get in/out of the shower
  • How to adhere to precautions while completing everyday activities

Physician, Physician Assistant or Nurse Practitioner, and Nurse Navigator

Your surgeon and the healthcare team will visit you regularly at the Joint Replacement Center to monitor your progress and overall health. At discharge, you’ll receive your medication prescriptions, plus any equipment you need to help you move around while you recover.

Two to four weeks after surgery, you’ll have a follow-up appointment with your surgeon. Your surgeon’s office will direct you about scheduling periodic appointments after that.

Planning Your Discharge

From the minute you decided to have joint replacement surgery to today, the Joint Replacement Center team has been working with you to get you home and back to your daily activities as soon as possible. When you get to go home is based on:

  • Evaluation before surgery
  • Your progress with therapy
  • Strength and endurance levels
  • Your joint coach and other support resources.

Your surgeon and the Joint Replacement Center team will work with you to determine the level of care and follow-up you’ll need after you go home to ensure a full recovery — and then your social worker and case manager will arrange it. Also, your nurses and therapists will advise you on how to perform in-home exercises to help you continue strengthening your new joint.

Discharge Options

We also will work with you to determine your best option for continuing therapy after you leave the Joint Replacement Center. Your options include:

  • Outpatient therapy at one of three Memorial outpatient therapy locations, including the Orthopedic and Neurosciences Center
  • A combination of home-based therapy followed by outpatient therapy
  • A skilled nursing rehabilitation facility.

Whatever the choice, we will make sure all of your discharge plans are taken care of after your surgery. Before you leave the Joint Replacement Center and are going home, our staff will ensure you have everything you need at home by calling your pharmacy of choice to check on availability of your blood thinner, and our social worker will obtain equipment (such as a walker) for you. If you are going to a skilled nursing facility, your equipment and medications will be arranged by the facility before you go home.