Total Joint Replacement Postoperative Instructions

    FOR THE FIRST SIX WEEKS

  1. For the first six weeks, you must only bear 50% of your weight on your operative leg using a walker or two crutches. This is to allow your muscles to heal and let your implant begin to adhere to your bones.
  2. Follow your hip precautions!! These are:
    a) < 70 degrees flexion for 1st six weeks, then < 90 degrees flexion for lifetime
    b) No internal rotation (turning toes toward body)
    c) No adduction (crossing legs, legs close together)
    d) Adjust height of chairs, toilet seats, beds, sofas, etc. to prevent too much hip flexion
    e) If you need any of these precautions explained, call Dr. Scott's office or ask your physical therapist to demonstrate
  3. If you have had a hip replacement revision, you must wear your knee immobilizer for the first six weeks. You may remove it only when supervised for knee range of motion two to three times per day.
  4. You must wear your surgical stockings for six full weeks. You may take them off occasionally, and you may wash them. These stockings help to prevent blood clots from forming in your legs.
  5. It is recommended that you take one baby aspirin tablet per day unless you are taking another blood thinner.
  6. Do not take any Non-Steroidal Anti-inflammatory medications for the first six weeks. These medications may interfere with the bonding of your bone to the implant. Examples of these medications are: Motrin, Ibuprofen, Advil, Vioxx, Celebrex, etc.
  7. You may walk as much as you can tolerate. Discomfort is your guide about how much you may do, however, you must remain 50% weight bearing for the first six weeks.
  8. You will have home physical therapy and home nursing after surgery if you go straight home from the hospital. The nurse will remove your staples at 14 days post-op. If a home nurse or physical therapist does not contact you within one day of arriving home, please contact Dr. Scott's office.
  9. Your first post-operative visit with Dr. Scott must be 5-7 weeks after surgery. We will take new x-rays at that time. This appointment should be on your surgery letter sent from our office. If you are unsure of the date and time, contact our office.
  10. No driving for six weeks, no matter which leg is affected. After six weeks, practice in a parking lot first before resuming driving. Never drive while on narcotic medication.


    11. WOUND CARE

  11. Call Dr. Scott's office as soon as possible if you have drainage from your incision or if you develop excessive heat, redness, or swelling around your incision.
  12. You may place ice in a plastic bag and put it over the affected area to aid with pain control and swelling. Make sure the bandage does not get wet.
  13. No bathing in a bathtub, no swimming, and no whirlpools/hot tubs for the first six weeks. You may shower 48 hours after staple removal if there is no drainage from the incision. Leave the tapes on your incision until they become loose and begin to fall off. At that time, you may remove them yourself.
  14. DO NOT, UNDER ANY CIRCUMSTANCES, ALLOW ANY HEALTH PROFESSIONAL TO INSERT ANYTHING ONTO OR INTO YOUR INCISION WITHOUT SPEAKING TO DR. SCOTT!! THIS CAN LEAD TO INFECTION INSIDE OF THE JOINT, WHICH MAY RESULT IN REPEAT SURGERIES. Dr. Scott does not advise any culturing of wounds after surgery. Do not put any salves or ointments on the incision.


    15. POSSIBLE COMPLICATIONS

  15. Call Dr. Scott's office immediately if you have any of the following symptoms: severe calf/leg swelling, pain while squeezing calf, pain with moving foot up and down. These may be symptoms of a blood clot and we will order an ultrasound of your leg to check for a clot.
  16. Call Dr. Scott's office if you have a fever, chills, or you contract any type of infection elsewhere such as sinus, chest, teeth, or skin.
  17. Go to an emergency room immediately if you develop any difficulty breathing or chest pain.


    18. REMINDERS

  18. Perform the exercises shown to you by your hospital physical therapist 3-4 times per day.
  19. Total hip patients: You must follow your hip precautions strictly for the rest of your life. These are:
    a) < 70 degrees of flexion for the first six weeks, then < 90 degrees flexion for life
    b) No internal rotation (turning toes toward the body)
    c) No adduction (moving legs close together or crossing legs)
    d) Make sure that anything you sit or rest on is high enough to prevent too much flexion of your hips. This includes chairs, beds, toilet seats, sofas, etc.
    e) If you need any of these restrictions explained to you, call the office or ask your physical therapist to show you.
  20. All total joint patients: You may need antibiotic treatment before any dental work, even light cleanings. Please call our office before any procedure is scheduled if you have any questions, or consult our Dental prophylaxis summary, or consult the American Academy of Orthopaedic Surgeons Advisory Statement for more details.
  21. Smoking delays bone growth around implants. It is strongly advised that you quit smoking if you are a smoker.


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