NAH Joint Replacement Program

Your home recovery

Physical and/or occupational therapy is vital to your recovery. Your doctor may order outpatient or home health therapy. Regardless, you should be doing your exercises daily as instructed. Every day, try to walk a little further than the previous day. Written instructions will be given to you upon discharge. 

Correct elevation is above the level of the heart. Elevation reduces swelling which relieves pain and speeds healing. Swelling usually increases during the first few days home from the hospital. This is improved by spending one hour in the morning and one hour in the evening with the feet elevated above the heart. Swelling is generally worse in the evening after large amounts of activity. Wear your compression stockings for six weeks on both legs. Avoid standing in one position for a long period of time for the first few weeks after surgery.
Ice is helpful to relieve pain and swelling. Apply ice to the incision six to eight times a day for 15 to 20 minutes. Never put ice directly on the skin. This will be helpful after physical therapy.
Keep your incision dry. Do not apply oils, creams, or lotions to the incision site. There should be a decrease in drainage from the time you left the hospital. The skin edges may appear red or irritated due to the staples. Once the staples are removed, the redness will gradually decrease. Redness that spreads beyond the staple line should be reported to your surgeon. Bruising will gradually go away.
You will be given a prescription for pain medication, which you will need to get filled at your pharmacy on the way home from the hospital. Take your medication as directed on the label. If you feel you need a refill, please call the pharmacy and the pharmacist will contact the Surgeon’s office. You can begin to substitute Tylenol for the prescription medication at any time. Avoid Ibuprofen, Naproxen, Advil, or other non-steroidal anti-inflammatory medications until your Surgeon says it is OK (typically 6 weeks later). Do not drink alcohol or drive while on narcotics.
You will receive a prescription for a blood thinning medication which can be faxed to your pharmacy. You need to take this medication at the same time every day. For knees and hips, typically you will be on this medication for 6 weeks to prevent blood clots.
Unless otherwise directed, you should resume any regular medications.
Many people have trouble sleeping for the first six weeks after surgery. Limit your intake of caffeine (coffee, tea, chocolate) and try to stay awake during the day. It is OK to sleep on your side; just use pillows for your comfort. Some people sleep in a recliner for a period of time after their surgery.
A combination of pain medications and vitamins may cause a temporary loss of appetite and even upset your stomach. Light, non-fatty foods are more easily digested, and please do not forget to drink plenty of fluids.
During your hospital stay, a physical therapist will instruct you on how to walk on stairs. The pace at which you regain agility on stairs depends on individual traits and is hard to predict. 
High heels should be avoided for the first three months. A well-fitting, flat, closed-toe shoe is safest. Examples include sneakers or tennis shoes. Slip-on shoes or sling backs tend to slide off your foot and may cause a loss of balance.
Your surgeon will let you know when you can drive, usually 1-3 weeks after surgery. It is against the law to drive while on narcotics.
Getting back to work depends on how quickly you heal and how much demand your job puts on your new joint. It is not unusual for someone who does a lot of walking, standing or physical labor to be off work for three to six months. Someone who has a desk job and can park close to the office may be able to return to work a few hours each day as soon as two weeks after surgery. Your surgeon and therapist will help you decide when you are strong enough to return to work.
Within one to two months, you may resume activities such as walking, swimming, golfing, dancing and low resistance bicycling. After surgery, you can expect gradual improvement for the next 18 months. You can look forward to less pain, stiffness, and deformity. You will begin to enjoy the activities of daily living with more comfort and move toward a more independent lifestyle.