I can’t sleep at night because my leg is uncomfortable. What can I do?
It is natural for our bodies to change positions while we sleep. Your ability to do this on your own may be limited and you may need someone to help reposition your leg. Turn the leg all together to reduce the twisting motion. Use pillows to help support the leg. Ice is very helpful to decrease pain.
I’m having muscle spasms in my thigh, especially at night. What can I do?
People who have maintained a pretty high level of activity prior to surgery sometimes have irritable muscles in the early post-operative period due to a decrease in activity and more time spent lying down. Staying active and doing your leg exercises can help with this. If you find your leg muscles are tightening up on their own or your leg is jerking in your sleep, there is medication we can give you to relax your muscles.
When can I drive after surgery?
You may start to drive once you are not requiring narcotic pain medication and when you have progressed away from the walker. You should use your own judgment as to when you can appropriately move your leg to operate the foot pedals. This usually occurs around 2 weeks for surgery on the left lower extremity and around 4 weeks for surgery on the right lower extremity.
I haven’t had a bowel movement since surgery. Should I be worried?
Several changes have occurred that can disrupt your regular schedule. The anesthesia and pain medication can slow down your stomach. Your appetite after surgery often changes temporarily and you are eating less than usual. It is important to drink plenty of fluids, eat foods that do not sit heavy on your stomach, and take the stool softener and laxative if needed.
How long do I have to wear these TED hose?
TED hose help with swelling and also help prevent blood clots by compressing the veins. You are to wear the TED hose 24/7 for the first two weeks after surgery and then you can take them off at night and wear them during the day for the next two weeks. You may take them off briefly for showering and bathing.
My leg is swollen and it hurts. The pain medicine doesn’t help. What should I do?
Swelling in the leg is normal after joint replacement surgery. It should go down with elevation of the leg. If it does not go down with elevation or if the amount of swelling stays the same or increases in the morning, then call the office. Sometimes we need to order a study to rule out DVT. The test is called a venous duplex study and it is a non-invasive study to give us information on how the blood is flowing through the leg. If a blockage has developed, then it needs to be managed a bit differently and you may need to start a different blood thinning medication. If the test is negative, then it means that you do not have a DVT and you still need to elevate your leg periodically so that your foot is higher than your heart.
When can I shower?
You can shower the day after surgery, once your drain is removed. Remove the dressing, use gentle soap, pat the incision dry, and place a clean and dry dressing over the incision. Do not place any creams, lotions, or ointments over the incision.
If you have a knee replacement, use the TED hose to keep the dressing in place. Do not use any adhesive. Change the gauze pad daily.
If you have a hip replacement, remove the dressing at one week and let open to air.
When can I immerse my incision in water (e.g. bath, swimming pool, hot tub, ocean)?
Typically, you should not take a bath or get in water for 3 weeks. Your incision must be clean and dry without any drainage before you can immerse your incision.
Do I need physical therapy?
Yes, the physical therapist plays an important role in your recovery after total knee arthroplasty. You will see a physical therapist 2-3 times per week for at least 6 weeks. Your therapist will help you regain motion, build strength, and help you reach your post-operative goals. Your therapist will also keep your surgeon informed of your progress.
Can I go up and down stairs?
Yes, initially, you will lead with your non-operative leg to go up stairs and will lead with your operative leg when going down stairs. You can use the phrase, “UP with the good and DOWN with the bad” to help you remember. As your leg gets stronger, you will be able to perform stairs in a more regular pattern.
I feel depressed. Is this normal?
It is not uncommon to have feelings of depression after your joint replacement surgery. This may be due to a variety of factors such as limited mobility, discomfort, increased dependency on others, and medication side-effects. Feeling of depression will typically fade as you begin to return to your regular activities. If your feelings of depression persist, you should consult your family physician.
How long will I need pain medication?
Initially, you will need strong oral pain medication (such as Percocet). Most people are able to wean off the stronger pain medication after 2-4 weeks and then can switch to an over-the-counter medication such as Tylenol. You should avoid taking anti-inflammatories (such as ibuprofen, Advil, Aleve, etc.) while you are taking a blood thinner (such as aspirin, Eliquis, Xarelto, or Coumadin) as these medications together can cause stomach upset and bleeding.
How long do I need to take a blood thinner?
To prevent and reduce the incidence of blood clots, you will be given prescription for a blood thinner such as aspirin, Eliquis, Xarelto, or Coumadin, to take for a total of 4 weeks after surgery.
When can I travel?
You may travel as soon as you feel comfortable. It is recommended that you get up to stretch or walk at least once every hour when taking longer trips. This is important to help prevent blood clots and reduce swelling. During the first 6 weeks after surgery, you should not travel for extended periods of time as that could interfere with your physical therapy.
Will I set off metal detectors at airports?
You may set off the machines at airport security depending on the type of knee implant you have and the sensitivity of the security checkpoint equipment. You will be provided with an implant card that you can carry in your wallet.
When can I return to work?
This depends on your profession. Typically, if your work is primarily sedentary, then you may be able to return to work after approximately 2-4 weeks after surgery. If your work is more rigorous, you may require up to three months before you can return to full duty. In some cases, you may require more time to return to your work.
Can I have sex?
Yes, as soon as you are comfortable.
Can I drink alcohol?
You should not consume alcohol while you are taking narcotic medication (pain medication). You should also avoid alcohol consumption while you are taking blood thinners.
What activities are permitted following recovery from surgery?
After completion of your physical therapy, you may return to activities as tolerated. Some of the best activities to help with range of motion and strengthening are walking, biking, swimming, and using an elliptical trainer. You should wait until 2 months after surgery before you return to lifting weights. Use light weights to begin with, and focus on good technique and repetition.
What activities should I avoid?
You should avoid high impact activities such as running and jumping. These high impact exercises can increase the wear on your joint replacement.
When do I see Dr. Chaudhary again?
The first follow up appointment is scheduled for two weeks after your surgery. Subsequent appointments are typically at 6 weeks and 12 weeks after surgery.
Do I need to take antibiotics before I go to the dentist?
Yes, you should wait for three months after your joint replacement before scheduling any elective dental cleaning or non-urgent dental procedure. Please call our office before your dental appointment and we will provide the prescription for antibiotics.
Will I receive an implant card for traveling?
Yes, you will receive a wallet card that will inform people that you have a joint replacement. You should receive this card around 6 weeks after your surgery.
What is my hip made of?
The outer shell of the new socket is made of metal. The inner shell, or liner, is made of a plastic called polyethylene. The head is made of either metal or ceramic depending on what your surgeon feels is necessary. When the head is joined with the new socket, the new hip can produce a smooth, nearly frictionless movement. The stem, which fits into the thigh bone, is commonly made of titanium.
My leg feels longer since surgery. Should I be concerned?
Your leg length is assessed during surgery and your surgeon uses X-ray and makes every effort to ensure your leg lengths are equal. It is not uncommon to feel that the operative leg is longer after surgery. For most patients, it just takes time for this feeling to resolve. It is important to not use a shoe lift, unless recommended by your surgeon.
My thigh is numb on the outside. Is this normal?
When the skin incision was made down the front of your hip, the small nerves in your skin were cut. These small nerves were the ones that gave you sensation in your skin. The nerves to the tissue under your skin are still intact and there is no other change to the bigger nerves in your leg. It could take 6-12 months for the numbness to subside.
What is my knee made of?
Your knee is made of a cobalt-chromium femoral component and a titanium tibial baseplate. In between the two is an ultra high molecular weight polyethylene insert (plastic). The back of the kneecap has also been resurfaced with a plastic button.
My knee is red and warm, is that normal?
Feeling warmth and redness are normal after total knee replacement. Drainage from the wound and fever above 101.5 degrees are worrisome and should not be ignored. Call us at (513) 354-3700 if you have any concerns.
My knee clicks. Is something wrong?
Our knees have a little bit of play in them to allow us to bend them. The clicking is coming from the metal and plastic surface tapping against each other. As you regain your thigh muscle strength, there is much less clicking or by then you have gotten used to it. Patients may notice more clicking when walking in their yards or on uneven surfaces.
My knee is numb on the outside. Is this normal?
When the skin incision was made down the front of the knee, the small nerves in your skin were cut. These small nerves were the ones that gave you sensation in your skin. The nerves to the tissue under your skin are still intact and there is no other change to the bigger nerves in your leg. It could take 6-12 months for the numbness to subside.
What are good positions for my knee? What positions should I avoid?
You should spend some time each day working on straightening your knee (extension) as well as bending your knee (flexion). A good way to work on extension is to place a towel roll underneath your ankle when you are lying down. A good way to work on flexion is to sit on a chair and bend your knee or use a stationary bike. Avoid using a pillow or towel roll behind the knee for any length of time.
Can I kneel?
After 2 months, you may try to kneel. Although this may be uncomfortable initially, you will not injure your knee replacement. Most people find the more you kneel, the easier it gets. You may also find it more comfortable to use a kneeling pad.