Henry M. Dunn, M.D.

Do I need to stay in the hospital? More than 70% of patients go home the same day after hip or knee replacement surgery. Some patients with certain medical conditions may need to stay one night overnight.

Will I need physical therapy? Yes, physical therapy is very important during the recovery period most patients do physical therapy 2 to 3 times a week for the first 4 to 6 weeks. Make sure that you schedule your physical therapy to start 1 week after your surgery.

Will I need to go to a rehabilitation hospital? This is a rare occurrence, usually in cases where patients don't have social support at home to help with recovery after surgery.

How long is the surgery? The surgery takes between 60 and 90 minutes.

Will I need a catheter, stockings, or blood transfusion? Very unlikely. These were historically more common 20 years ago; however, this is exceedingly rare with modern surgery.

When will I begin walking after surgery? Right away! You'll be allowed to put weight on your operated leg as soon as the surgery is complete and the anesthetic has worn off. You will ambulate with a front-wheel walker with physical therapy in the recovery room on the day of surgery. Most patients continue to use a walker for balance for the first 2 to 3 weeks.

Will I be able to take the stairs? Yes. The physical therapist will show you and work with you on how to navigate stairs with a new joint replacement. If you have stairs in your home, you should limit how often you go up and down stairs for the first week as you are working on regaining your balance.

Should I buy any special furniture to help with recovery? No, this is not necessary.

How active should I be? You can walk as far as you are able to tolerate; however, you may have more muscle fatigue and discomfort with increased activity early on. Overdoing it will not damage the prosthesis but may cause more muscle ache. In the first few weeks, emphasize range of motion exercises over strength training or long-distance walking. As you begin to recover further, you will be able to walk longer distances.

How long will I be on pain medication? Most patients take very little medication after the 3rd or 4th week, however, sometimes up to 6 weeks. The pain medicine is there for your comfort, and you do not have to take them if you do not have significant discomfort. You will wean from pain medication to NSAIDs (ibuprofen) and Tylenol after the first few weeks.

When can I shower? You may start showering the first day after surgery. Let the water run over your dressing and pat dry with a towel. For knee replacements, you may rewrap the knee with the ACE wrap after showering to help decrease swelling.

Is swelling of the lower leg normal after surgery? Yes, it is very normal for there to be swelling in the operative leg after surgery. The swelling may take multiple months to completely resolve. The leg will tend to swell more on days when you are standing upright for long periods or on days when you are more active. Remember to elevate your leg above the level of your heart when resting to decrease swelling.

How often should I be icing? Ice should be used for the first 2 to 3 weeks to help minimize swelling and inflammation. You should aim to ice the surgical site for 20 minutes every 2 hours for the first week.

Is numbness around the incision normal? Numbness is common over the outer aspect of the hip or knee. This generally improves but takes 6 months or longer. Some patients will have permanent numbness over the outer aspect of the incision.

When will I be able to drive? Most patients return to driving around 3 weeks after surgery. You may return to driving when you feel comfortable enough, feel that you have control of your leg, and are no longer taking narcotic medication.

How long will I be off work? Every patient recovers differently. Most patients are able to return to office work between 6 to 8 weeks. For those patients whose work entails heavy labor, it typically takes 12 weeks to fully recover prior to returning to work. It is recommended that you tell your employer that you will need 8 to 12 weeks off, and if you feel you can go back to work safely, we can provide you with a note to return to work earlier than your scheduled date.

When can I have sex? As soon as you feel comfortable.

When can I travel after surgery? Long-distance flying increases the risk of blood clots, especially in the first 6 weeks after surgery. It is recommended to not have long-distance flights for 6 weeks after surgery. For long-distance driving, try to stop every hour with a periodic break to do calf exercises and stretches. Traveling less than a 3-hour drive can begin immediately after surgery based on your comfort level.

Will I set off the alarms at the airport? Very likely, yes. You no longer need to have any card proving that you have a joint replacement. The TSA agent will likely wand over your replacement site at the security checkpoint.

Can I drink alcohol? After surgery, you are more sensitive to the effects of alcohol. This in combination with narcotic pain medication can make you dangerously sleepy. It is recommended that you limit alcohol intake while on narcotic medication

Is it normal to have difficulty falling asleep? This is very common after joint replacement surgery. It is recommended that you take a dose of pain medicine before going to bed.

Can I sleep on my side or back? Yes! You can sleep in any position that you find comfortable. There is no precaution after hip or knee replacement surgery on positioning. You may find it more comfortable to sleep with a pillow between your legs.

Is it normal for the knee replacement to make noise? Yes, this is due to the mechanical new prosthesis. The knee will make noise with certain types of movements. A click or clunk that is without discomfort is normal and not concerning

Will my legs be equal in length? Leg length does not change with knee replacement. With a hip replacement, an intraoperative X-ray is taken to determine your exact leg length to minimize any difference in leg length discrepancy. The priority during hip surgery is to give a stable hip replacement that does not dislocate (or pop out of socket), and this may require making the operative leg slightly longer. The operative leg may feel longer initially after surgery due to the muscles that were previously contracted being stretched during surgery. This typically relaxes in the first few weeks after surgery.

How long do joint replacements last? New generation vitamin E, highly crosslinked polyethylene (or plastic) was introduced in 2001. Since then, there has been no significant radiographic evidence of wearing of the plastic liner of hip or knee prosthesis for over 24 years. The newest generation of hip and knee implants allows for bone to grow onto the prosthesis instead of using cement, which also improves implant longevity. The rate in the literature for all-cause hip or knee revision is 0.5% per year.

What activities should I not do? There are no significant limitations to what you do with your new replacement. You may gradually return to jogging, tennis, golf, pickleball, surfing, skiing, hiking, etc. It is recommended that you avoid high-impact activities, such as skydiving, rock climbing, or jumping from heights greater than 5 feet.

When can I go to the dentist? Refrain from dental work for 2 months after your joint replacement. After 2 months, you may resume normal dental cleanings. Oral bacteria can travel into the bloodstream during dental work; for this reason, historically antibiotics have been recommended before dental work to prevent bacterial contamination of the joint replacement. It is recommended that you take antibiotics before dental work for the first year after surgery.

When can I get a flu shot after surgery? Right away. There is no restriction on getting vaccinations after surgery.