Total Joint Replacement

Before Surgery

Prepare Home
◦Remove rugs, railing for the stairs, bath bench, toilet seat riser, or
grab bars.

Walker/Crutches/Cane
Make sure to set up a ride home after
discharge and a caregiver for
approximately 1 week.
 Will receive two phone calls before surgery
◦ Insurance confirmation - demographic information
◦ Nurse registration – to review medical history and
medications and confirm scheduled procedure
 Any patient on a blood thinner needs to speak with their primary
doctor and surgeon regarding use 1-2 weeks before surgery

Overnight bag
◦ All labeled medications in the prescription bottle (except
pain medication), loose fitting shoes, and comfortable
clothes
◦ CPAP if used for sleep apnea
Day of Surgery
Nothing to eat or drink after midnight
including coffee, water, gum, hard candy,
etc.
Shower as instructed the night
before/morning of surgery.
Medications as instructed during pre-
procedure phone call with nurse.
After Surgery
 Surgeon will speak with family after the
procedure.
 Expect to be in recovery for 1-2 hours
after surgery.
 Wi-Fi is available within the building
 Overnight Stay
Expect to stay 1-3 days
◦ See joint recovery plan
◦ Family allowed overnight; one visitor meal provided
per day

Equipment
Ted hose (white socks)
Athrombics (leg massage)
Ice (polar cooler or packs)
Incentive spirometry (volurex)
Reason
Prevent blood clots
Prevent blood clots
Decrease swelling/pain
Prevent respiratory complications

Continuous Passive Motion (CPM) Assist with range of motion for

Total Knees
 Pain
Goal: Well Controlled Pain Levels
◦ Scale 0-10
◦ Pain should be tolerable but not likely pain free.
◦ Be proactive, it is easier to control pain than catch up to
severe pain.

◦ An anesthesiologist will discuss pain control options

prior to surgery.
 Common Medications
Narcotics Additional Pain Antibiotics
Medications
 Morphine  Tylenol • Ancef
 Dilaudid  Gabapentin • Clindamycin
 Tramadol  Celebrex
• Vancomycin
• Keflex
 Oxycodone  Toradol
 Hydrocodone  Vistaril • Possible Side
◦Possible Side  Valium Effects:
Effects • Rash
 Naropin • Itching
 Constipation
• Flushed face
Nausea  Exparel
Itching ◦Side effects vary
Drowsiness based on the
Dizziness medication given.
 Common Medications Cont.
Nausea & Stool Softners
Blood Thinners Vomiting &
Prevention Laxatives
Fragmin then Zofran Colace
Aspirin Benadryl Miralax
Scopolamine Senna
Xarelto then Patch Milk of
Aspirin Decadron Magnesium
Coumadin Reglan Prunes or Prune
Aspirin Phenergan juice
◦Possible Side
Effects: ◦Possible Side
Drowsiness
◦Possible Side Effects:
Dizziness Abdominal
Effects: Constipation
Mild bleeding Cramping
Bruising Diarrhea
Physical Therapy:

Therapy begins the day of or day after

surgery, depending on your doctor. You
are expected to participate in 2 sessions
per day.
Total Knee Replacement

Patients who have had a total knee

replacement will begin outpatient therapy
within a few days of leaving the hospital.
◦ If you are able to schedule your appointment
before you come for surgery, you will have a
better chance of getting the date and time you
prefer.
◦ A prescription for therapy (2-3 times a week)
will be given to you prior to discharge.
 Total Hip Replacement
Standard Total Hip
◦ Hip precautions – to be followed for 8 weeks
unless your surgeon specifies otherwise.
 Do not bend your hip into more than 90 degrees of
flexion (right angle).
 Do not cross your legs, either at the knee or the
ankle.
 Do not let your toes (hip) rotate inward.
Anterior Total Hip
◦ No precautions to follow, unless specified by
your surgeon.

o Outpatient therapy will be ordered after

your first follow up appointment if
needed.
Post-Op Activities
Please consult your physician with
specific questions about returning to
activities.
Driving – per physician guidelines
Kneeling – 8 weeks
Dancing – 8 weeks
Bicycling – 4-8 weeks
Golfing – 6-8 weeks
Exercises
Quad Sets – squeeze top of thigh, pushing
knee flat. Hold for 10 seconds. Repeat 20
times.
Exercises
Hamstring sets – tighten muscles on back
of thigh, digging heel down and back.
Hold 10 seconds. Repeat 20 times.
Exercises
Heel slide – bend knee as far as you
comfortably can. Hold 5 seconds. Repeat
20 times.
Exercises
Short arc quad – with a rolled towel or
coffee can under knee, tighten muscles on
top of thigh and straighten knee. Hold 10
seconds. Repeat 20 times.
Exercises
Straight leg raise – keeping knee straight,
lift leg 6-8 inches off bed. Hold 5 seconds.
Repeat 20 times.
Exercises
Long arc quad – from a seated position,
straighten knee. Hold 5 seconds. Repeat
20 times.
Arm Exercises
Chair push-ups
Bicep curls
Shoulder raises
Side (lateral) shoulder raises
Frequently Asked Questions
Why do I have to start therapy so soon?
How often/how long will I have to go to
outpatient therapy after my knee
replacement?
Do I still have to do my exercises at home
after I start therapy?
Can I just do my exercises at home and
skip outpatient therapy?
FAQ, continued
Why do I need someone to stay with me
after I leave the hospital?
How long will I need a walker/crutches?
Will we practice the stairs?
Will I see my doctor before I leave?
Discharge Planning
A RN will speak with you either the day
of or day after surgery reguarding any
needs or plans for at home.
Assist with ordering equipment
Assist with setting up Home Health Care
or Rehab services if needed.
 Please don’t compare your surgery to
anyone else’s or even to a previous surgery
that you’ve had.

Each surgery is unique and each person

heals differently.

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