Microsoft word - knee_hipreplacementpostopscottmartinmd.docx

What to Expect with Knee & Hip Replacement
Initial Preparation
• If you smoke, it is VERY IMPORTANT to stop before your surgery  Smokers can have difficulty under anesthesia and an increased risk of developing complications with healing • If you have a complicated medical history:  Please visit your Primary Care Physician for any special clearance tests you may need Pre-Operative Evaluation
• Will be scheduled for you by Monica LaHair (p: 617-732-8138) at the Brigham and Women’s Pre-Operative
Testing Center (Weiner Center)
• At your pre-op appointment, you can expect:  Blood work and physical examination  Meeting with an anesthesiologist to discuss your anesthesia  Possible donation of 1-2 units of your blood
Pre-Operative Medication
• It is helpful to moderately decrease the amount of pain medication you are taking 1-2 weeks prior to surgery  It will be easier for you to manage post-operative pain • If taking anti-inflammatory medications (e.g. Advil, Motrin, Aleve, Ibuprofen, Naprosyn) for musculoskeletal pain  Please discontinue use 12-14 days prior to surgery • If taking aspirin-like products prescribed by your Primary Care Physician or Cardiologist  Please discontinue 12-14 days prior to surgery *IF approved by your prescribing physician • The day prior to surgery: DO NOT EAT OR DRINK AFTER MIDNIGHT
 You may be prescribed a dose of Coumadin (blood thinner)  You may take morning medication with a sip of water
Normal Expectations After Surgery: Mobility
First Few Days:
• After surgery, you will be in the PACU (Post Anesthesia Care Unit) until stable then transferred to the floor
• Most patients are able to get up and walk the next day with help
 Getting in and out of bed  Using crutches  Going up and down stairs • Generally, you will require a 3 day hospitalization
 Nursing staff, care coordinators and a physical therapist (PT) will work with you to determine whether it’s best to be discharged to your home with services or to an inpatient rehabilitation facility First Months:
• If discharged home, you will have a home physical therapist typically for 6-8 weeks before transitioning to an
outpatient physical therapy facility  The home PT helps with daily activities, walking, stairs and strength training • You may drive a vehicle with an automatic transmission 4-6 weeks after surgery  Your driving leg needs to be strong.  Please go to the nearest Registry of Motor Vehicles for a Driver Clearance Test if you are uncertain about • You may travel a few weeks after surgery  Take breaks and stretch every 45 minutes to prevent a blood clot • If travelling by plane in the first 4 weeks after surgery, non-invasive ultrasound tests are usually performed to rule out a blood clot (DVT: deep vein thrombosis)  T.E.D compression stockings are recommended to be worn during the flight 75 Francis St • Boston, MA 02115 • (p) 617-732-8138 For additional information please see Long Term:
• You will be seen for an x-Ray one year post-operatively and then every two years
• Knee or Hip replacements can normally last 15-20 years or longer if no loosening or infection.
 Varies depending on activity level and other factors Pain Management

• Initially, you will receive an Epidural or PCA (Patient Controlled Anesthesia: intravenous pain medication you • When discharged home, you will receive a narcotic pain medication prescription  To prevent constipation, take a stool softener (e.g. Colace) • After 4-6 weeks, most people switch to Tylenol and/or NSAIDS (e.g. Aspirin, Ibuprofen, Advil, Motrin, Aleve)
• If prescribed Coumadin, you should not take NSAIDS at the same time
• Avoid alcohol while you are on Coumadin and/or narcotics

General Instructions

• For any questions or concerns about your post-operative anticoagulation medication:  Please call the BWH Anticoagulation Clinic at (617)-732-8887
• If you have staples over your incision, they will be removed within 1-2 weeks after surgery
• If you have suture and steri-strips over your incision, the suture will likely dissolve and not need to be removed
 Leave the steri-strips in place for 3-4 weeks or until they fall off on their own • You may shower or bathe (get the incision wet) 10 days after surgery if it is not draining  After, leave the incision open to air or cover lightly to protect it from irritation • Wear the T.E.D compression stockings for up to 6 weeks  If comfortable, wear them longer  Decreases swelling • To prevent infection, antibiotics are given before a medical procedure (antibiotic prophylaxis)
 Needed to prevent infection of the knee prosthesis for at least two years after surgery  Taking antibiotics is recommended for:  All dental procedures including cleaning  Colonoscopies and upper GI (gastrointestinal) investigations  If you tolerate antibiotics, it is recommended to practice antibiotic prophylaxis for as long as possible  The antibiotics are generally taken 1 hour prior to the medical procedure What To Be Aware Of
• Please call our office (617-732-8138) or the On-Call MD after hours (617-732-6660) if you have  Incision drainage for more than 48 hours  Redness  Calf pain with swelling  Fever 75 Francis St • Boston, MA 02115 • (p) 617-732-8138 For additional information please see


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