Recovery After Surgery at Center for Orthopedics and Sports Medicine

On the first day after your surgery, you may get out of bed and begin physical and occupational therapy — typically for several brief sessions a day. These are first steps on your way to getting back into the routines of your life!

In the days following surgery, your condition and progress will continue to be closely monitored by your orthopedic specialist at Atlantic Medical Group Center for Orthopedics and Sports Medicine, nurses, and physical therapists. A good deal of time will be given to exercising the new joint, as well as deep-breathing exercises to prevent lung congestion. Gradually, pain medication will be reduced, the IV will be removed, diet will progress to solid food, and you will become increasingly mobile. Every individual is different, and insurance coverage will differ as well. Generally speaking, a total of four days (including the day of the surgery) in the hospital is typical.

Joint replacement patients are generally discharged from the hospital when they are able to achieve certain rehabilitative milestones, such as getting in and out of bed unassisted or walking 100 feet. Your physician will assess your progress and decide whether you are ready to go directly home or to a facility that will assist with your rehabilitation.

Usually a case manager is assigned to work with you as you move through your rehabilitation routines. As the days progress, expect to become more independent using two crutches or a walker.

If you need to work with a physical therapist after your joint replacement surgery, the therapist will begin an exercise program that you can perform in bed and in the therapy department. The physical therapist will work with you to help you gain confidence and increase your range of motion.

To help you gain confidence with your new joint, the physical therapist (or nurses) will also show you:

• How to get out of bed
• How to use the bathroom
• How to get dressed

Leaving the hospital will depend on when you “graduate” from physical therapy. When you leave the hospital, the physical therapist should give you a list of activities, exercises, and “do’s and don’ts” to follow. An occupational therapist or nurse may also be assigned to help with special needs. An occupational therapist may show you how to use certain devices that assist in performing daily activities, such as putting on socks, reaching for household items, and bathing.

You shouldn’t be surprised if you feel a little shaky and uncertain for the first day or two after you’re discharged. However, you should soon get a routine going and gain confidence in your new joint — the start of a new life with less pain. (As with any surgery, expect to take pain medication for a few days while you are healing.)

If you had a hip or knee replacement, you may need a walker and/or crutches for about six weeks, then a cane for another six weeks or so. Your doctor or orthopedic specialist as well as your case manager will be in touch with you, so use these opportunities to ask questions or discuss concerns, and keep your team up-to-date on your progress.

The decision to resume a normal daily routine is one that only you and your doctor or orthopedic surgeon can make. However, there are some general guidelines that your doctor may give you.

• You should have no restrictions on leaving your home as long as your safety and comfort are assured. Just don’t tire yourself out; a good balance of exercise, rest, and relaxation is best for helping your body heal and gain strength.
• You may need to take antibiotics before dental work (including dental cleaning) and any surgical procedure that could allow bacteria to enter the bloodstream. Ask your healthcare provider whether you will need to take antibiotics at certain times to prevent infection.

When to resume driving a car, going back to work, and/or participating in sports activities are all highly individualized decisions. Be sure to follow your doctor’s or orthopedic specialist’s advice and recommendations.

What to Expect When You’re Fully Recovered

When fully recovered, most patients can expect to return to work — unless your type of work is not advisable for people with artificial joints. Examples of these include construction work, certain types of carpentry, and occupations that involve repeated high climbing or lifting. You should discuss your situation with your doctor.

You may also be advised to avoid certain activities, including some athletics, as they may place excessive stress your new joint. Examples of these activities include:

Hip/Knee

• Skiing (snow or water)
• Basketball
• Baseball
• Contact sports
• Distance running
• Frequent jumping

Shoulder

• Any activity involving lifting or pushing heavy objects
• Any activity that places excessive stress on your shoulder joint
• Hammering and other forceful arm/shoulder movements
• Boxing and other arm/shoulder impact sports

After Joint Replacement

A good rule of thumb is that acceptable physical activities should:

• Not cause pain, including pain felt later
• Not jar the joint
• Not place the joint in the extremes of its range of motion
• Be pleasurable

The success of your joint replacement will strongly depend on how well you follow your orthopedic surgeon’s instructions. As time passes, you will potentially experience a dramatic reduction in joint pain and a significant improvement in your ability to participate in daily activities. Remember, however, that joint replacement surgery will not allow you to do more than you could before you developed your joint problems.

It’s important to have realistic expectations. For example, artificial joints have limitations:

• Excessive joint “loading” because of the patient being overweight or strenuous activity, such as running and hiking, may injure the artificial joint.
• The artificial joint will not restore function to the same level as normal, healthy bone.
• The life span of the artificial joint is not infinite. It cannot be expected to equal that of normal, healthy bone.
• Adverse effects may result in a need for additional surgery, including revision or removal of the artificial joint.