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Hip or knee replacement - in the hospital after

Alternate Names

Hip replacement surgery - after - self-care; Knee replacement surgery - after - self-care

Introduction

You will stay in the hospital for 2 to 3 days after having hip or knee joint replacement surgery. During that time you will recover from your anesthesia and the surgery.

Right after surgery

Even though the surgeon may talk to family or friends right after surgery is done, you will still spend 1 to 2 hours after surgery in a recovery room before going to your room. You will likely wake up tired and groggy.

You will have a large dressing (bandage) over your incision (cut) and part of your leg. A small drainage tube may be placed during surgery to help drain blood that collects in your joint after surgery.

Back in your room

You will have an IV (a catheter, or tube, that is inserted into a vein, usually in your arm). You will receive fluids through the IV until you are able to drink on your own. You will slowly resume a normal diet.

You may have a Foley catheter inserted into your bladder to drain urine. Most of the time, it is removed the day after surgery. You may have some trouble passing your urine after the tube is removed. Make sure you tell the nurse if you feel bloated.

Your nurse will show you how to prevent blood clots.

  • You may wear special compression stockings on your legs. These stockings improve blood flow and reduce your risk of getting blood clots.
  • Most people will also receive blood-thinning medicine to further reduce the risk of blood clots.
  • When you are in bed, move your ankles up and down. You will also be taught other leg exercises to do while you are in bed to prevent blood clots. It is important to do these exercises.

You may be taught how to use a device called a spirometer and do deep breathing and coughing exercises. Doing these exercises will help prevent pneumonia.

Your doctor will prescribe pain medicines to control your pain.

  • You can expect to have some amount of discomfort after surgery. The amount of pain varies from person to person.
  • You may receive pain medicine through a machine that you can use to control when and how much medicine you receive. You will receive the medicine through an IV, oral pills, or a special tube placed into your back during surgery.
  • You may also have a nerve block placed during surgery, which may be continued after surgery. Your leg may feel numb and you may not be able to move your toes and ankle. Make sure you talk with your doctor before and after surgery to make sure that your sensation is normal.

Your doctor may also prescribe antibiotics to prevent infection.

You will be encouraged to start moving and walking

Your nurses will encourage you to start moving and walking.

You will be helped out of bed to a chair on the day of surgery. You may even try to walk if you feel up to it.

You will work with specialists to get moving again and to learn to take care of yourself:

All of this takes a lot of hard work on your part. But the effort will pay off in the form of a faster recovery and better results.

By the second day after surgery, you will be encouraged to do as much as you can by yourself. This includes going to the bathroom and taking walks in the hallways with help.

After knee replacement, some surgeons recommend using a continuous passive motion machine (CPM) while you are in bed. The CPM bends your knee for you. Over time, the rate and amount of bending will increase. If you are using this machine, always keep your leg in the CPM when you are in bed. It may help speed your recovery and reduce pain, bleeding, and risk of infection.

You will learn the proper positions for your legs and knees. Make sure you follow these guidelines. Improper positioning can injure your new hip or knee joint.

Getting ready to go home

Before you go home, you will need to:

  • Be able to move or transfer in and out of bed, in and out chairs, and off and on the toilet without help
  • Bend your knees almost to a right angle or 90° (after knee replacement)
  • Walk on a level surface with crutches or a walker without help
  • Walk up some steps with help

Some people need a short stay in a rehabilitation center or a skilled nursing facility after they leave the hospital and before they go home. During the time you spend here, you will learn how to safely do your daily activities on your own. You will also have time to build strength while you recover from your surgery.

References

Mihalko WM. Arthroplasty of the knee. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 12th ed. Philadelphia, PA: Mosby Elsevier; 2012:chap 7.

Harkess JW, Crockarell JR. Arthroplastyof the hip. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 12th ed. Philadelphia, PA: Mosby Elsevier; 2012:chap 3.

Eikelboom JW, Karthikeyan G, Fagel N, Hirsh J. American Association of Orthopaedic Surgeons and American College of Chest Physicians guidelines for venous thromboembolism prevention in hip and knee arthroplasty differ: what are the implications for clinicians and patients? Chest. 2009;135:513-520.

Jones CA. Total joint arthroplasties: current concepts of patient outcomes after surgery. Rheum Dis Clin North Am. 2007;33(1):71-86.


Review Date: 8/12/2013
Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
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