What to expect within the first three months following surgery

Be patient in your recovery

It’s normal to feel tired and a bit vulnerable in your first weeks at home after surgery. You may also feel frustrated that you can’t do all the things you want to straight away. Get plenty of rest until you feel stronger. Making plans to gradually increase your activities over the following weeks may help. 

To maximise your recovery, it’s important to:

  • Understand how to take your pain medication. Ask questions if you’re not sure.
  • Follow your doctor’s instructions on promoting circulation in the first few weeks. This may include wearing compression stockings, taking medication and continuing your exercises.
  • Commit to your exercise program, as it will be very important for your recovery.

The following information is intended as a guide to help you through the transition from hospital to home. However, it’s important you follow any specific advice your consultant, nurse or therapist gives you.

Ask for help!

Ask for help!

Although your ultimate goal is to do things for yourself, don’t try to do too much too soon.

Recuperation takes approximately six to 12 weeks, and you may feel weak during this time, as well as experiencing some discomfort and swelling. Post operative swelling is normal but it is important to minimise it. If the joint swells, ice may be used. You can also help by ensuring the leg is elevated some of the time.

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Get comfortable

Get comfortable

Following treatment, avoid tight clothes, including belts or tight underwear. Loose garments are generally more comfortable, and a lot easier to put on and take off.

It is expected that you will have some degree of pain for several weeks following surgery. Take your pain medication according to your surgeon or hospital’s advice. Your hospital will most likely recommend you wear your elastic stockings for around 6 weeks post surgery.

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Rest and activity

Rest and activity

Exercise is important after your operation, but so is relative rest. Take time to rest and recover when you return home from hospital.

Set aside short periods of time every day specifically for total relaxation, and make sure your friends and family know this is an important part of the recovery process.

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Household jobs

Household jobs

Avoid all strenuous and taxing jobs immediately after surgery. Only attempt small chores when you feel up to it, and even then, have somebody helping you if possible. Here are a few tips to help you recover:

  • Avoid heavy cleaning and household tasks ( for example vacuuming, changing beds and cleaning showers. ) Ensure this is completed before the operation or ask family or friends to help in the first few weeks after surgery.
  • Don’t get down on your knees to scrub floors. Use a mop and long-handled brushes (or get someone else to do it!).
  • Plan ahead. For example, gather all your cooking supplies at one time, and sit down to prepare your meal, instead of standing. To provide a better working height, use a high stool, or put cushions on your chair when preparing meals.
  • Place the cooking supplies and utensils you use more often where you can reach them without bending or stretching too much.
  • If you’ve had a hip replacement and you need to bend down to open the oven, fridge, or a low cupboard, you will find it easier on your new hip to take that leg behind you while bending the other.
  • Don’t bend over your washing machine, use a pull up stick to pull it out. Use a clothes horse instead if a washing line to avoid reaching.
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Walking

Walking

As you begin to feel more comfortable, you can start walking longer distances. It is very important not to overtire yourself during the first six weeks – shorter, more frequent walks are best. It takes most people four to six weeks to recover fully from their operation, and your surgeon and physiotherapist will advise you how far you may be able to walk, and at what stage of your recovery. It is expected you will progress from using two elbow crutches to one, then no aid over a period of around 6 weeks. However refer to your surgeon or occupational therapist for specific advice.

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Steps and stairs

Steps and stairs

While you’re in hospital, your physiotherapist will show you the right way to manage steps and stairs. Remember going up steps: good leg leads up first, then operated leg, then crutches (or cane).  Down steps: crutches (or cane) first, then operated leg, then good leg.

Watch a short video on how to do this

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Eating

Eating

You may lose your appetite or suffer from indigestion through inactivity while you’re in hospital and when you’re recovering at home. Eating smaller meals, but more often, can help with this. Milky drinks are a healthy source of energy for the recovery period.

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Going to the toilet

Going to the toilet

The difference in your diet and the reduced physical activity, combined with prescription medication can cause irregular bowel habits. This is perfectly normal, and will pass, but if you begin to suffer constipation, a high fibre diet with plenty of fresh fruit and vegetables will help.

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Washing and bathing

Washing and bathing

You won’t be able to get in and out of a bath for the first six to 12 weeks, so it’s best to have a shower, using a shower chair or stool to sit on and remembering not to bend too low.

It is a good idea to have more than one bar of soap in the shower as they can drop. Soap on a rope is helpful. Not surprisingly, the shower is one of the most common places to dislocate your hip. Do not rush or panic and be careful.

Make sure you follow any specific advice occupational therapy staff give you, which may cover using specific equipment to help you maintain your independence. 

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Dressing

Dressing

Your occupational therapist will have advised you the safest method to get dressed.When you have returned home from hospital, you should continue following your therapist’s advice when getting dressed for 12 weeks.

  • Do not cross your legs when dressing.
  • When dressing, sit on the side of the bed or in a suitable chair. This will help your balance.
  • Collect all the clothes you’ll be wearing and put them on the bed next to you before you start.
  • Avoid twisting and overstraining to reach them.
  • Always dress your operated leg first and undress it last.
  • Do not wear tight garments over the wound – this can cause discomfort.
  • Start wearing shoes as soon as you start to move around, using the shoehorn on the inside of the recently operated leg.
  • Avoid twisting while putting on clothes – always pull them straight up or down.
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Sitting

Sitting

Use the chair your occupational therapist has recommended. Avoid sitting for long periods, and get up and walk around regularly.

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Sleeping

Sleeping

For hip replacement, after your operation you may wake up in the recovery room with a pillow between your legs. This is to stop you from crossing your legs and potentially dislocating your hip. For comfort’s sake it’s best to sleep on your back at first, but as you recover, you will be able to sleep comfortably on your side, with a pillow between your legs to stabilise your new hip.

For knee replacement, sleep in any position that is comfortable. Try to avoid putting a pillow under your new knee when you are sleeping on your back as this may prevent you regaining full extension of the knee joint.

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Sexual activity

Sexual activity

You can resume sexual intercourse as soon as you feel physically and mentally ready, taking care to protect your new joint. Many people resume sexual activity between six to eight weeks after surgery, by which time the surgical incision should have healed, and the muscles and ligaments are healing properly. Avoid sexual positions that cause pain.

Sexual activity following hip replacement

After hip replacement surgery, try to stick to sexual positions that involve lying on your unaffected side or your back at first. Here are some precautions you can follow for the first three months to avoid dislocating your hip during sex:

  • When lying on your unaffected side, keep the leg on your recently operated side straight or slightly bent.
  • Don’t let your legs cross over
  • Position pillows to support your foot and leg on your operated side, and to prevent your leg from rolling off the pillows during sex.
  • The back position is suggested for both men and women, as it usually is the most comfortable position immediately after hip replacement.
  • Don’t bend your new hip more than 90 degrees.
  • Keep the toes on your recently operated side in a neutral position.
  • Put one or two pillows under your thigh on your recently operated side for support and comfort.
  • Move the leg on your recently operated side as little as possible.
  • No restrictions apply to the non-operated leg.

Sexual activity following knee replacement

Avoid sexual positions that cause you pain in the recently operated knee area, and positions that may cause twisting or strain the knee.

After knee replacement surgery, try to stick to sexual positions that involve lying on your unaffected side or your back at first – these are considered the most comfortable positions immediately after knee replacement. Try putting one or two pillows under your recently replaced knee for comfort, and bend the knee only as much as you can comfortably.

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Driving

Driving

You will need permission from your  surgeon to start driving again. This is usually around 6 weeks after surgery but sometimes longer. It is important to follow your surgeon's advice, for your own safety and the safety of others. Driving too early may also have implications for your insurance should you have an accident. Also, avoid travelling long distances as a passenger, by car or by plane, for at least a month after your operation, as this can cause excessive swelling and discomfort.

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Getting into a car as a passenger

Getting into a car as a passenger

After joint replacement surgery, getting into a car can be tricky. For comfort and ease, slide the seat back on its runners and recline the seat slightly to give yourself as much legroom as possible. It may be easier if the car is parked away from the kerb, so you get into it on the level.

Watch a short video on how to do this

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Swimming and gardening

Swimming and gardening

Avoid either swimming or gardening for at least six weeks after your operation. Then it’s best to refer to your surgeon or GP. Some gentle exercise in water is fine as long as your wound is completely healed or appropriately covered with a waterproof dressing.

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Work

Work

It’s best to feel completely recovered before you return to work. If possible, go back on a part-time basis and build up to full-time hours gradually. You should discuss this with your GP or consultant at your follow-up appointment, as it really depends on the type of work you do. If you require a sick note for your employer, ask for one before you leave the hospital.

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Medical advice

Medical advice

Keep your doctor’s appointments, and contact him or her if you suspect anything is wrong.

It’s important to monitor your own healing, mobility and function on a regular basis after your operation. You may need to check in with your doctor two or three times during the first two years, and at intervals of two to three years thereafter. During those visits, your surgeon will take X-rays and monitor wear to the replaced joint.

Your artificial joint should last for many active years, so you should always consult your orthopaedic surgeon if you begin to experience pain in your artificial joint, or if you suspect something is not working correctly.

It’s important to watch out for infection – your new joint is a foreign substance to your body, and germs from other infections can move to your new joint. Call your family doctor immediately if you have any signs of skin infection, urinary tract infection, abscessed teeth, and so on. Treating these early can be crucial to protecting your new joint.

Tell your dentist or family physician about your joint replacement before any procedure, such as dental work, a cardiac catheter, bladder exam, or any surgery. Chances are, you’ll need to take a course of antibiotics first to prevent infection.

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Next Steps

Contact your GP or health professional to discuss your options