After your surgery

General guidance following hip and knee surgery. Your specific instructions take precedence.

Pain

Some pain is expected and is not a sign that something is wrong. It is easier to stay ahead of pain than to catch up with it, so take regular pain relief in the first days rather than waiting until it becomes severe. You will be given a plan on discharge and it will usually step down over one to two weeks.

Constipation from pain medication is very common and worth pre-empting.

Your wound

Your surgical dressings are sterile and waterproof. They should remain on for 10-14 days post surgery unless instructed otherwise by Dr Spelman. You can shower with the dressings on for most hip and knee procedures unless told otherwise.

General principles:

•          Keep the dressing clean and intact until told otherwise

•          Do not apply creams or ointments to the wound unless instructed

•          Some bruising and swelling is normal, and swelling can persist for months after joint replacement

•          Elevating the limb when resting helps

Swelling

Swelling around a replaced joint can last three to six months. This is normal. Elevation, ice and staying on top of your exercises all help.

Moving

Movement is treatment, not a risk. You will usually be up on the day of surgery or the day after.

Follow your physiotherapy programme. Progression after most procedures is based on meeting strength and movement targets, not on the calendar — which is why two people having the same operation can progress at different rates.

Driving

You must be able to perform an emergency stop, be off strong opioid pain medication, and be out of any brace that prevents safe control of the vehicle.

Check with your insurer — some policies have specific requirements after surgery. Dr Spelman will advise when you are safe to drive; the legal responsibility remains yours.

In general, if you have surgery on your right leg you will need to wait 6 weeks until you are cleared to drive. If you have surgery on your left leg and have an automatic car you may be able to drive at the 2-4 weeks post-op.

Flying

You should not plan any air travel in the 6 weeks following your joint replacement due to increased risks of blood clots.

Returning to work

Depends on the procedure and on what your work involves. Desk work is usually possible far sooner than manual work. Ask at your appointment — if you need a certificate, it is much easier to arrange in person.

Dental and other procedures after joint replacement

Any routine dental cleaning should be delayed for 6 months following a joint replacement. If any emergent work is done in this time it is recommended you have antibiotic cover starting 2 hours prior to the procedure.

For major dental work the jury is still out, but out of an abundance of caution Dr Spelman recommends lifelong antibiotic prophylaxis for major dental procedures if you have a joint replacement.

Tell any treating doctor or dentist that you have a joint replacement.

Call the rooms if

•          Increasing rather than decreasing pain

•          Fever or chills

•          Spreading redness, heat, or discharge from the wound

•          Wound edges separating

•          Calf pain, tenderness or new swelling

Seek urgent medical attention — do not wait

•          Chest pain or shortness of breath

•          Sudden inability to bear weight on the limb

•          High fevers or any major concern that you do not think can wait until the morning

Out of hours, go to your nearest emergency department. If the surgery was recent, tell them what was done and when. If possible and you are safe it is best to present to The Epworth Hospital emergency department who will speak to Dr Spelman directly.