FREQUENTLY ASKED QUESTIONS AFTER JOINT REPLACEMENT
What Results Should I expect?
You should plan for and expect a successful outcome from your joint replacement surgery. Generally, patients experience less pain and more mobility in their joint, and can resume most of the activities they enjoyed before the onset of arthritis. Long-term studies show that over 90% of artificial joints are intact and fully functional after 10-years and 80-85% at 20 years. Your artificial joint will last longer if you maintain your ideal weight, low impact exercise, and undergo routine follow-up examinations.
What is the recovery time?
After surgery, you will be using a walker for about the first week after surgery. When ready, you will transition to using a cane for about 1-3 weeks. By 4 weeks after surgery, many patients might not need to use any external supports. We ask that you use a walker and/or cane to help with balance, it will also help you to be able weight-bear as comfort allows. It can take up to 3 months to return to 80% function and you can continue to improve as far as mobility and function is concerned, for up to 1 year after your surgery. Just keep in mind that everyone heals and recovers at a different pace.
When will I be able to walk?
Our goal is to get you up and walking as soon as it is safe to do so! Your joint will structurally be able to withstand your entire weight while walking immediately after surgery. Because of normal pain after surgery, most people need some type of assistive device (cane, walker, crutches) usually for a few weeks. In rare instances, whether due to bone quality, prior deformities or surgical complications, you may have a period of partial or no weight bearing after surgery.
When can I drive?
Patients can usually drive around 3 to 4 weeks after surgery. It is very important that you are off all narcotics and are not using an assistive device before you start to drive. It is also important that if you are having a right sided joint replacement that you are able to press the brake down quickly in case of an emergency. You want to make sure that you are comfortable and confident that you are able to operate your car safely. We suggest practicing in a parking lot prior to driving on the road.
When can I travel?
You may travel after your first in clinic post-operative appointment. It is recommended that you get up and either walk or stretch at least once each hour during long trips. This is to help prevent blood clots. If you are thinking of going on a long trip within the first 3 months after surgery, we suggest you take one 81 mg of Aspirin twice daily beginning 2 days prior to your trip and complete this regimen 2 days following your trip.
When can I return to work?
That answer depends on your occupation. If you have a more sedentary job and are not on your feet all day, you could return after 4 to 6 weeks. If you have a more labor-intensive job, it could be 12 weeks before you can return to your job. We suggest that all patients plan to be off work a minimum of 6 weeks, and we can adjust as needed depending on your recovery and progression.
Why does the skin around my incision feel numb?
When you undergo a joint replacement, the sensory nerves are interrupted which results in the numbness around the incision, particularly after a knee replacement. This will improve over the course of 1 year, but it could always feel somewhat different.
What kind of activities are not allowed or are allowed after a joint replacement?
This is a great question. Our goal with this surgery is to improve your quality-of-life so I want you to get back to the activities that give you joy! That being said, this isn’t your 20 year old joint again. So while your joint is structurally sound, strenuous activities might cause you more discomfort. Additionally, high impact activity like running or jumping can also wear out the plastic liner and other components sooner, leading to a potential need for “re-do” surgery. However, there is no way to know exactly how much activity will do this. Regardless, I do ask that all my patients avoid trying any impact activities for a minimum of 4 months after surgery due to the need for your body to fully heal. Low impact actives that are safe to do, and encouraged, include walking, gardening, golfing, doubles tennis, hiking, cycling and swimming. Please discuss with Dr Vaux if you have any questions regarding specific activities.
Is this a minimally invasive surgery?
This is a great question. I use minimally invasive techniques to protect your bone and soft tissues, however, “minimally invasive surgery” has no true definition. For example, some people think “minimally invasive” corresponds to the size of the skin incision, but the size of the incision varies by patient and is typically related to your body habitus. Bigger legs will get bigger incisions. The worst thing you can do is have an incision that is too small because the stress on the incision from the surgeon “forcing” the implants into a smaller space can place your incision at risk for wound complications. At the end of the day, our goal is to perform a procedure that is safe, precise, and associated with less postoperative pain, good wound healing, and a quicker recovery.
Is Outpatient/ Same-Day Discharge an option for me?
If you are healthy, do not use assistive devices, and have lots of help at home, you may be a good candidate for outpatient or same-day discharge total joint replacement. Please see the section on outpatient/ same-day discharge joint replacement and talk with Dr Vaux or Megan Hebda, PA about whether this is an appropriate option for you.
Will I be able to kneel on my operative extremity?
For knee replacements, after a few months you may try kneeling on your operative extremity. It can be painful at first, but it will not harm your knee. The discomfort is coming from your incision and the healing tissues. Kneeling will become more comfortable as time passes. Often beginning with kneeling on a pillow or something soft can help to desensitize the incision.
My knee replacement makes a clicking or bumping noise. Is this normal?
Yes, this is NORMAL as the metal articulation is contacting the plastic. This is not harmful to you.
I think my leg feels longer now. Is this possible?
For the majority of people, this will not happen. In the case of a knee replacement, this is usually the result of straightening out a knee that pre-operatively had a significant bow to it. In hip replacement surgery, there can be a slight leg length discrepancy post operatively, which is accepted in order to achieve a stable hip replacement that does not dislocate. Most people are born with a leg length discrepancy that averages from ¼ inch to 1 inch. Over time your body will adapt and your gait will normalize. Occasionally, we can consider a shoe lift if needed.
Which approach will be used for my hip replacement?
There are multiple different approaches or ways to perform a hip replacement. The most common are the posterolateral and direct anterior approach. Both have an excellent track record and no difference in outcomes long term. Dr Vaux will discuss which approach is right for you based on your bone geometry, body habitus and other factors.
What type of anesthesia will be used for my joint replacement?
In most cases, a spinal anesthetic will be administered by the anesthesiologist. This is typically accompanied by light medical sedation. A spinal anesthesia gives us the ability to decrease the amount of general anesthesia you get so you wake up with less pain, nausea, and other issues that some patients can get with general anesthesia. However, some patients are not good candidates for spinal anesthesia and instead receive general anesthesia. In outpatient surgery and in some hospital cases a general anesthesia is used. Please discuss with Dr Vaux and your anesthesiologist if you have further questions or a strong preference.