Recovering after joint replacement
Many people find it more comfortable to recover from joint replacement surgery in their own home.
Our teams are committed to supporting you to return home sooner and we expect you will go home the day of, or the day after, your surgery at Fremantle Hospital. We will ensure you can:
- manage your pain
- walk safely (usually with a walking aid)
- manage your essential daily activities.
Read how you can actively support your healing and recovery both in hospital and once you return home.
The sooner you get up and walk after your operation, the better and faster your recovery will be.
Keeping still after surgery will cause swelling and stiffness around the joint and increase pain. Gentle movement reduces this risk and can help avoid complications such as blood clots. It will also reduce how long you will need to stay in hospital.
We will support you to get on your feet and walking as soon as possible after surgery. This will be shortly after you arrive on the ward.
Many people can support their full weight on their operated leg after surgery. Our physiotherapy and nursing teams will help you get out of bed, stand and walk. You will be encouraged to get dressed in your own clothes, with supportive footwear.
When you first get up after your operation you will use a walking aid such as a frame or crutches. This will help you walk with a normal pattern and support your balance if needed. Before you return home, we will provide you with a suitable walking aid to borrow throughout your recovery.
Joint replacement surgery is often painful, and the first few weeks after surgery can be difficult and uncomfortable. You can expect this pain to be different to your arthritis pain before surgery. Please know this pain is a normal part of your healing process.
Most patients experience the most intense pain on the second day after their operation because:
- the anaesthetic may take this long to fully wear off
- swelling and inflammation is at its worst.
Whether you are in hospital or at home, you will receive the same pain relief to manage your pain.
You should use your pain medication to make sure you can manage essential activities such as toileting, showering and your post operative exercise.
You should still expect mild to moderate pain when moving. Remaining still, however, will increase stiffness and swelling, leading to more pain and side effects from medication use.
Pain relief options
You will recover quicker if your pain is well managed.
Whether you are in hospital or at home, you will be offered:
- regular pain medications to be taken regularly as prescribed
- breakthrough (extra) medications you can take in addition to your regular pain medications, including opioid pain medications such as tapentadol or oxycodone. We recommend you only take these if pain is preventing you doing essential activities.
Please take your regular and breakthrough pain relief medications as prescribed, as they are most effective when they work together.
Regular icing is the most effective way to control your pain and swelling.
It is also important to rest – while regular and gentle movement is important, too much activity can aggravate your healing tissues and cause further pain and swelling.
Potential side effects
Opioid pain medications have the potential to cause side effects including:
- nausea and vomiting
- itchy skin
- low blood pressure
- dizziness
- addiction
- hallucinations
- constipation.
Constipation may mean opening your bowels less than usual, hard or lumpy stools, or straining during bowel movements. It is a common side effect of the strong opioid medication. To manage this, make sure you:
- use the constipation relieving medications as recommended
- drink enough water
- eat enough fibre
- reduce your opioid medication when possible.
When in hospital, please let your treating team know if any side effects are bothering you, as we can modify your pain relief plan.
Once you have returned home, please contact your joint replacement nurse if side effects are bothering you.
Medications to take home
When it is time for you to go home, you will be given medications to:
- manage pain
- reduce inflammation
- reduce the risk of complications including constipation and blood clots.
Your nurse or pharmacist advise how to take these medications and about any side effects. We encourage you or your support person to ask any questions you have about your medication.
Before you go home, make sure you understand when and how to take your pain medication. This will help you manage your pain so you can move and keep up with your post-operative exercises.
Reducing pain relief
As your body heals after surgery you can expect your pain to reduce.
Each person experiences pain differently, but we expect you to gradually reduce and then stop taking the opioid medications over the first two weeks. Long term, these strong pain medications can lead to more side effects, damage your health and possibly lead to addiction.
If you need support to reduce or stop some of these medications, please discuss this with your joint replacement nurse or general practitioner (GP).
Any medications that you do not use after your surgery should be taken to a community pharmacy to be disposed of.
Swelling is very common after a joint replacement. While it is a normal reaction, it can make you more uncomfortable and moving your joint more difficult. The following advice can assist to manage swelling.
Rest
How much activity you can do as you recover will depend on many factors, including your strength and fitness.
We recommend you reduce activity while you recover, including time on your feet, extended walks, and strenuous exercise programs. This will require you to have support from family and carers once you return home.
Resting for the first 2 to 6 weeks after your operation will give your body a chance to recover from the surgery, but it is important to keep your joint moving. Swelling can be an excellent guide to how much activity you can be doing.
Icing
Ice can be very effective in relieving pain and swelling. We encourage you to apply ice to your joint for 20 minutes each hour you are awake and especially after exercise.
Elevation
Aim to lie flat or rest with your leg above your chest height (eg with a pillow under your foot) for at least 20 minutes an hour for the first two weeks (and beyond this if necessary).
Gentle movement
While we suggest resting from energetic activity, it is very important you keep your new joint moving. This helps move the swelling out of the joint and prevents it becoming stiff. Your post-operative exercises will assist with this. Moving around your house regularly for essential activities such as toileting or going to the kitchen is also important.
It is also helpful to gently massage your new joint. While you have a dressing on, you can gently rub your affected leg around the dressing. You can also do this once the dressing has been removed.
Sleeping can often be disrupted after surgery. This is a common response due to:
- pain and swelling
- medications you are taking
- resting more than usual.
You can support better sleep by:
- managing your pain and swelling
- avoiding daytime naps
- focussing on post operative exercises and light activity during the day.
Try and avoid using sleeping pills to assist with sleep as these can be dangerous in combination with your pain relief medications.
Your sleep will continue to improve as you get back to your usual activity.
At the end of your operation, your surgeon will apply an absorbent, flexible and comfortable dressing to your wound. This dressing is designed to stay in place as long as possible to encourage healing, minimise the risk of infection and reduce medical waste.
In most instances, this dressing will stay in place until you see a nurse, or your GP, two weeks after your operation. If it comes off before then, please contact your joint replacement nurse.
Your dressing has a showerproof seal and can be worn in the shower. Please avoid baths or swimming for the first 2 weeks after your surgery.
If you have concerns
It is normal to see a small amount of bleeding on the dressing after your surgery. Your wound will still continue to heal normally.
Please contact your joint replacement nurse if:
- you are concerned there is too much bleeding, it is increasing, or the dressing starts to leak
- your dressing gets wet or comes off
- you notice excessive swelling or redness.
Appointments
A number of follow up appointments will be organised before you return home from hospital. These include:
- phone appointments with the joint replacement nurse
- wound check and stitches removal
- physiotherapy
- a review with your surgeon.
If you do not live local to Fremantle Hospital, these may be able to be done closer to your home, or as a virtual appointment.
Remember
You can phone your joint replacement nurse for advice on:
- pain
- medications
- wound healing
- mobility
- follow up appointments.
For more information
Phone the joint replacement nurse on xxx or email the joint replacement nurse
The next step in your journey
Read about exercises to support your recovery, or return to Your joint replacement journey