Total Joint replacement

Post-Operative Instructions

Total Joint Replacement

Important: if you need to have a dental procedure, endoscopy or any surgery (major or minor) and have a joint replacement we recommend you have Antibiotic cover prior to your procedure to help lower the risk of any infection going to your hip or knee prostheses.The standard Antibiotic regime is Amoxycillin 2g orally 1 hour prior to the procedure.

Wound

Keep wound covered and dry. At approximately 10-14 days your clips will be removed by a doctor and your wound assessed. Dr Bhimani does not allow his pts to swim or bathe for approximately 3 weeks after surgery to make sure your wound is completely healed and has no threat of infection.

Physiotherapy

Physiotherapy is an imperative part of your rehabilitation. You will exercise everyday while in hospital. You may have already booked into a rehabilitation unit for after hospital or booked into a physiotherapist as an outpatient. Here you will be working on strengthening and getting yourself back to your everyday activity. Formal Physio usually lasts 6 weeks. At your 6 week follow up appointment with Dr Bhimani you will discuss any further rehabilitation and return to activities.

Pain Management

Pain management has an imperative role in your recovery. It is important to stay on top of your pain throughout your rehabilitation. You will be on multiple medications even once you have left hospital. It is important to understand what medication you are taking and how to manage this once at home. Over the page is a more detailed list of the common medication Dr Bhimani prescribes. You may be prescribed different medication to these to suit any pre-existing conditions, allergies and intolerances.

Blood Clot Prevention

Wear your long thigh high compression stockings for 6 weeks post-surgery unless instructed not to by a doctor. You should remove before going to sleep and put back on each morning. You will also have blood thinning medication which may continue when you go home. Report to a health professional any increasing pain in your calf, shortness of breath, chest pain, and rapid pulse and breathing.

Warning signs

Please contact Dr Bhimani’s office or seek medical advice if you experience any of the following:

Fever, chills, persistent discharge from your incision, increasing pain or excessive bleeding.

Post-Operative Appointment

You will see Dr Bhimani in his office at 6 weeks. At this appointment your progress will be assessed and expectations discussed. You will need to bring a new X-ray of your joint to this appointment, a request form for this will be given to you before you leave hospital.

Medications for your upcoming joint replacement:

Recovery from joint replacement surgery can be painful, however, because it is important for you to mobilise early on your new joint, helping you stay comfortable is our primary goal. To assist with your rehabilitation and to help minimise the risk of you experiencing severe pain we routinely commence our patients on a range of new medications. Using multiple types of pain relievers (multimodal analgesia) lets us treat your pain more effectively and also minimises side effects because we can use lower doses than if only one pain reliever is used. Listed below are some of the common medications that you may be started on.

Paracetamol

You will likely already be taking paracetamol. It is a simple but safe and effective pain reliever which helps us minimise the doses of the other medications which have potential for more harmful side effects.

Anti-inflammatory

Usually Celecoxib (Celebrex) or Meloxicam (Mobic). Anti-inflammatories offer very effective pain relief but they do have potential side effects which can affect the stomach, kidneys, or heart. We will select a drug and dose that best suits you keeping in mind your age and medical history. We usually prescribe these drugs for 1-2 weeks after which they become optional, to be taken as needed.

Tapentadol SR (Palexia SR) or Targin

Opiates are the strongest pain relievers and are important to help you mobilise and keep you comfortable for the first few weeks after your surgery. Targin and Palexia SR are both slow release medications which will keep most of your pain under control. They are addictive medications and can have serious side effects so we will choose a safe but effective dose for you. The higher doses needed initially will need to be lowered when you feel that your pain is manageable and you are not requiring many doses of extra pain relief through the day.

Endone or Tapentadol IR (Palexia IR)

You will be prescribed a quick acting medication which offers you flexible control over your pain levels. These can be taken when pain is moderate to severe or preventing you from exercising or sleeping.

Pregabalin (Lyrica)

Lyrica is a non-addictive analgesic which targets pain in a different way to your other medications. It allows us to use lower doses of the other medications and helps treat your pain more effectively. It also helps improve the quality of your sleep while in hospital. If deemed suitable for you, we generally prescribe Lyrica for 1-2 weeks after joint replacement surgery.

Movicol or Coloxyl &Senna

Opiates are highly constipating medications so we recommend you take one of these preventative medications until no longer taking opiates. They will not cause you to have diarrhoea but will help prevent opiate-induced constipation which can be distressing.

Aspirin

Dr Bhimani usually prescribes Aspirin for 6 weeks after your operation to help prevent blood clots. If you have any allergies, pre-existing conditions or are at a higher risk of clots you may be prescribed another anti-coagulant over this period.

Summary

Every patient responds to surgery, pain and medications differently. It is important to communicate any concerns while you are in hospital so your medications may be adjusted and tailored to optimise pain relief and improve the quality of your recovery. If you are already at home and have any concerns it is important to see your GP or contact Dr Bhimani’s office.