With an estimated 1.4 million joint replacement operations performed in the United States each year, superb postoperative care for these and other orthopaedic surgery patients is vital for optimal recovery.
Setting clear expectations about what to expect, what is normal and what could be concerning is the foundation for a good recovery, said Endeavor Health Physician Assistant Patrick Lester, PA, who works with patients and their family members to help with postoperative care.
Lester offers seven postoperative care tips for ortho surgery success:
Be on the lookout for concerning signs.
“It’s absolutely normal for swelling to occur on the surgical site, but we tell people to be aware of concerning signs that may indicate a blood clot like redness, excessive warmth to the touch and significant pain around the calf,” said Lester, who stressed that any of these warrant a call and consult with the medical team.
Get walking.
In the hours and days immediately following surgery, patients are encouraged to ice and elevate the joint that was operated on, and to continue to walk. “Walking after surgery is super important,” said Lester.
“How frequently you walk matters more than the duration of the walk. Start by walking around the house for a minute or two every hour and then progress to longer, 30-minute walks.”
Walking helps improve blood flow, decrease swelling and maintain pulmonary function after surgery, he added, all important reasons to walk and move as much as possible after surgery.
Ensure proper home care.
Caregivers including spouses, partners and adult children can play an integral role in patients’ recovery as they can help persuade them to keep moving despite pain and to stay on top of medications.
“The patients who come in referring to their spouse as ‘Nurse Ratched’ are usually those who do the best,” Lester said with a laugh.
While it can be more difficult for patients to recover on their own, home rehabilitation therapy begins a few days after surgery and specially trained nurses and physical therapists play a key role in helping patients with medication and strategic exercises.
Address pain.
“We tell patients to expect the pain to be the most intense for the first two weeks and to follow their prescribed medication schedule to stay ahead of the pain,” said Lester. “We don’t want the pain to be prohibit patients from getting up and walking which is critical to recovery.”
Patients may also feel surprisingly good after surgery as the nerve block anesthesia medication can still be in their system. It’s very likely that their pain will intensify in day two or three after the procedure, Lester explained. Scar tissue develops and swelling can increase which adds pressure on the joint and contributes to pain.
Control swelling.
Compression socks/sleeves are another important aspect of recovery as they are very helpful in controlling swelling, said Lester. “As much as you can, we advise patients to wear them for the first two weeks after surgery,” he added.
Eat well and get enough sleep.
Getting good nutrition is another vital component of optimal recovery. “The body needs the appropriate caloric intake including sufficient protein to heal,” said Lester. Sometimes appetite can be negatively impacted after surgery, but it’s still necessary to take in healthy nutrients.
Knowing that sleep can also be disrupted, especially after knee replacement is another part of setting expectations. It can take up to six weeks or even three months to return to normal sleep patterns, so Lester encourages patients to follow good sleep hygiene including the 3-2-1 rule: stop eating three hours before bed, stop fluids two hours before bed and stop electronics one hour before bed. Doom scrolling never helps people fall or stay asleep.
Stop smoking.
Finally, for patients who smoke, it’s important to quit or at least cut back before and for a minimum of six weeks after surgery as smoking has proven to delay healing, especially at the incision.
As always, make sure to double-check with your care team on the postoperative care strategies that are most appropriate for you.
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