Common Questions

Common Questions

What do I need to bring to the hospital prior to my joint replacement surgery?

You will need to bring a list of your medications, medical history and emergency contact information.  It is recommended you bring a set of clothes and shoes that you plan to wear at home upon your discharge as your therapists will work on activities such as dressing and walking safely with you.  It is recommended that your pants be loose fitting to allow your incision to be assessed easily with minimal disturbance to you.  If you use additional medical supplies such as a walker, cane, or a pair of crutches, please bring them so we can inspect them and instruct you on proper use.  If you currently do not have these supplies, but will require them upon your discharge, these will be arranged for you.  Also if you use a home sleep apnea machine, please bring this with you for continued use during your hospitalization.


What should I NOT bring with me to the hospital?

It is recommended that you leave cash, credit cards and valuables at home.


How do I get ready for surgery?

Screening and assessment should occur 2-3 weeks before your surgery whenever possible. You will be required to attend Total Joint class (make this a link to the power point slides) prior to your total joint replacement. You are encouraged to attend so that you can start your education and preparation for your upcoming surgery and recovery phase.


Will I need to receive a blood transfusion?

Sometimes after this type of surgery, a blood transfusion may be needed. Your blood counts will be monitored daily while you are in the hospital. Depending on the result and how you are responding with your therapy, the doctor may advise that you receive a blood transfusion. Whenever possible, arrangements can be made to have your own blood donated a few weeks before your planned surgery. Therefore, if you need a transfusion, your own blood can be given back to you. If not, you will receive blood issued from the American Red Cross Blood Bank. Remember, that all blood is thoroughly inspected and deemed safe before it is released.


In order to decrease your potential for a blood transfusion, we ask that 1-4wks prior to your surgery that you begin taking an Iron Supplement (325mg twice a day with food).  If you have active stomach ulcers or issues with nausea or cannot tolerate the Iron it is not required.  Please make sure you are taking a stool softener while you are taking Iron- this can be constipating.  Your pharmacist can help you find this over the counter.  You can even purchase a stool softener and Iron supplement combined.


Will I have home-care services after discharge?

Depending on your recovery after surgery and insurance coverage, it will be determined what kind of home care services you may need. The physician, nurse therapist, Case Manager, and Home Care Coordinator will help with those decisions and arrangements.


What happens at the time of discharge from the hospital?

For patients going home the day of surgery, expect to go home when your condition is stable.  The amount of time will vary depending on the type of procedure and how you personally respond.  Arrangements should be made prior for an adult to drive you home and stay with you the first night.  Appropriate discharge instructions and necessary prescriptions will be given to you at the time of discharge.  For patients staying one or more nights in the hospital, your doctor will tell you when you will be discharged and give any special instructions.  On the day of discharge, you can anticipate the time to be mid to late morning.  Appropriate discharge instructions will be given and discussed with you in full detail prior to your discharge from the hospital.  Discharge instructions will include bathing instructions, medication (how much and when to take), how to manage pain, how and when to use special equipment, physical activity, resuming sexual relations, driving, returning to work, things to watch for and report to physician, wound care, and dressing changes. 


What about swelling, redness, bruising or drainage?

It is normal to have some swelling after surgery. This gradually subsides but may be present for several days to weeks. Elevation and ice therapy will help to reduce swelling, and is strongly recommended.  It is not unusual to have some redness around the wound and some clear, yellow or blood-tinged drainage. Bruising (black and blue) around the surgical site is common.  Occasionally blisters may develop. They may open by themselves or we may open them in the office. If so, a dressing will be applied. Despite great care, any wound may become infected and for this reason the surgical site must be kept as clean as possible and the discharge dressing instructions must be followed. The signs of infection are increasing pain, a lot of drainage or pus coming from the wound, with redness and fever. If infection is suspected, please call the office or go to your nearest hospital or the emergency department.


What about driving or flying?

As a general rule, you may return to driving once you are off pain medications and have regained your normal strength and reflexes.  You must feel safe enough to drive that your ability wouldn't be questioned if an accident were to occur.  It is illegal to drive if you have recently taken pain medications and these are circulating in your body.   Air travel is allowed as soon as you feel capable. However, if you had a joint replacement you should not fly before 6 weeks because of the increased risk of blood clots.


After knee replacement surgery, is it normal for my knee to look larger or be slightly warmer than my other knee which has not had knee replacement surgery?

It is common for a post-operative knee to be larger or slightly warmer to the touch than the other knee that has not recently had joint replacement surgery. That is a very common feature and finding and is not necessarily related to the parts being a different size than the amount of bone that was resected. It is your body's natural response to surgery to have a little swelling and warmth for several months up to a year after surgery.


Is it normal to have numbness along the outer or lateral aspect of the incision?

It is common to develop some numbness or change in sensation over the outer aspect of the knee after surgery. Incisions that are made directly over the front of the knee may cut across the sensory nerves to the outer aspect of your knee. Generally, after four to 6 months, much of the skin sensation will return. However, occasionally some permanent loss of sensation may be noted.


I have occasional clicking or clunking in my knee after surgery.  Is this normal?

The implants in your knee are made out of metal and plastic.  The components will separate slightly with gravity.  When you swing your knee to walk, for example, a clicking sound may be heard as the pieces come into contact.  It does not mean the components are loose or broken and it should not cause any pain. 


What if my medications make me constipated?

Some medications commonly used following surgery have the potential to contribute to constipation for patients.  Some of these medications include pain medications as well as iron supplementation.  It is recommended that you take a stool softener while on these medications, if you do not have a prescription for the stool softener your local pharmacist can help arrange for an over-the-counter stool softener.


What if my pain medications make me nauseated?

Pain medications have the potential side effect of nausea.  For this reason it is recommended that you take these medications with food.  If the food does not help with your nausea, a new medication may need to be prescribed and you should contact the office for additional discussion.


Will the implant set off metal detectors at airports?

Yes, they usually do. Our clinics used to supply patient with a card/document to show airport security, but since 9-11 security does not seem to accept these cards.  Just allow for extra time (10-15 minutes) for security personnel to use a hand held metal detector to assess you.


How long will my replacement last? 

The majority will last a lifetime, but occasionally implants can wear out or become loose over time.  On average, artificial joints have a lifespan of 10 to 20 years.  Longevity of the prosthetic knee varies from patient to patient. It depends on many factors, such as a patient's physical condition, activity level, and weight, as well as the accuracy of implant placement during surgery. It is useful to keep in mind that prosthetic joints are not as strong or durable as a natural, healthy joint, and there is no guarantee that a prosthetic joint will last the rest of a patient's life.


How long after surgery should I wear compression stockings (T.E.D.S)?

Compression stockings improve blood flow, reduce swelling, and prevent injury to the walls of you veins.  They are used to lower the chance of blood clots forming in your legs.  The chance of blood clots forming is much higher during or soon after hospital discharge because your muscles are less active.  Wear your compression stockings until you return to your pre-surgery activity (this may take 2-6weeks).  Prior to discharge, you can ask your doctor if you may take them off at bedtime, however, it is important to put them on again before getting out of bed when your legs are the least swollen.  Stockings should also be removed at least once a day for hygiene purposes and check for skin irritation.  Launder your stockings every three (3) days to keep them clean. 


What is my total joint made of?

The most frequently used components in our practice are the following:

How will my pain be managed postoperatively? 

A certain amount of pain may be expected for many patients recovering from surgery.  The goal is to work with you to control your pain and keep you comfortable following surgery.  Both drug and non-drug treatments can work well in controlling pain.  Be sure to tell your provider which pain control methods that have (or haven't) worked well for you in the past.  Report any allergies you have and medicines you currently take.  Postoperative pain management is generally determined by the type of procedure being preformed and the patient's tolerance to pain. You may have a preoperative option to receive a nerve block which will aid in immediate postoperative pain. If a physician feels a nerve block will be beneficial for you, they will discuss the option with you on the day of surgery.  For immediate postoperative pain, IV pain medication is commonly used until you are tolerating fluids.  Once you are tolerating fluids, oral pain medication is used for pain control.  Depending on the procedure, a prescription for oral pain medication will be given to you at the time of discharge. It is important to take your pain medications as prescribed during the first 48hrs to prevent your pain from becoming out of control.  The first 24-48 hours after surgery can, and may be the most painful. Other ways to help relieve pain include massage, music, hot or cold packs, positive thinking, relaxation techniques, and body repositioning.  


What are common side effects of pain medication?

The most common side effects of pain medicine are upset stomach, nausea, sleepiness, dizziness, and constipation.  Make sure to take food or drink with any medicine that upsets your stomach.


How do I prevent postoperative constipation?  

Some medications commonly used following surgery have the potential to contribute to constipation for patients.  Some of these medications include pain medications as well as iron supplementation.  It is recommended that you take a stool softener while on these medications, if you do not have a prescription for the stool softener your local pharmacist can help arrange for an over-the-counter stool softener.


Constipation can be caused by many things including medication, inactivity, and changes in diet.  The following are tips you may find helpful to prevent constipation:

  • Drink plenty of fluids.  Drinking at least 8 cups daily will help keep the stool soft.
  • Drinking juices, especially prune juice and apple juice, will help keep stool loose.
  • Drink a hot beverage about ½ hour before your usual time for a bowel movement. 
  • Hot liquids often help to start bowel activity.

Increase the fiber in your diet.  Include foods such as:

  • Whole-grain bread, cereals, and pasta.
  • Fresh fruits and dried fruits such as prunes, raisins, and dates.
  • Fresh vegetables.
  • Dried beans and peas.
  • Whole-grain products such as barley or brown rice.
  • Snack foods: fig cookies, oatmeal cookies, raisin or date bars

Activity such as walking can help start bowel activity.  Make sure to follow doctor advice for activity.


Starting a stool softener 1-2 days prior to surgery and continuing it postoperatively may help prevent constipation.  If constipation continues to be an issue following surgery, you may need a laxative.  If the doctor does not prescribe a stool softener or laxative postoperatively, ask your pharmacist which over the counter stool softener or laxative they recommend. 


What are signs of post-surgical infections? 

Signs and symptoms of an infected surgical site include:

  • Warmth: The area around the wound is warmer than the surrounding skin
  • Swelling and Redness:  Increased redness and swelling around the wound or swelling spreading to other areas.  Some redness and swelling is expected in the first 48 hours.
  • Drainage: Persistent drainage that involves blood, clear fluid, or pus. 
  • Odor:  A new or stronger odor is present or a foul or sweet smelling odor coming from the wound.
  • Pain: Increased pain or change in pain location
  • Fever:  Fever above 101 degrees F or persistently about 100 degrees F.
  • Separation:  Any place where the incision is separating or opening. 

Should I apply ice or heat to an injury?

Ice should be used in the acute stage of an injury (within the first 24-48 hours), or whenever there is swelling. Ice helps to reduce inflammation by decreasing blood flow to the area in which cold is applied. After 72 hours, heat may be used along with ice on the injury.   Heat increases blood flow and may promote pain relief after swelling subsides.  Heat is commonly used for chronic injuries without swelling or inflammation.  Sore, stiff, nagging muscle or joint pain is ideal for the use of heat therapy. Heat may also be used to warm up muscles prior to exercise or physical therapy.


Why is my throat sore following surgery?

A sore throat after surgery is a common complication of anesthesia.  The insertion of the endotracheal tube or other type of "breathing tube" can result in a sore throat after the surgery.  The tube can result in throat irritation which may last up to two weeks.  Throat lozenges can be used to alleviate the symptoms.


When will I be able to return to work following surgery?

It is our goal to get you back to work in some capacity as soon as it is safely possible.  This is usually discussed at your first post operative appointment in detail.  Your first post operative appointment will take place between 7-14 days after surgery.  An appropriate return to work slip to be given to your employer will be given during your first post operative visit.


What medications should be discontinued prior to surgery? 

In preparation for your surgery, stop taking all Non-Steroidal Anti-Inflammatory (NSAID) medications 5 days prior to your surgical procedure.  Examples include Ibuprofen, Motrin, Aleve, and Naprosyn.  Patients taking Celebrex, Mobic, or Relafen may continuing taking up until the night before surgery.  Tylenol may be taken as needed.  If you are taking Aspirin please check with your prescribing physician to see if you can stop taking it 5 days prior to surgery.  Patients on Coumadin, Plavix, or Aggrenox please check with you primary care physician as to when you should stop taking prior to surgery (usually 4-7 days prior). 

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BayCare Clinic,, is the largest physician-owned specialty-care clinic in northeastern Wisconsin and Michigan’s Upper Peninsula. It is based in Green Bay, Wisconsin. BayCare Clinic offers expertise in more than 20 specialties, with more than 100 physicians serving in 16 area communities. BayCare Clinic is a joint partner in Aurora BayCare Medical Center, a 167-bed, full-service hospital. Follow BayCare Clinic on Facebook and Twitter.