THE
FIRST 6 WEEKS
AT HOME

Getting back to normal

During your first six weeks following joint replacement, please remember that you’ve undergone major surgery and your recovery can take up to 12 months. It’s important that you follow these guidelines when you return home:

  • Continue to take painkillers as prescribed to enable you to walk around and manage your pain and swelling.
  • Use both crutches/sticks when moving around. The length of time these are needed may vary and could be up to 12 weeks. Your Consultant will advise you about how long you should use both crutches. When it’s time to gradually wean yourself off your aids do so as your leg becomes stronger and your confidence increases. If you’re using two crutches/sticks and you wish to try with one, always use it on the opposite side to your operated leg.
  • Gradually try to increase your walking distance. Walk frequently throughout the day.
  • Your operated leg will feel stiff each morning when you wake up. Don’t worry about this, the stiffness should wear off given time.
  • Avoid crossing your legs as this might affect your circulation.
  • Wear sensible footwear and avoid high heels.
  • A healthy diet and not smoking will help the wound to heal as well as your overall recovery.

Getting mobile

It’s important to move around as much as possible in the first six weeks following joint replacement. For the first few days, make sure you change position every half an hour to an hour to reduce stiffness. Try to increase your walking distance each day.

When you leave hospital, you may have walking sticks or crutches.

After two weeks, most people can manage with one walking aid indoors – in the opposite hand to the operated leg. You’ll know when you’re ready to manage with one walking aid when you can manage to walk about without limping.

It’s a good idea to continue with two walking aids when you’re outside as you’re likely to be walking further.

How much rest and how much activity?
Most people feel tired for the first few weeks at home and it can be frustrating not being able to get on with your usual activities. Planning to gradually increase what you do each day can help you feel more in control and gain confidence as you achieve your goals. However, remember that it’s also important to take enough rest. Choose a comfortable supportive chair that’s not too low.

Diet 
For the first few weeks, you may not feel as hungry or may have indigestion. This is due to lack of activity and it’s a good idea to have small, regular meals and plenty of fluids.

Some people also have constipation due to the change in their activity level and as a side-effect of some painkillers. If this is a problem, aim to eat a higher fibre diet with more fruit and vegetables but ask your GP for advice if you’re worried.

Washing
Follow any advice that your healthcare team have given you and avoid getting right down into a bath for the first three months. A rubber mat can help prevent slipping in the bath or shower.

Housework
Avoid standing for long periods of time and if you need to bend down, put the operated leg behind you while you bend the other knee.

Pain relief
Take any pain relief medicines at least half an hour before you do your exercises and try to gradually reduce the amount you take each day.

You should aim to reduce or stop the strongest painkiller, tramadol or oxycodone within five days after leaving hospital. If your pain remains well controlled, continue to take the other painkillers and then reduce the amount again in the next few days.

Usually tramadol or oxycodone should be stopped first, then ibuprofen and finally paracetamol. If your pain gets worse when you stop any of the painkillers, start taking that painkiller again. You can try to stop it again in another couple of days. If you’re worried or if your pain does not improve or if it gets worse, please phone the Fortius Joint Replacement centre for advice.

Caring for your wound

  • Keep your wound dry and covered with the dressing until the stitches/clips are removed (around 10-14 days)
  • Your wound will be covered with a waterproof dressing, please use the limbo (waterproof cover) when showering
  • Contact us if you are worried about your wound – if there is discharge, redness, pain, heat or odour or if you have a temperature or feel unwell
  • If you need to change your dressing, wash your hands first and be careful not to touch the dressing

Daily activities

Getting into bed

  • Stand at the head of the bed close to the pillows and make sure you can feel the bed on the back of your legs
  • As you slowly sit, slide your operated leg forwards, reach backwards with both hands, keeping hold of your walking aids
  • Put your walking aids within reach
  • Move towards the centre of the bed and slide your bottom round so you’re facing the foot of the bed
  • Lift your leg into bed while you slide round; use the end of your stick or a towel to help if necessary
  • Slide and lift the other leg into bed

Getting out of bed

  • Use your arms to sit up straight
  • Move your bottom near the edge of your bed
  • Move your legs towards the edge of the bed, using a stick or towel to help if necessary to lower your operated leg to the floor
  • Position your stick/crutches
  • Using both hands, push off the bed
  • Before you stand, make sure you have put on your shoes
  • Get your balance before you start to walk

Dressing yourself

You may find some dressing aids helpful – shoehorns and sock aids, for example.

Remember:

  • Collect all your clothes together so you can easily reach them
  • Sit on the side of the bed or in a supportive chair to help your balance
  • Dress your operated leg first and undress it last
  • To put on pants or trousers, lower them to your feet, put in operated leg first and repeat with unoperated leg before pulling them up
  • Don’t wear tight clothes that may be uncomfortable over the wound
  • Always wear shoes when you are walking

Discharge goals:

Weeks 1-2 Goals include:

  • Gradually increasing the distance you walk with your sticks/crutches each day
  • Using the stairs (if you have these) each day
  • Becoming independent when washing/showering
  • Becoming independent when dressing/undressing
  • Doing some light household activities, eg making tea, ready-made meals etc
  • Carrying out your exercise programme at least twice a day


Weeks 2-4 Goals include:

  • Move from using two sticks/crutches to one as advised
  • Walk at least quarter of a mile (0.4 KM)
  • Go up and down stairs several times each day
  • Shower, dress and undress without help
  • Increase household activities
  • Continue with your exercise programme at least twice each day                      

Weeks 4-6

  • Walking with one stick/crutch and start to try without as advised
  • Walk quarter to half mile (0.8 km) each day
  • Improve stair climbing
  • Continue with your exercise programme four times each day

Weeks 6-12

  • Aim to walk without your stick/crutch without limping
  • Walk up and down stairs with alternate feet as normal
  • Walk half to one mile (1.6 km) each day
  • Improve your overall strength
  • Start to do your non-competitive sporting activities

Fortius Joint Replacement Centre
at Bupa Cromwell Hospital

164 -178 Cromwell Road
Kensington
London
SW5 0TU


E: info@fortiusclinic.com

Appointments: +44 (0)203 693 2119

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