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After You Leave the Hospital

When to Call the Doctor
What Happens Next
Discharge Instructions
Follow-up Appointments
Dressing Changes and Incision Care
At-home Guidelines for Driving and Exercising
Equipment and Therapy

When to Call the Doctor

Call the Orthopedic Clinic at 913-588-6100 from 8 a.m. to 4:30 p.m. weekdays, or visit your nearest emergency room/urgent care after hours, on weekends or holidays.

Signs and Symptoms to Report Immediately

Warning Signs of a Blood Clot

  • Sudden shortness of breath
  • Sudden onset of chest pain
  • Localized chest pain with coughing
  • Severe pain in your calf and leg unrelated to your incision
  • Tenderness or redness of your calf
  • Swelling of your thigh, calf, ankle or foot 
Warning Signs of an Infection
  • Persistent fever of 101.5 degrees Fahrenheit
  • Shaking chills, difficulty breathing, confusion/disorientation
  • Increasing redness, tenderness or swelling of the wound
  • Thick, foul-smelling, yellow drainage from the wound
  • Increasing pain with both activity and rest

What Happens Next

Our patients often have further medical or recovery needs once they receive a doctor’s permission to leave the hospital.

During a patient’s hospital stay, the discharge planning team will take time to learn about any potential discharge needs and to find answers and options. Possible ongoing care options that may be discussed with patients and family members include:

Inpatient Rehabilitation
This program provides intense, short-term physical, occupational and/or speech therapy for a total of 3 hours each day. The goal of this program is to help patients return to home.

Please keep in mind that a patient may still need 24-hour assistance or supervision after discharge.

Skilled Nursing Facility
These facilities provide short-term care, including physical, occupational and/or speech therapy. The level of care depends on the patient’s ability to participate. This is a less intense program and may be recommended for patients who are unable to participate in 3 hours of therapy each day. The goal of this program is to help patients return to home.

Home Health
These programs offer skilled intermittent care and treatment for illness or injury. This may include nursing services, physical therapy, occupational therapy and/or speech therapy.

Outpatient Therapy
For patients who require further physical, occupational and/or speech therapy, services may be set up with our hospital team or at a location closer to the patient’s home.

Discharge Instructions

When your doctor feels you are stable enough to go home, you will be released from the hospital.

Please arrange for someone to pick you up from the hospital by noon to transport you home.

Your nurse will review your discharge instructions, including all medications. You can choose to have your medications filled at The University of Kansas Hospital Outpatient Pharmacy in the main lobby. This will conveniently allow you to pick up your medications before leaving the hospital.

Ask your nurse about any information you do not understand.

Follow-up Appointments

For the next 6-8 weeks, you will continue to heal and recover from surgery. It is essential to your recovery that you attend your follow-up appointments.

Your doctor will assess your progress during these appointments.

  • A 2-week follow-up appointment will be made for total knee replacements to remove sutures or staples. 
  • A 6-week follow-up appointment will be made for total hip replacements. 

The timeframe for the follow-up appointments is listed as a guideline and will be scheduled as necessary based on your procedure and recovery by your doctor.

Dressing Changes and Incision Care

Your surgical incision will have an Aquacel® dressing that will allow you to shower. Your dressing will be changed before you leave the hospital and will remain on for 7 days.

After 7 days, a dressing of gauze and tape may be placed over the healed incision. Do not use ointments or creams. If your incision site is completely healed without scabbing, drainage or open wounds you may shower after the Aquacel® dressing is removed.

At-Home Guidelines

Walking
Walking is an important part of your recovery, but guidelines must be followed.

  • Use your walker or crutches when walking, as instructed, until your initial follow-up visit. Although you may feel you can walk without the walker, your bones take from 6-8 weeks to heal. Walking without your walker may slow or hinder your recovery.
  • Walk daily and increase the distance each day, allowing rest between activities.

Sitting and Driving
Resting during your recovery is important, but it’s also important to stay active.

  • Do not sit for extended periods of time. Getting up, walking and changing positions are important to recovery.
  • Stop every hour during long car trips to get out and move around.
  • Use a pillow or chair cushion to raise the seat on low chairs.
  • Do not cross your legs.
  • As a safety precaution, do not drive while taking pain medications.

Sports and Exercise
While exercise is good, it’s important to recover as directed by your doctor.

Use these precautions:

  • Do not engage in high-impact activities such as running, jumping, aerobics, basketball, tennis and skiing during the first 3 months after your surgery.
  • Realistic activities include unlimited walking, swimming, golf, driving, hiking, biking and other low-impact sports.

Sleeping
If you prefer to sleep on your side, place a pillow between your knees to keep your hips aligned properly.

Bathing
Do not submerge your incision site. This includes restrictions to baths, hot tubs and swimming pools, until the incision site is completely healed. You may shower with the Aquacel® dressing intact.

Sexual Activity
Sexual activity may be resumed once the surgical incision has healed. If you have had hip surgery, maintain hip precautions.

Equipment and Therapy

Equipment

  • TED hose: Stockings are often worn up to 6 weeks after surgery to increase the blood circulation in your legs and prevent blood clots from forming. Assess your skin daily for irritation to prevent skin breakdown.
  • SCD (sequential compression device) foot pumps: The sleeves, placed on your feet while you’re resting in bed, pump air throughout to stimulate circulation and increase blood flow.
  • Trapeze: A metal frame may be placed around your bed while you’re in the hospital. Hanging above you will be a triangle that you can use to adjust your position in bed. Upper arm strength comes in handy with this tool as your new hip or knee heals. It’s important to transition away from using the trapeze when preparing to go home.
  • Drain: Your doctor may place a drain near your surgical incision during the operation. The drain provides a way for excess fluid/blood to escape into a container. Your nurse or aide will empty the container regularly, recording the amount of fluid. The drain will be removed by your doctor after the drainage has decreased (usually 1 or 2 days after surgery).
  • Foley catheter: A small tube will be inserted into your bladder during surgery to drain urine. The tube will be removed 1 or 2 days after surgery.
  • Walker: Physical therapists may provide a walker for your use while you’re in the hospital. Case management staff may assist you in arranging for a walker if you need one at home.
  • Bedside commode: A bedside commode or elevated toilet seat may be helpful after surgery. You may want to purchase one for your home prior to your surgery. Typical toilet seats are too low for hip replacement surgery patients. Your new hip should not bend past 90 degrees.

Therapy

Physical therapy
A physical therapist will visit you each day you are in the hospital. Your participation with the physical therapist will help you regain your independence after your surgery.

With your physical therapist, you will review and practice postoperative exercises, ways to get in and out of bed, standing, walking and stair-climbing techniques. Your physical therapist’s recommendation will help determine when you return home or if further rehabilitation at another facility is indicated.

Knee precautions
Knee replacement surgery patients will receive guidelines to adhere to from their physical therapists. Precautions include:

  • Do not put pillows under your knee.
  • Avoid raising the foot of the bed while in the hospital.

Hip precautions
Your new hip should not bend past 90 degrees.

Specific guidelines are provided for hip replacement surgery patients. The guidelines are customized for the type of procedure your doctor completed and will be reviewed with you by your physical therapist and occupational therapist.

  • Do not sit on low, soft chairs or low toilets. Do use chairs that keep your knees lower than or even with your hips.
  • Do not reach down for items on the floor. Do use your reacher.
  • Do not bend, stoop, squat or perform other activities that cause extreme hip bending (tying shoes, putting on socks, reaching into low kitchen cabinets.)
  • Do not bend your leg that was operated on back while standing.
  • Do not rotate your leg that was operated on outward or inward.
  • Do not plant your feet and twist at your hip. Do pick up your feet and turn your entire body.
  • Do not roll to get out of bed.
  • Do not move your leg that was operated on into an extreme position to the side.

Occupational therapy
An occupational therapist will visit with you several times while you are in the hospital to evaluate your ability to successfully perform daily living activities.

Your occupational therapist will help you achieve everyday tasks, such as getting dressed while adhering to movement and weight-bearing precautions. You will be advised on using any adaptive equipment, such as reaching devices, shower equipment, elevated toilet seats or a bedside commode.

Your occupational therapist’s recommendation will help determine when you return home or if further rehabilitation at another facility is indicated.