Post-operative FAQ’s


 

Q: Do I need a special card to tell the airport screeners that I have a metal implant?

A: You do not need a card to get through the airport; however, your implant will likely set off the metal detector. In this day and age, you will need to be hand-screened, so please leave extra time when you travel. We do provide an implant card for your convenience, which will be available postoperatively.


Q: Will I need a walker or cane after surgery?

A: When discharged, most patients need a cane or walker for support while walking, typically these devices are no longer needed after 4 weeks. Hip resurfacing patients typically use crutches for 2-3 weeks after surgery while their bone gets used to the new implant.


Q: What if I have minimal pain and feel great, can I return to sports?

A: Modern surgical and anesthesia has allowed us to get patients back to activities faster than ever! However, one thing that has not changed with time is how quickly our tissues adjust to the new implants after surgery.  For hip replacements, it takes 6 weeks at a minimum for the bone to grow into the new stem.  For hip resurfacing patients, your bone must get used to the new implants during the first few months (during this time, the bone is very week!). The risk of dislocation is the highest during the first few months following surgery while the tissues heal. For knee replacements, the knee joint must get used to the new knee prior to swelling improvement.  Remember, it is definitely possible to overdo it during the first few months after surgery.


Q: Is leg swelling normal after surgery?

A: Yes, swelling a bruising around the surgical site and down the leg are common after hip and knee surgery.  As you become more mobile and beginning walking further, the swelling and bruising may even travel further down the leg, even to the foot. Remember, swelling and warmth around knee replacements can occur for several months after surgery. To improve this, you should elevate your legs at night by lying on your back and placing pillows under the legs so that they are above your heart. Avoid standing or sitting for longer than 15 to 20 minutes at a time and avoid letting your legs dangle when seated. Use compression stocking (the stockings from the hospital) that you can put on during the day – have someone help you on with them in the morning, use them during the day, and then take them off at night. If you did not get the compression from the hospital, you can purchase knee high, medium (15-20 mm Hg) compression surgical stockings at most drug stores.


Q: How do I reduce scarring after surgery?

A: Patients who develop keloids or prominent scarring after surgery or injury to the skin should expect a similar reaction.  There are many topical creams and gels to minimize scar formation after surgery.  Mederma, for example, is a scar extract that may minimize scarring.  This gel should be applied only when the skin is completely healed, usually 2 to 3 weeks after surgery.  You can use for up to 8 weeks total. 



Q: Can I get an MRI or a CT?

A: Yes, the metals used in hip and knee replacements and hip resurfacing are safe with CT and MRIs. An MRI in the area of the hip implant, however, will not yield good pictures because of artifact created by the metal. MRI of a hip resurfacing should be performed at a facility with experience with techniques used to suppress the metal artifact.


Q: When can I shower?

A: You can shower as soon as you get home if you have dissolvable stitches; if I felt that you would be better served with staples or sutures, then you will have to completely cover the staples/sutures before showering, or wait until they are removed (7-10 days postop). With either stitches or staples, do not immerse the incision in water, just pat it dry


Q: How long should I use the pain medication?

A: This is different for each patient; some are able to use Tylenol or Advil after you leave the hospital, and others require pain medication as needed for 2-3 weeks. A general rule is that you should try to decrease your use of these medications as time passes.


Q: When should I go to outpatient therapy?

A: For hip patients, I like to see you in follow up before you go as an outpatient; that way I can tailor your PT to what you need. For knee patients, I would like for you to be in a supervised therapy program right after discharge.


Q: When can I drive?

A: You should not drive as long as you are taking narcotic pain medication. Most patients are able to drive by 6 weeks if the operative hip or knee is the left side with an automatic transmission.  Returning to driving is dependent on when your reaction time (how quickly you can react to apply the brake pedal) returns to normal.  For most patients, this is around 6 weeks.


Q: I feel “clicking” inside the joint where I had surgery, is this normal?

A: The clicking is a result of the soft tissue (capsule) moving across the knee or the hip. This sensation usually diminishes as your muscles get stronger.


Q: My thigh, knee, and calf hurt. Is that normal?

A: Yes, your leg is twisted completely around during the surgery, so it is expected that you have soreness up and down your leg.


Q: Can I work out in the gym?

A: You can go to the gym and resume upper body workouts, as long as the hip/knee is in a non-loaded position (you should be sitting, not standing, when using weights).


Q: When can I return to work?

A: It depends on your occupation. It is never a mistake to take more time off in the beginning of your recovery, as it will give you time to focus on your hip. I recommend taking at least 3 weeks off for a single resurfacing, and 6 weeks for a double. Keep in mind that you may still be using crutches and it may be difficult to commute.


Q: When can I go to the dentist?

A: Please wait until 3 months after surgery, as the hip/knee is still healing and there is increased blood flow to this area.


Q: Can I travel?

A: In general, I like to see you before you fly. If you are traveling by car, you should be sure to take frequent breaks so that you don’t feel too stiff when getting up. On an airplane, I like you to wear compression stockings (if within 1 month postop), and take a couple of walks during the flight. Having an aisle and bulkhead seat will help you get more space.


Q: Should I be taking any medications or supplements for bone health after a hip replacement or resurfacing?

A: Yes, I recommend that everyone take calcium and vitamin D to help maintain bone strength. Generally, 1000-1500 mg of calcium citrate and 400 IU of Vitamin D are adequate. Occasionally I will also prescribe a medication to help promote bone strength.


Additional Resources


https://hipknee.aahks.org/total-hip-replacement/

https://orthoinfo.aaos.org

https://www.nih.gov/health-information

https://www.arthritis.org/about-arthritis/understanding-arthritis/

Location
Ugo Ihekweazu, MD
7401 Main Street
Houston, TX 77030
Phone: 713-369-2259
Fax: 281-501-5981
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713-369-2259