Joint Replacement Rehabilitation Information:

Total Knee     Shoulder Joint     Knee Joint     Hip Joint

Discharge and Recovery

Now your readjustment is beginning, and you are sufficiently stable to return home with the assistance of your support person. You need to do the following for a successful outcome.

Walking (hips & knees)

• Use your walker or crutches until you are given further instructions from your surgeon. Although you may feel you can do without these devices, remember that healing continues for the next six to eight (6-8) weeks. Protect yourself by using a supportive device, such as a walker or crutches.
• If you are not bearing full weight after surgery, progress your weight bearing as your surgeon has advised.
• Walk as much as you can every day, within your comfort level. Follow the instructions given by your physical therapist.
• Walk frequently on level ground. Go outside if weather permits, or choose a large area, such as a shopping mall.

Sitting/traveling

• You may sit if tolerated but must get up, walk, and change your position at least every two hours.
• DO NOT travel a long distance (over one hour) until cleared by your surgeon.
• During long car trips, stop at 45-minute intervals, get out and move around. If you don’t take breaks, you will become uncomfortably stiff and experience swelling, which may lead to blood clot formation.
• Your new joint may activate metal detectors required for security in airports and some buildings.

Exercise

• Exercising is very important. It is better to exercise more often during the day than to only do it one to two (1-2) times each day.
• You must balance exercise and rest periods each day.
• Follow your home exercise program daily, as instructed by your physical therapist.
• Exercise is not a temporary program, but continuous and ongoing.
• DO NOT use exercise equipment until approved to do so by your surgeon or therapist.

Driving

• DO NOT drive until your surgeon has cleared you and you are NOT taking any pain medication. This may be a liability issue with your insurance company.
• This varies, based on the type of surgery you had; please consult your surgeon.

Avoiding Falls

• Your surgeon and physical therapist will help you decide what assistive devices will be required following surgery and when these devices can be safely discontinued.
• A fall can damage your new joint and may result in further surgery, even years later.
• Stairs, showers, and bathtubs are hazards until your joint is strong and mobile. You should use a cane, crutches, walker, handrails, or someone to help you with the stairs until you have improved your balance, flexibility, and strength.
• Sometimes pets can cause falls; be careful around your pet(s) or make other arrangements for your pet(s) for a few weeks.

Sexual Activity

Many patients and their partners experience a great deal of anxiety in regard to sexual activity. This section is designed to address these issues and, hopefully, allay your anxieties.

Q:  What effect will total joint arthroplasty have on sexual relations?

A: Generally, you may have a great deal of pre-operative pain and stiffness, which not only interferes with your walking, but also with your ability to have enjoyable intercourse. Joint surgery will alleviate a significant amount of the pain and stiffness, and therefore, assist you to enjoy comfortable intercourse.

Q:  When may we resume sexual intercourse?

A: The incision and the muscles require approximately four to six (4-6) weeks for satisfactory healing. Therefore, it is generally safe to resume sexual intercourse in approximately four to six (4-6) weeks following surgery. Ask your surgeon at your first post-operative appointment when you may resume sexual activity.

Q: What positions are safe and what precautions should be followed during sexual intercourse?

A: It is generally advised that you assume the more passive role of being in the “bottom position”. As the joint heals, you may assume a more active role. After several months, you may resume sexual activity in any comfortable position.

Q: What should my partner be aware of?

A: Communicate openly and freely with your partner with respect to your level of comfort, concerns, and anxieties.

Sex following joint surgery is possible and can resume quickly. Initially, the “bottom position”, maintaining your legs abducted (spread apart) and slightly flexed will be the safest and most comfortable position, which will also require the least energy expenditure by you, the patient.

As you progress, you will be able to pursue a more active role in sexual intercourse. Remember, if there are any questions or concerns that you or your partner may have, feel free to ask your surgeon, nurse and/or physical therapist.

If you would like more information, ask your nurse for the “Sex After Total Joint Replacement” booklet.