Recovering From Surgery

"Great things are done by a series of small things brought together."
- Vincent Van Gogh

Patients must remember a few things about their recovery after surgery.

1. Every patient recovers at a different pace. Comparing yourself to others may give you over-confidence or frustration.

2. Recovery happens in phases, and it takes many weeks to months for hip and knee replacement to begin feeling "normal".

3. Dr. Deans and his team are experienced in guiding post-op recovery. They will educate you and guide you along the way, including setting goals and expectations that push you in your functional recovery.

___________________________________________

Early after surgery, in particular from the day of surgery to 7-10 days post-operatively, the focus of your recovery is management of pain, swelling, and early range of motion. It is equally as damaging to be too active too fast, as it is to sit in a chair or lay in bed without any movement. This is the period of time when your body is going through high levels of inflammation from the surgery, you will have the greatest amount of pain, and your body has greater nutritional and fluid demands for healing. Specific details on your recovery can be seen in the Post-Operative Protocol button, below.

After the first 7-10 days, most patients begin having a decrease in pain, swelling, and are ready to start increasing activities. For knee replacement patients, this means getting more steps during the day, performing home-based exercises as in the post-op protocol, and working with physical therapy. For hip replacement patients, most do not work with formal physical therapy and the expectation is to begin getting more steps during the day and performing home exercises in your booklet.

Most hip replacement patients start to turn the corner significantly after 2-3 weeks, and are ready to increase their daily step count, start doing bike or elliptical, and increase their home or gym exercises. Symptoms of pain and swelling are your guide at this point of your recovery, and it is normal with greater levels of activity to have more pain and soreness, particularly at night.

Most knee replacement patients starting seeing significant improvements in function after 4-6 weeks. At that point, they are also ready to start advancing their therapies and exercises as based on protocol below.

After 6 weeks, every patient recovers differently. Some patients at 6 weeks will begin saying they "forget about their hip" or "forget about their knee". However for many, it takes closer to 3 months for hip replacements and 6-12 months for knee replacements before patients feel that the joint is now fully recovered and "normal."

As general guidance, post-operative phases and focuses are as follows:

First 7-10 days

Ice 10 minutes of every hour or every other waking hour of the day.
Increase daily caloric intake, particularly lean protein consumption.
Consider an anti-inflammatory diet, such as Mediterranean diet.
Consider compression socks or compression stockings for swelling.
Limit daily walking and high-impact exercise.
Give yourself grace, and prioritize rest and recovery over exercise.

Weeks 2 to 6

Continue icing as much as needed, particularly at the end of the day.
May begin normalizing caloric intake, however continue prioritizing intake of lean protein.
Consider an anti-inflammatory diet, such as Mediterranean diet.
Continue compression socks or compression stockings for swelling, if needed.
May begin increasing daily walking, home-based prescribed exercises.
Continue to give yourself grace -- it is not normal for your joint to feel "normal" at this point.

Weeks 6 to 12

This is the period of recovery where the greatest functional gains are experienced.
For knee replacements, continue increasing your exercises and activities as guided by your physical therapist and our protocol below.
For hip replacements, it is not time to begin weaning into your favorite activities -- golf, walking longer distances, swimming, weight training, etc.
Higher-impact activities that include cutting and pivoting, like pickle ball, will likely feel better closer to 12 weeks recovered.
May re-establish your normal daily diets and caloric intake. However, Dr. Deans' team recommendation is to prioritize your nutrition and portions for a healthy lifestyle.

Total hip replacement recovery:

75% recovered by 6 weeks

100% recovery by 3+ months

Total knee replacement recovery:

50% recovered by 6 weeks

75% recovered by 3 months

100% recovery by 6-18 months

Literature would support that both total hip replacements and total knee replacements continue to improve in function for out to 12 or even 18 months from surgery. That means, while you are working on your exercise and functional recovery, one of the most important factors in recovery is -- time. Passing time will allow your body to re-establish normalcy from it's years of osteoarthritis!