Discharge Advice following Hip and Knee Replacement

  • Reference Number: HEY-1019/2018
  • Departments: Orthopaedics

Introduction

This leaflet aims to provide you with advice on how to look after yourself following your surgery. We want you to understand what to expect on the day of discharge from hospital, and when you are at home.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.   If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

What should I expect before I leave hospital?

Once the doctor or nurse says you can go home, the following arrangements will be made:

  • You will be seen by a physiotherapist who will advise you of do’s and don’ts during your recovery.
  • You may be seen by an occupational therapist if needed, who will help ensure your safety for going home; they may wish to speak to your family if you give permission for this.
  • Your wound will be checked by your nurse who will give you advice on caring for your wound (see below).
  • Your medications will be ordered from pharmacy if you require any, and explained to you when the nurse gives them to you.
  • You will be given an approximate discharge time to arrange for your transport to collect you. It is expected that you arrange your own transport; if you have any difficulties please let us know as soon as possible.
  • An outpatient appointment to see your consultant will be sent to you in the post.
  • Your GP will be sent an electronic copy of the medications that you have been discharged home with; otherwise you will be given a letter to take to your GP to let him/her know about your hospital stay.
  • You will be given your own copy of the GP letter.

How should I care for my wound when I get home?

The Aquacel dressing can stay on the wound for 14 days after your operation. Please don’t be alarmed if there is some slight leakage on the wound dressing, however, if the leakage becomes excessive, i.e. saturates the dressing, please get in touch (see contact details at the end of this leaflet).

Can I have a bath or shower?

The Aquacel dressing is waterproof, therefore you can have a shower.  Please use a walk in shower and avoid over the bath shower.

When will the dressing be removed?

The District Nurse or Practice Nurse will take off your dressing and remove any clips two weeks after the operation. On discharge, you will be provided with a clip remover and dressings to pass on to the District Nurse or Practice Nurse.

Is there anything I can do to help myself?

For effective pain control, you should take your pain relief medication regularly. If you need more, please contact your GP for another prescription.

  • If you have had a knee replacement, apply an ice pack to your operated knee regularly throughout the day as directed by your physiotherapist. This will help to reduce swelling and pain following your surgery. The Ice pack should always be chilled prior to application and not applied directly to the skin; a thin towel or paper towels can be used to wrap the ice pack and protect your skin.
  • You will be discharged home with blood thinning medication to reduce your risk of developing any blood clots until your mobility returns to normal (please note that this may not apply if you take Warfarin). You should follow the directions on the box and complete the full amount you are given to take home. Do not double up the dose if you forget to take your tablets. Once you have completed the full course no further medication is required.

My leg is swollen; is this normal?

It is normal for the operated leg to become swollen and this can persist for several weeks. If your swelling increases and causes pain which is not relieved by taking pain relief medication and rest, please ring any of the telephone numbers provided within this leaflet for advice or call your GP.

It will help to rest with your legs elevated on the bed for periods throughout the day between exercise and walking.

It is unlikely that you will have any of the following problems but it is important to look out for the following and contact your own GP if you have any concerns:

  • Increase in pain in the calf of your operated leg
  • Increased redness or swelling around the wound area
  • Increase in wound leakage/discharge
  • Bleeding from the wound

Developing other infections can affect your new hip or knee replacement. Please see your GP if you develop any infections such as: chest, bladder, bowel, dental etc. or if you have any cuts or lacerations.

How Long Should I Wear The TED Stockings For?

 You will be given an extra pair of TED (anti-embolism) stockings to take home with you. You should wear your stockings for 6 weeks. You are able to remove the stockings to wash your legs but this should not be for any longer than 30 minutes.

Please refer to anti-embolism stockings information booklet for how to use and care for your TED stockings.

What about exercise?

Please refer to your exercise booklet for more information.

Unless advised differently by the physiotherapist on the ward, you can move to just using one stick, on the opposite side to the operated leg, when you feel confident and able to do so.

To help strengthen your muscles and improve healing, you should continue at home the exercises you have been taught. Please increase your level of mobility a little bit every day.

You should exercise, mobilise and rest regularly, increasing the level gradually to help your muscles recover before you start another session.

What should I eat?

A good diet and effective hydration helps you to recover faster and also prevents constipation. Ensure you eat and drink well after your operation:

  • Increase your daily intake of fibre. High fibre foods include vegetables, fruit and cereals.
  • Drink plenty of water.
  • Take in an Iron rich diet.

You may be given laxatives to help prevent constipation if required. If you have loose stools please do not take any laxatives. If you do experience problems with constipation please contact your GP.

 When can I return to work?

This will depend on the type of work you do and the speed of your recovery. We normally suggest returning to work no earlier than 6 weeks following your surgery if you have a non-manual job. If you undertake a manual job you may need longer. We therefore advise you to discuss this with your surgeon during your follow up appointment.

Can I drive after the operation?

 You should only return to driving when you can be in complete control of your car and can comfortably manage an emergency stop. For most patients this would be around 6 weeks after surgery. You may want to discuss this with your doctor at your follow up appointment and contact your car insurance  provider to seek advice prior to driving.

When will I get a follow-up appointment?

A follow-up appointment is booked for approximately 6 weeks after the operation. At this appointment you will see your surgeon to check on your progress. After your initial follow-up, you will have a series of follow-up appointments planned by your surgeon to continue to check on how you are doing with your new joint.

Who should I contact if I think there is a problem?

You will receive a follow up phone call from a specialist nurse after your discharge, but please do not wait to be contacted if you have any concerns please contact  Ward 9 on (01482) 623009

Alternatively, you can contact the specialist nurse on: (01482) 623009 Ward 9 CHH  or  (01482) 675181 Orthopaedic outpatients (this may be an answer machine and queries will be picked up throughout the day)

If you have not heard anything within 14 days of going home, please contact the relevant hospital on the telephone number above.

What do I need to know about my outpatient appointment?

  • If you are diabetic you are advised to bring something to eat and drink with you. Please also ensure that you have with you any necessary medications to control your diabetes.
  • If you have asthma please bring your inhalers with you.
  • If you have angina please bring your GTN spray with you.

Please be aware that if you are using hospital transport, you may be waiting a little while either before and/or after your appointment.

We wish you a safe and speedy recovery.

  • Hull and East Yorkshire NHS Trust (Main Switchboard): (01482) 875875
  • Ward 9 Castle Hill Hospital: (01482) 623009

How do I return the equipment?

Please contact the relevant number below for the return of Therapy equipment. Your therapist will discuss this with you.

You can also return your Therapy equipment, such as the large gutter frames to the following address:

Ward 9, Castle Hill Hospital, Castle Road, Cottingham, HU16 5JQ

Please do not return:

  • Ice Packs
  • Any small aids given to you by your Therapist, for example: shoe horns, helping hands, sock aids, leg-lifters and long handled sponges.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact the  Orthopaedic Ward (01482) 673009

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and well-being and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.