Should I make any special preparations before my operation?

Should I be doing any special kind of exercises before my surgery?

I’m feeling quite nervous about having the operation. How do I know if I’m doing the right thing?

Are most people satisfied after joint replacement surgery?

Can I keep taking my arthritis medication and other drugs right up until the day of surgery?

How long will I have to be in the hospital after hip or knee replacement surgery?

Will I need a general anaesthetic?

Is recovery from joint replacement surgery painful?

How will my pain be controlled after surgery?

Will I need a blood transfusion during surgery?

What are the main risks of this kind of surgery?

Why do I have to take a blood-thinning drug after surgery?

Why are some joints cemented while others aren’t?

Can I stay in the hospital for therapy or will I have to go elsewhere?

How can I find out what rehabilitation services are available to me and my family in the Greater Toronto Area?

How long will I need to be off work?

Will I need special equipment in my home?

I have had a knee replacement. When can I start driving again?

I have had a hip replacement. When can I start driving again?

What sports and leisure activities are safe after knee or hip replacement?

How long will my new artificial joint last?

Are there any long-term risks after joint replacement surgery that I should know about?

I am having both my knees replaced at the same time? Will my experiences and recovery be different? If so, how?

I am having both my hips replaced at the same time? Will my experiences and recovery be different? If so, how?

Why would someone decide to have bilateral knee or hip replacement surgery?

Why is my doctor suggesting that I have bilateral joint replacement surgery? Are there any advantages to having both joints replaced during just one operation?

I had my first hip replacement about 10 years ago and made a good recovery. Now I'm having pain again, and my doctor says it's time for revision surgery. Why is this happening?

Is joint replacement surgery different the second time around? If so, how?

Will I feel any different after my revision surgery compared to how I felt after my first operation? Also, will my second joint replacement last longer than my first one did?

Should I make any special preparations before my operation?

You and your family should start thinking about what kind of help you will need once you get home and also about re-arranging your surroundings to make things easier and safer for you. Making these plans well before your surgery means you won’t have to worry about them so much later on.

This is also a good time to think about your overall health and fitness. Being as fit as possible before undergoing a joint replacement may help you recover more quickly. If your doctor has suggested you lose weight, try making some changes to your diet and be as active as possible. If you still smoke, this is a good time to quit – smoking interferes with healing and may slow down your recovery.

Should I be doing any special kind of exercises before my surgery?

The best way to strengthen your legs in preparation for surgery is to walk regularly. Don’t be afraid to walk while waiting to have your surgery – it won’t hurt your knee or hip joint. Follow the “two hour” pain rule: If your joint hurts for longer than two hours after your walk, you have done too much. Do what you can to manage the pain and walk a bit less the next day.

Besides walking, your surgeon may recommend that you do some regular pre-operative exercises. Some are aimed at strengthening your arms and shoulders, which will help you cope with crutches or a walker after surgery. Other exercises will help maintain the strength of your leg muscles. The exercises should take about 20 minutes to complete, and if possible, you should do them twice a day.

I’m feeling quite nervous about having the operation. How do I know if I’m doing the right thing?

Once you have been given a date for joint replacement surgery, it’s normal to feel a bit anxious. You may wonder what surgery and rehabilitation will be like and how long it will take you to get better. The idea of replacing part of your body – your knee or hip joint – may seem strange. You may also be worried about how you’ll do in the hospital, whether there will be any complications, and how you’ll manage to get around your home. Finally, you may wonder if the joint pain that bothered you before the surgery will finally go away or improve so you can get around and do more.

If you are having these thoughts, you certainly aren’t alone! The good news is that most people who have knee or hip replacement do well and are happy with the results. If you have special concerns about your own situation, it’s good to share them with others before your operation. This will help you feel less anxious as the surgery approaches. Speak to your family doctor or your surgeon.

Are most people satisfied after joint replacement surgery?

Studies show that most people are satisfied with the results of their surgery. They expect that the operation will ease or cure pain in their knee or hip and allow them “get back to normal.” In fact, this is the usual outcome. But your overall health and age play a part in how well you will feel after the operation. It’s a good idea to talk to your family doctor or your surgeon and make sure you have a realistic idea of your own recovery.

Can I keep taking my arthritis medication and other drugs right up until the day of surgery?

Some prescription and over-the-counter medications – mainly aspirin (ASA) and drugs known as NSAIDS (non-steroidal anti-inflammatory drugs) – are known to cause bleeding. You should stop taking them for seven to 14 days before your operation. Your surgeon will review all your medications and tell you which are safe to take and which should be stopped for awhile. Tell your doctor if you use any herbal preparations, since some of these products can also increase bleeding and should be stopped temporarily before and after your surgery.

How long will I have to be in the hospital after knee or hip replacement surgery?

Most people go home within a few days to a week after surgery. This is followed by several weeks of rehabilitation therapy. Full recovery after knee or hip replacement surgery usually takes at least six months.

Will I need a general anaesthetic?

The choice of anaesthesia during your surgery depends on many things, including your age and general health. If your surgeon suggests a general anaesthetic, you will be given medication that puts you into a deep sleep during the operation and blocks pain sensations. Some patients are able to have a spinal anaesthetic. This involves injecting a drug into your lower back to completely block pain sensations during the surgery. You will remain awake during the operation, although you may be given other medication to make you drowsy and relaxed.

Is recovery from joint replacement surgery painful?

You should expect some discomfort right after surgery which should gradually improve over the next few days and weeks. As your wound heals and you get used to living with your new joint, the joint pain you experienced before your operation should start to improve or disappear.

How will my pain be controlled after surgery?

Your Care Team will do everything possible to keep you comfortable. Depending on your hospital, you may have access to Patient-Controlled Analgesia (PCA) – a system that allows the patient to control the delivery of his or her own pain medication. Other pain relief options include spinal blocks, injections and pills containing pain-killing drugs.

It isn’t a good idea to “tough it out” after surgery and refuse treatments to ease your pain. Research shows that patients who ask for and receive pain medication actually do better during their rehabilitation. That’s because when you’re in pain, it may be harder for your therapist to get you moving

Will I need a blood transfusion during surgery?

Blood loss is common during joint replacement surgery. Even though your surgeon will do everything possible to control this during your operation, you may still need a blood transfusion. Some patients ask whether they can donate blood themselves before surgery (known as “autologous” blood donation) or whether a close family member or friend with the same blood type can donate blood.

Your surgeon will tell you whether these options are available or even advisable. He or she may suggest that you take a prescription drug called erythropoietin alfa before your operation. Taking this drug, which encourages your body to produce more red blood cells, may reduce your need for a blood transfusion during surgery.

What are the main risks of this kind of surgery?

The two main risks after joint replacement surgery are infection and blood clots. Infection is always possible after any kind of surgery. But having any artificial device – such as your new knee or hip joint – in your body, increases the chance that you will develop an infection around the joint. In hospital, you will be given antibiotic drugs to kill any harmful bacteria already in your system. This may be followed by a doctor’s prescription for antibiotic medication that you will take at home.

Another risk is that you will develop a blood clot some time after your operation. There are many kinds of blood clots, and some are more serious than others. Most blood clots that develop after knee or hip replacement surgery develop in veins in the leg. This usually affects the operated leg, but clots can also develop in the other leg. In rare cases, such a clot can travel to the lungs, a serious condition known as “pulmonary embolism.”

Why do I have to take a blood-thinning drug after surgery?

Your risk for developing a blood clot goes up and stays up for at least two months – possibly longer – after the operation. There’s no way to predict who is at highest risk for developing blood clots after surgery, so all patients having knee or hip replacement are treated with drugs called “anticoagulants.” These drugs make your blood thinner and less likely to clump together. You may be told to keep taking these pills for several weeks after surgery or longer, depending on your overall health.

Why are some joints cemented while others aren’t?

Artificial joints are usually attached to the leg bones in one of two ways. Your doctor will decide which method is best for you.

Some people have cemented joints. Here the new artificial joint is attached with a special material that acts like glue, bonding it to the person’s own bones. With uncemented joints. a special coating is used that allows your own bone to adhere – or stick to – the new artificial joint. Over time, your body produces new bone tissue that grows into tiny spaces in the coating, attaching the new joint even more firmly.

Can I stay in the hospital for therapy or will I have to go elsewhere?

Many people expect that after they leave the hospital, they will go to an in-patient rehabilitation hospital to recover. This happens in some cases. But thanks to recent advances in surgical techniques, most people can now go home after surgery, as long as they have the proper support. They continue their rehabilitation at home or else undergo regular out-patient.therapy at a rehabilitation centre.

How can I find out what rehabilitation services are available to me and my family in the Greater Toronto Area?

The GTA Rehab Network provides a valuable "Rehab Finder" service. Click here for more information.

How long will I need to be off work?

If you work outside the home, your surgeon can give you some idea of how much time you will need to be away from your job. This information should be shared with your employer. Most people undergoing knee or hip replacement should plan to take at least four weeks off. If your work involves heavy physical labour, it may not be a good idea for you to return to this particular job. Talk to your surgeon – he or she may be willing to discuss your situation with your employer.

Will I need special equipment in my home?

If you are having knee or hip replacement surgery you will need: a walker (with or without wheels, depending on your needs); two canes (many people start off using two canes for support, then graduate to using just one); a raised toilet seat; and a long-handled reacher. Hip surgery patients may also find a portable hip cushion useful.

Other equipment which may be helpful includes: a bathtub seat or shower chair; professionally installed grab bars beside the tub and toilet, a long-handled bath brush for washing feet and legs, and professionally installed blocks to raise your bed or chairs if they are too low.

I have had a knee replacement. When can I start driving again?

How soon you can start to drive depends on many factors: the type of surgery you had, whether your new joint is on your right or left side, and what kind of car you drive. Most people wait around six weeks before driving, although some can start driving a bit sooner than that.

I have had a hip replacement. When can I start driving again?

How soon you can start to drive depends on many factors: the type of surgery you had, whether your new joint is on your right or left side, and what kind of car you drive. Most patients should wait at least six weeks before driving, although some can start driving a bit sooner than that.

IMPORTANT: Before you can get behind the wheel of a car after hip replacement surgery, you must have permission from your surgeon

What sports and leisure activities are safe after knee or hip replacement?

Your surgeon will tell you what is considered safe. In general, avoid “high impact, high contact” activities like running, jogging and playing contact sports. These place heavy and frequent strain on your knee or hip joint and have carry a greater risk for injury. Instead, focus on enjoyable “low impact, low contact” activities like swimming, cycling, or walking.

How long will my new artificial joint last?

Over time, artificial joints wear down or may loosen and need to be replaced. Most joint replacements last between ten and 15 years, depending on many factors, including how much stress is placed on the new joint. For example, your artificial joint will last longer if you are not overweight, if you avoid hard physical work and if you avoid stressing the joint during sports or leisure activities

Age is also a factor: if you were 60 or older at the time of surgery, chances are that your new knee or hip will last the rest of your life. The younger you were when you had the surgery, the more likely it is that you will eventually need a second operation to replace your first artificial joint with a new one.

Are there any long-term risks after joint replacement surgery that I should know about?

Unless your doctor tells you otherwise, it’s important to follow recommendations for preventing blood clots, not only while you are in hospital, but possibly for weeks or months afterwards. Remember to write down your doctor’s instructions about preventing blood clots and refer to your notes when you go home.

You are also more vulnerable to infection for some time after your operation. Be sure to tell your dentist that you have had a joint replacement before you undergo any dental procedures after your surgery. This includes routine cleaning. Cleaning your teeth and gums could allow bacteria to enter your bloodstream and travel to your artificial joint. Your doctor or dentist may prescribe an antibiotic to be taken before dental work.

Before you have any other kind of surgery or a test that involves inserting instruments into your body, tell the specialist doctor about your joint replacement operation. It may be necessary for you to take antibiotics before such procedures are done.

I am having both my knees replaced at the same time? Will my experiences and recovery be different? If so, how?

Most of the information on this website applies to people who are having both knees replaced during a single operation (called “bilateral” surgery) and those who are having both knees replaced within a three-month period, but in two separate operations (called “staged” surgery). But there are some exceptions. You are at slightly greater risk for blood loss and for a post-operative blood clot. It will probably take you longer to recover, both in hospital and during rehabilitation, than if you were having just one joint replaced. You should also expect to spend some time in a rehabilitation hospital. Finally, you may require extra equipment, such as a set of crutches and two canes to help you during your recovery.

I am having both my hips replaced at the same time? Will my experiences and recovery be different? If so, how?

Most of the information on this website applies to people who are having both hips replaced during a single operation (called “bilateral” surgery) and those who are having both hips replaced within a three-month period, but in two separate operations (called “staged” surgery). But there are some exceptions. It will probably take you longer to recover, both in hospital and during rehabilitation, than if you were having just one joint replaced. You should also expect to spend some time in a rehabilitation hospital. Finally, you may require extra equipment, such as a set of crutches and two canes to help you during your recovery.

Why would someone decide to have bilateral knee or hip replacement surgery? Are there any advantages to having both joints replaced during just one operation?

This depends on many things – why you need surgery, how severe your symptoms are in each joint, how much help you have at home and your work situation, to name a few. This is something to discuss with your surgeon.

Why is my doctor suggesting that I have bilateral joint replacement surgery? Are there any advantages to having both joints replaced during just one operation?

This depends on many things - why you need surgery, how severe your symptoms are in each joint, how much help you have at home and your work situation, to name a few. This is something to discuss with your surgeon.

I had my first hip replacement about 10 years ago and made a good recovery. Now I'm having pain again, and my doctor says it's time for revision surgery. Why is this happening?

People who are aged 60 or older at the time of their first operation can expect that their artificial hip joints will last the rest of their lives (although there are a few exceptions to this rule). But if you were under age 60 at the time of your first surgery, chances are greater that you will eventually need revision surgery. That's because most artificial joints only last between ten and 15 years. Eventually, the hip joint wears down and becomes loosened, causing pain.

Is joint replacement surgery different the second time around? If so, how?

Most of the information on this website applies to people who are having revision surgery. But there are some exceptions. It may take you a few days longer to recover in hospital than it did after your first joint replacement operation. If you're having revision knee surgery, you are at slightly greater risk for blood loss. Both hip and knee revision surgery are associated with a slightly higher risk for a post-operative blood clot. Finally, Before you do any of the exercises after joint replacement surgery described and shown on this web site, be sure to check with your doctor or physiotherapist.

Will I feel any different after my revision surgery compared to how I felt after my first operation? Also, will my second joint replacement last longer than my first one did?

Patients report high levels of satisfaction after revision surgery. There's no evidence that people do any worse - or any better - after knee or hip revision surgery. Technology, implant design, and post-operative therapy have improved since your first surgery. So if you follow advice about precautions, keep your weight down, and do what you can to protect your new knee or hip joint, it should last as long as - and possibly longer than - your first artificial joint. But how long your second new joint will last also depends on why the revision was needed in the first place.