Dr. Caillouette Orthopedics

The duration of recovery and rehabilitation vary widely from patient to patient depending on a variety of factors such as:

  Your total joint status

  The type of procedure performed

  Age

  Weight

  Physical/medical condition

Depending on these factors, some patients are walking with a walker as soon as several hours after surgery. Others may require a day of bed rest before they are ready to stand. Every patient will go through the same stages of rehabilitation, but may progress at different paces.

Pain Management:
Many patients are concerned with the amount of pain they may experience after total joint replacement surgery, and how they will manage that pain. Remember that total joint replacement surgery is designed to reduce your pain. You will, however, experience some discomfort following surgery as your wound heals and you adjust to your new joint replacement. A strategy will be developed unique to your situation to manage your pain through your recovery and rehabilitation.


			Below you will find recommended daily activity guidelines for your first few days following surgery. Most hospital stays range from 4-5 days. The following is a general recommendation of daily activities for your hospital stay after surgery: Patient Activities - Day 1: 1. Tests & Assessments: While in the recovery room following your surgery, an X-ray of your affected joint will be taken. The nurse will closely monitor your vital signs, listen to your heart, lungs and stomach. Post-surgical pain will be controlled with medication. Surgical dressings will be checked frequently. 2. Medical Assessments: An IV will be placed in your arm before surgery. This will remain in place following your procedure to ensure that you are adequately hydrated. Your IV will remain in place until you are able to tolerate liquids and IV pain medication is no longer required. You may have a catheter in place to drain urine from your bladder. Throughout your hospital stay, you will wear white, elastic stockings to prevent blood clots from forming in your legs. These stockings will be removed twice a day for 30 minutes at a time. You will be asked to use an incentive spirometer to help expand the lungs and prevent respiratory problems. 3. Medications: Pain medications and antibiotics will be administered after surgery through an IV. Please keep the nurse informed of your pain management needs. Also let the nurse know if your need medication to address nausea or itching. 4. Activity If you are able, a physical therapist will assist you to sit up at the edge of the bed and progress to standing with the aid of a walker. Your physical therapist will review all of your post-surgical exercises with you. Your nurse will have you perform ankle pumps to help with circulation and turning onto your non-operative side. Patient Activities - Day 2: 1. Tests & Assessments: A blood sample will be taken to monitor your blood count. A blood transfusion may be required if your blood count is low. Your vital signs will be checked approximately every 4 hours when you are awake. 2. Medical Assessments: If you are tolerating food and liquids, your IV fluids may be discontinued. An IV tube will remain in place to administer your IV medications. If you received oxygen overnight, it will be discontinued on this day. Dr. Caillouette may choose to remove your surgical drain, after which your dressing may be changed or reinforced. You will continue use of the incentive spirometer 10 times per hour. 3. Medications: Your pain medications and antibiotics will be reviewed by Dr. Caillouette and the nursing staff. Depending on your pain level, pain pills may be started. If so, you should request pain pills every 3-4 hours to keep your main manageable. The pain medications you will be using at home will be reviewed with you and you may begin the home medications if needed. 4. Activity: You will get out of bed with the help of your physical therapist, sit in a chair, walk with the aid of a walker, and perform a variety of exercises. 5. Nutrition and Diet: A dietician is available to assist with any diet modifications to help meet your nutritional needs. 6. Education and Preparing To Go Home: Your case manager will discuss your plans for returning home. This will be a good time to address any outstanding questions you may have. You are encouraged to invite your caregiver to attend scheduled classes at Hoag Hospital. These sessions will allow you and your caregiver to feel more comfortable with the activities and expectations upon returning home. Patient Activities - Day 3: 1. Tests & Assessments: Another blood sample may be taken today to monitor blood count or bleeding time if you have been ordered a post-surgical blood thinner. 2. Medical Assessments: If your IV fluid has not yet been discontinued, it will be done today. Your IV tube will be removed. Your urinary catheter will be removed when you are able to transfer out of bed. Once removed, you must drink plenty of fluids. Use of the inventive spirometer will continue 10 times per hour. 3. Medications: Pain medication may still be needed to keep your pain manageable. If you have not yet had a bowel movement since surgery, a laxative will be administered. 4. Activity: You activity level will progress and you will be assisted with getting dressed, walking down the hallway, and eating all meals while sitting upright in a chair. You will continue working with your physical therapist on your exercise program and will progress the ability to get in and out of bed and step up and down a curb. Depending on your progress, you may participate in group therapy sessions to learn skills in dressing, grooming, walking, and home activities. 5. Nutrition and Diet: You may not have much of an appetite after surgery, but today you should start to feel more like eating. Focus is high on protein snacks, which will be made easily available to you. 6. Education and Preparing To Go Home: A home health agency nurse will contact you to make arrangements for any home equipment and therapy requested by Dr. Caillouette. Patient Activities - Day 4: 1. Tests & Assessments: Another blood sample may be taken today to monitor blood count or bleeding time if you have been ordered a post-surgical blood thinner. 2. Medical Assessments: Use of the inventive spirometer will continue 10 times per hour. 3. Medications: You will continue to require pain medication to keep your pain level manageable. 4. Activity: To assist in resuming the activities of daily living, the following will be encouraged: Walking in the hallways and patio area with the staff and family members. Getting dressed in casual clothes for all activities. Increasing your overall activity level. 5. Nutrition and Diet: Your diet should return to normal over the next several days. You need to eat well to aid in the healing process. Patient Activities - Day 5: 1. Tests & Assessments: It is unlikely that another blood sample will be required today. 2. Medical Assessments: Use of the inventive spirometer will continue 10 times per hour. 3. Medications: Dr. Caillouette and the nursing staff will review the medications you will need after leaving the hospital. 4. Activity: You may be discharged today depending on your progress and medical status. The rehabilitation staff will review your home exercise program, activities for home, and all assistive and adaptive equipment. Your discharge plan will be reviewed by the nursing staff. 5. Nutrition and Diet: Your diet should return to normal over the next several days. You need to eat well to aid in the healing process. 6. Education and Preparing To Go Home: You will review specific home instructions with your nurse and caregiver. You are encouraged to ask any questions and address any outstanding concerns.

			Download our guidelines for pre and post-surgical exercises here Download our comprehensive brochure about Total Knee Replacement to refer to offline here. You will need Adobe Acrobat Reader to view items that you download from this site. If you do not already have this on your computer, you can download it from Adobe here.