Frequently Asked Questions
When can I drive after surgery?
+You can usually resume driving once you are off narcotic pain medications and can safely operate a vehicle. Your reaction time after surgery is slowed for at least 2 weeks. Typically, patients will return to driving around 4-6 weeks post-surgery, you should be confident in your ability to brake in emergency situations before you resume driving.
How do I manage pain after surgery?
+Pain management after surgery is being approached differently than it has been in the past. Your body will interpret surgery as a new trauma and will respond with swelling and inflammation. In fact, swelling and pain will worsen for about the first 7 days and then will typically decrease as you continue to recover. To manage this, we initially focus on reducing swelling and restoring basic function, this is very important for knee replacements. We will use a wide range of medications, ice packs or cold therapy machines, elevation of the leg, and exercises. Our goal, especially in the first 2 weeks, is to reduce inflammation and improve range of motion and walking. It is possible to overwork your healing muscles and tendons and cause more inflammation and bleeding and therefore Dr. Montgomery requests that you focus more on making small consistent improvements throughout your recovery rather than hope for big improvements to be made in physical therapy sessions. In addition, Dr. Montgomery encourages you to minimize use of addictive pain medicines (opioids / narcotics) as much as possible and strongly advises that you DO NOT take before therapy sessions. If you require narcotics to get through therapy the joint is being pushed too hard and you need to find alternative exercises, having short term pain afterwards that can be treated effectively with pain medicine is acceptable and normal.
For pain that is not controlled (8/10 or greater):
Step 1: Ensure you have taken your acetaminophen (Tylenol) and anti-inflammatory medicines, do not skip these believing that they are “not strong enough”. Our goal is to utilize all available pain control pathways and we should ensure we use the safest ones first.
Step 2: Ensure the operative leg is elevated with your ankle higher than your knee and your knee higher than your heart. We want the fluid from the swelling in your leg to drain to your heart where it can be pumped throughout the body and eliminated. Use cold therapy machines and ice packs as instructed. Avoid activities that make your joint feel worse.
Step 3: If you still have pain, take another 100mg celecoxib (celebrex) tablet, wait 30 minutes.
Step 4: If you still have pain, take 1 oxycodone 5mg tablet wait 1 hour
Step 5: If you still have pain, you may take a second Oxycodone but you will need to wait for 5 hours before taking any further doses.
For a comprehensive guide to total joint replacement, including information on preparation and daily recovery expectations, please see Dr Andrew Wickline’s total hip or knee replacement guides found here:
Hip Booklet:
Dr. Andrew Wickline’s Total Hip Replacement Guide
Knee Booklet:
Dr. Andrew Wickline’s Total Knee Replacement Guide
↓
For 10% off – Use discount code: SPENCER10
Can I resume normal activities after surgery?
+Most patients return to normal activities, with some patients returning to high activity levels and competitive sport. Please bear in mind that high-impact activities like running or jumping may lead to decreased lifespan of the implant. Dr. Montgomery does not apply any formal activity restrictions and you can discuss specific activities with him if you have further questions.
The American Association of Hip and Knee Surgeons website is an excellent resource for additional information and can be found here:
Returning to sports after total hip replacement:
https://hipkneeinfo.org/hip-care/resuming-sports-after-hip-replacement/
Returning to sexual activity after total joint replacement:
Will my joint replacement set off metal detectors?
+Joint replacements will commonly set off metal detectors, but not always. Due to the high number of patients with hip and knee replacements, patients are no longer required to provide documentation of their hip or knee replacement. If the required, inform the security agent of your hip or knee replacement, they may have to perform additional or manual screening as well.
How can I prepare for hip or knee replacement surgery?
+Preparing for surgery includes stopping certain medications, arranging for help at home, and optimizing your health through diet and exercise. Please review the patient education section of this website for more information and be sure to check out these other helpful resources:
Dr. Adam Rosen’s Youtube Channel is full of great information and videos:
Dr. Adam Rosen – Knee Pain & Arthritis Information
The American Association of Hip and Knee Surgeons has a website dedicated to patient education and information:
AAHKS Patient Information Webpage
For a comprehensive guide to total joint replacement, including information on preparation and daily recovery expectations, please see Dr Andrew Wickline’s total hip or knee replacement guides found here:
Hip Booklet:
Dr. Andrew Wickline’s Total Hip Replacement Guide
Knee Booklet:
Dr. Andrew Wickline’s Total Knee Replacement Guide
↓
For 10% off – Use discount code: SPENCER10
Will I be able to walk right after surgery?
+Yes, most patients are encouraged to start walking with assistance on the day of or the day after surgery to promote healing and restore mobility. In some rare instances this may not be the case.
What are the risks of joint replacement surgery?
+The major risks with joint replacement surgery include: infection, pain, stiffness, instability, blood vessel & nerve damage, fracture of the bones around the implants, loosening of the implants, blood clots, or complications related to anesthesia. Dr. Montgomery will discuss these risks and how to minimize them.
The specific risks of each procedure are presented at the bottom of each page in the surgical services section.
How long do hip and knee replacements last?
+Modern implants are designed to last 15-20 years or longer, depending on factors like activity level, weight, and overall health. Age plays a greater role here, the younger you are at the time of surgery, the higher the chances that you will need a revision surgery in your lifetime. Data suggests about 3 out of 4 patients that receive a hip replacement at age 50 will not require any future surgery on the hip in their lifetime. At around age 70 that number increases to 9 out of 10 patients.
Lifetime Revision Risk of Partial Knee Replacements
Are there alternatives to joint replacement?
+Yes, and these should be attempted before resorting to surgery. Alternative treatments include physical therapy, medications, injections, nerve blocks and lifestyle modifications including weight loss when appropriate. These options may provide relief, and many times can postpone surgery for a significant amount of time but joint replacement may be necessary for long-term pain relief and mobility restoration.
What is fellowship training and why does it matter?
+Fellowship training is typically an additional year of advanced, specialized education and hands-on experience that a doctor undergoes after completing residency. In the case of hip and knee replacement, it allows surgeons to refine their skills, learn the latest techniques, and focus on complex joint surgeries. While there are certainly many examples of excellent hip and knee surgeons that did not complete fellowship training, there is data that shows fellowship training is associated with better outcomes and a smoother recovery. This is likely due to fellowship trained surgeons having high levels of personal interest in the area, which can certainly be present in non-fellowship trained surgeons as well! Your best bet is to find a surgeon that demonstrates special interest in hip and knee replacements and stays up to date on advancements in the field.
https://pubmed.ncbi.nlm.nih.gov/32540307/
- 1
- 2