A Caregiver Resource for the Joint Replacement Patient at Home
Being a caregiver can be important for those post-op patients recovering from joint replacement surgery. This information will help with some of the many questions and concerns about caring for a joint replacement patient.
Home Safety and Avoiding Falls
- Pick up throw rugs, tack down loose carpeting to avoid falls.
- Widen furniture paths to accommodate a walker or cane
- Place regularly used items such as remote controls, medications, cooking supplies and utensils, in easy-to-reach locations
- Be aware of all floor hazards such as pets, small objects, uneven surfaces, or extension/telephone cords
- Install nightlights in the bathrooms, bedrooms, and hallways to provide good lighting throughout the house
- Until recommended by a surgeon the patient shouldn’t engage in heavy lifting
- Un-tuck bedding to allow for easier access into and out of the patient's bed.
Patients will typically go through body changes, be aware that most are normal. Follow a surgeon’s recommendations if needed.
- A patient's appetite may be poor, have them drink plenty of fluids until their desire for solid food returns
- They may have difficulty sleeping, don’t let them sleep or nap too much during the day
- Their energy level will decrease for the first month.
- Be aware that pain medication that contains narcotics promotes constipation.
- Blood thinners may be prescribed to help avoid blood clots after surgery
The patient may be asked to wear special stockings that help compress the veins in their legs.
- Always follow the treating surgeon’s instructions when using stockings after surgery.
Biomet does not practice medicine and postoperative instructions may vary. The treating surgeon’s instructions should be followed in lieu of this general information.
- Keep the incision dry and covered with a light dressing.
- Patient should request showering/bathing instructions from surgeon.
- Notify the surgeon if there is increased drainage, redness, pain, odor, or heat around the incision, or if the patient’s temperature exceeds 100.5º F.
Changing the Dressing (ONLY IF DIRECTED BY SURGEON)
Wash hands to open all dressing change materials (ABD pads, 4x4 if needed, Betadine® swab if indicated) and remove stocking and old dressing.
- Inspect incision for the following:
- Increased redness
- Increase in clear drainage
- Yellow/green drainage
- Surrounding skin is hot to touch
- If Betadine® is ordered, take one Betadine® swab and paint the incision from top to bottom. Then turn the swab over and paint the incision from bottom to top. Use remaining swab to paint the drain site.
- Pick up ABD pad by one corner and lay over incision. Be careful not to touch the inside of the dressing that will lie over the incision.
- Place one ABD pad lengthwise and place the other ABD crosswise to form a "T" (to cover drain site) and tape dressing in place.
- increased redness
- increase in clear drainage
- yellow/green drainage
- surrounding skin is hot to touch
- Pain medicine at least 30 minutes before physical therapy.
- Gradually wean the patient from prescription medication.
- Change position every 45 minutes throughout the day.
- Use ice for pain control, but do not use for more than 20 minutes at a time each hour. Use ice before and after the patient exercised according to their prescribed program.
- A bag of frozen peas wrapped in a kitchen towel makes an ideal ice pack.
Recognizing & Preventing Potential Complications
Infection may have the following signs:
- Increased swelling and redness at incision site
- Change in color, amount, odor of drainage
- Increased pain in hip
- Fever greater than 100.5º F
Blood Clots in Legs
Surgery may cause the blood to slow and coagulate in the veins of the patient's legs, creating a blood clot. If a clot occurs despite these measures, the patient may need to be admitted to the hospital to receive intravenous blood thinners. It is important to be prompt upon the following signs:
- Swelling in thigh, calf or ankle that does not go down with elevation
- Pain, heat and tenderness in calf, back of knee or groin area. NOTE: blood clots can form in either leg
In order to help prevent blood clots:
- Use foot and ankle pumps as well as compression stockings
- Have the patient walk, as recommended by a surgeon
- Use blood thinners such as Coumadin® or Heparin
An unrecognized blood clot could break away from the vein and travel to the lungs. This is an emergency and you should CALL 911 upon the following signs:
- Sudden chest pain
- Difficult and/or rapid breathing or shortness of breath
In order to prevent pulmonary embolus prevent blood clots in the legs and recognize if a blood clot is in the leg and call a physician promptly.
Dislocation - Hip Only
Signs of Dislocation
- Severe pain
- Rotation/shortening of leg
- Unable to walk/move leg