FAQs

Find all the answers to the most frequently asked questions (FAQs) regarding joint issues.

1. Total Knee Replacement

Q1. What is the recovery time for total knee replacement surgery?

Everyone heals from total knee replacement surgery at a different pace. In most cases, however, you will likely use a walker or crutches for 2 to 4 weeks after your operation. You will then advance to a stick and wean to no assistive device at all. You will gradually return to normal function without any assistive devices. In general, most patients are close to full recovery after 3 months.

Q2. When do my stitches or staples come out after total knee replacement surgery?

Your surgeon may close your wound in a variety of ways. If you have staples, they should be removed 2 weeks post-operatively. This will be done nurse,in OPD deptt.of hospital If you have stitches, they are absorbable and do not need to be removed. The steri-strips that have been applied can be kept in place until they fall off on their own. They will help keep the skin edges together. If they have not fallen off by 2 weeks, it is OK to peel them off.

Q3. How long do I need a bandage after total knee replacement surgery?

You need a bandage for approximately 2 week or until the wound is dry. If desired, you may continue to wear a bandage to protect the incision from irritation.

Q4. When can I immerse my knee in water (e.g., bath, swimming pool, ocean, hot tub) after total knee replacement surgery?

You may immerse your knee in water after 4 weeks or even longer if there is no drainage from the incision. The incision must be healed before it is immersed in water.

Q5. How long will I be on pain medication after total knee replacement surgery?

You will likely require some form of pain medication after your hospital stay. Initially, you will be on a strong oral pain medication (such as a narcotic). Most people are able to wean off of their strong pain medication after 1 month and are able to switch to an over-the-counter pain medication (such as Paracetamol or ibuprofen). If you are on blood thinner, avoid taking any NSAIDs (e.g., aspirin, ibuprofen, Advil, Motrin, Aleve, Naprosyn) without first consulting your doctor.

Q6. How long will I be in the hospital after total knee replacement surgery?

The length of time spent in the hospital varies from patient to patient. Average length of stay for a total knee replacement is 3 to 5 days. Stay is more it other medical or surgical issues are there.

Q7. Do I need physical therapy after total knee replacement surgery?

Yes! The physical therapist plays a very important role in your recovery. You will see a physical therapist soon after your operation and throughout your stay at the hospital. If you go home, you will likely have a therapist come to visit you (usually daily),Your therapist will help you walk, regain motion, build strength, and reach your post-operative goals. Your therapist will keep your surgeon informed of your progress.

Q8. What exercises should I do after total knee replacement surgery?

You will be instructed by your physical therapist on appropriate exercises and given a list to follow. In general, swimming and a stationary bicycle are good exercise options. Regular conditioning and exercise should be continued indefinitely, even after your recovery is complete.

Q9. What equipment do I need at home after total knee replacement surgery?

Your needs will be addressed by your Physio. Typical equipment will include a walker or crutches. No CPM or hospital bed is needed.Cold Pack and Toilet seat elevators may be required,asadviced by physiotherapist.

Q10. What are good positions for my knee? What positions should I avoid?

You should spend some time each day working on straightening your knee (extension) as well as bending your knee (flexion). A good way to work on extension is to place a towel roll underneath your ankle when you are lying down. A good way to work on flexion is to sit on a chair or stationary bicycle and bend your knee. Avoid using a pillow or towel roll behind the knee for any length of time.

Q11. Can I use weights after total knee replacement surgery?

Generally, you should not use weights for the first 2 months after total knee replacement surgery. However, as everyone’s strength varies, consult with your physical therapist before using weights. Use light weights to begin with (1 to 5 lbs.) and gradually progress. No squats, lunges, or leg presses. Avoid exercises that cause significant discomfort or pain.

Q12. How long will I be on a “blood thinner” after total knee replacement surgery?

Typically, you will be on a blood thinner up to 1 month. The exact type and duration will be determined by your physician based on your specific medical history and risk.

Q13. Should I take iron supplements after total knee replacement surgery?

Iron supplements help your body replenish its iron stores and blood count, which may be depleted post-operatively. You may take an over-the-counter iron supplement or a multivitamin with iron for this purpose. Please note that iron may contribute to constipation and also darken the stool.

Q14. I am constipated after total knee replacement surgery. What should I do?

It is very common to have constipation post-operatively. This may be due to a variety of factors, but it is especially common when taking narcotic pain medication. A simple over-the-counter stool softener (Isabgol) is the best prevention for this problem. In rare instances, you may require a suppository or enema.

Q15. When can I drive after total knee replacement surgery?

If you had surgery on your knee, you should not drive for at least 1 month. After 1 month, you may return to driving as you feel comfortable.TAKING NARCOTICS. Most important, do not take chances, and only resume driving if you are confident in yourself. It is recommended that you test your driving ability prior to driving in traffic.

Q16. When can I return to work after total knee replacement surgery?

When you can return to work after total knee replacement surgery depends on your profession. If your work is sedentary, you may return as early as 3 to 4 weeks post-operatively. If your work is more rigorous, you may require up to 3 months before you can return to full duty. In some cases, more time may be necessary.

Q17. When can I travel after total knee replacement surgery?

You may travel as soon as you feel comfortable. It is recommended that you get up to stretch or walk at least once an hour when taking long trips. This is important to help prevent blood clots. Long flights or car rides may increase the risk of a blood clot. Use of a blood thinner such as aspirin may be indicated.

Q18. Will I set off the machines at airport security after total knee replacement surgery? Do I need a doctor’s note about my surgery?

You may set off the machines at airport security, depending on the type of implant you have and the sensitivity of the security checkpoint equipment. A wallet card or letter is helpful to travel.

Q19. What activities are permitted following total knee replacement surgery?

You may return to most activities as tolerated, including walking, gardening, and golf. Some of the best activities to help with motion and strengthening are swimming and a stationary bicycle.

Q20. What activities should I avoid after total knee replacement surgery?

You should avoid impact activities, such as running and vigorous racquet sports, such as singles tennis or squash.

Q21. Should I wear compression stockings (TEDS) after total knee replacement surgery?

Compression stockings are not required post-operatively routinely.

Q22. Should I use ice or heat after total knee replacement surgery?

Ice can be used for the first several days, particularly if you have a lot of swelling or discomfort. Once the initial swelling has decreased.

Q23. Can I kneel after total knee replacement surgery?

After 2 months, you may try to kneel. Although this may be uncomfortable initially, you will not injure your knee replacement by kneeling. Most people find the more you kneel, the easier it gets.

Q24. Can I go up and down stairs after total knee replacement surgery?

Yes. Initially, you will lead with your non-operated leg when going up stairs and lead with your operated leg when going down stairs. You can use the phrase, “Up with the good, down with bad” to help you remember. As your leg gets stronger (after about 1 month), you will be able to perform on stairs in a more regular pattern.

Q25. How much range of motion (ROM) do I need after total knee replacement surgery?

Most people require 70° of flexion (bending the knee) to walk on level ground, 90° to ascend stairs, 100° to descend stairs, and 105° to get out of a low chair. Your knee should also come to within 10° of being fully straight to function well.

Q26. What should I expect for my range of motion (ROM) after total knee replacement surgery?

Everyone’s range of motion (ROM) varies and depends on individual factors. Your potential will be determined at the time of your surgery. In most cases, you will have at least 90° of flexion by 4 to 6 weeks. Typically, ROM continues to improve with continued physical therapy. If your ROM is poor (less than 70° of flexion as you approach 4 weeks post-op), please call to notify your surgeon.

Q27. I think my leg feels longer after total knee replacement surgery. Is this possible?

In the large majority of cases, leg length is essentially unchanged after total knee replacement surgery. In rare cases, however, you may notice a change in leg length. This is more common when a severe deformity of the knee exists before surgery. At first, this may feel awkward. However, you will gradually become accustomed to your new knee and leg length.

Q28. Do I need antibiotics before dental work or an invasive procedure after total knee replacement surgery?

Yes. Please refer to the antibiotic prophylaxis recommendation sheet given to you. Avoid any dental cleaning or non-urgent procedures for 6 weeks post-operatively.

Q29. Do I need antibiotics when I get ill after total knee replacement surgery?

Typically, you do not need antibiotics for illnesses such as a cold or flu. These are caused by viruses. However, if you have a bacterial infection (such as strep throat), you should be placed on an antibiotic by your primary physician. This helps prevent infection from traveling to your joint replacement.

Q30. How long will my total knee replacement last?

This varies from patient to patient. Over 90% of knee replacements will be functioning well at 10 to 15 years post-op. With continued improvements in knee replacement technology, your new knee may last well beyond this.

Q31. When do I need to follow-up with my surgeon?

A follow-up appointment should be made post-operatively every 2 weeks, then at your surgeon’s discretion. Routine follow-up of your joint replacement will be scheduled over the lifetime of your replacement.

2. Total Hip Replacement

Q1. What is the recovery time for a total hip replacement?

Everyone heals from total hip replacement surgery at a different pace. In most cases, however, you will be restricted to using a walker or crutches for 1½ month after your operation. You will then be allowed to advance to a stick outdoors and no support around the house for several weeks. You will gradually return to normal function without any assistive devices. This usually takes about 3 months but may take longer

Q2. What is a dislocation of the hip?

A dislocation of the hip occurs when the femoral head (ball) comes out of the acetabulum (socket). While this risk is very small, typically less than 2%, you are given dislocation precautions to help avoid this happening.

Q3. What are the dislocation precautions for my hip (positions I should avoid)?

You should avoid flexing (bending) at the hip more than 90°. Avoid low chairs and furniture because they require too much bending at the hip in order to get up. If you must reach to the floor when seated, always reach between your legs, not to the outside. Use an elevated toilet seat to avoid excessive bending of the hip. If possible, use a chair that has arms. The arms provide leverage for you to push up to a standing position. When sitting, position your legs so that you can see your inner thigh, calf, and foot (not the outside).

Q4. How long do I need to follow my dislocation precautions after total hip replacement surgery?

Follow your precautions very carefully for the first 6 weeks. You should avoid extreme positions of hip flexion (bending) forever.

Q5. When can I discontinue using a raised toilet seat after total hip replacement surgery?

You may discontinue using a raised toilet seat between 6 and 10 weeks after your total hip replacement operation.

Q6. Can I sleep on my side after total hip replacement?

You may sleep on your operative side whenever you feel comfortable. You may sleep on your non-operative side at 4 weeks with a thick (8-10 inch) pillow between your knees.

Q7. How long do I need a bandage after total hip replacement surgery?

You need a bandage for approximately 2 week after total hip replacement surgery. If desired, you may continue to wear a bandage to protect the incision from irritation.

Q8. When can I shower (get incision wet) after total hip replacement surgery?

You may shower 5-7 days after your operation,but keep the dressing dry.

Q9. When can I immerse my hip in water (e.g., bath, swimming pool, ocean, hot tub) after total hip replacement surgery?

You can immerse your hip in water after 2-4 weeks, if there is no drainage from the incision.

Q10. How long will I be on pain medication after total hip replacement surgery?

You will likely require some form of pain medication for about 3 months after total hip replacement surgery. Initially, you will be on a strong oral pain medication (such as a narcotic). Most people are able to wean off of their strong pain medication after 1 month and are able to switch to an over-the-counter pain medication (such as ibuprofen). If you are on Coumadin (warfarin), avoid taking any NSAIDs (e.g., aspirin, ibuprofen, Advil, Motrin, Aleve, Naprosyn) without first consulting your internist.

Q11. Will I go to rehabilitation or home after total hip replacement surgery?

It depends. Many people are able to go home after their total hip replacement operation. Many factors will be considered in this decision. Will need family or friends to assist with daily activities, post-operative functional status as evaluated by a physical therapist in the hospital, and at home.

Q12. Do I need physical therapy after total hip replacement surgery?

Yes! The physical therapist plays a very important role in your recovery after total hip replacement surgery. You will see a physical therapist soon after your operation and throughout your stay at the hospital. If you go home, you will likely have a therapist come to visit you (daily). Your therapist will help you walk, regain motion, build strength, and reach your post-operative goals. Your therapist will keep your surgeon informed of your progress.

Q13. What exercises should I do after total hip replacement surgery?

You will be instructed by your physical therapist on appropriate exercises and given a list to follow. In general, swimming and a stationary bicycle are good exercise options. These exercises should be continued indefinitely even after your recovery is complete. Do not begin using a stationary bicycle until 4 weeks after surgery.

Q14. I think my leg lengths are different after total hip replacement surgery. What should I do?

It is not uncommon to feel as though your leg lengths are different after total hip replacement surgery. At surgery, leg lengths are assessed very carefully and an attempt is made to make them as equal as possible. Sometimes, the new hip has to be lengthened in order to obtain proper muscle tension (to help avoid hip dislocation). Wait 3 months before making any final judgments about your leg lengths. Your muscles and body take time to adjust to a new hip. In rare cases, a shoe lift may be prescribed for a true difference in leg lengths. In most cases, however, no treatment is necessary.

Q15. Can I use weights after total hip replacement surgery?

Generally, you should not use weights for the first 2 months after total hip replacement surgery. However, as everyone’s strength varies, consult with your physical therapist before using weights. Use light weights to begin with and gradually progress from 1 lb. to a maximum of 5 lbs.

Q16. How long will I be on a “blood thinner” after total hip replacement surgery?

Typically, you will be on “blood thinner” This medication is used to help prevent blood clots. you will stay blood thinner for 4 to 6 weeks.

Q17. How long should I take iron supplements after total hip replacement surgery?

Taking iron supplements for 4 weeks after total hip replacement surgery is usually sufficient. These supplements help your body replenish its iron stores, which may be depleted post-operatively.

Q18. I am constipated after total hip replacement surgery. What should I do?

It is very common to have constipation post-operatively. This may be due to a variety of factors but is especially common when taking narcotic pain medication. A simple over-the-counter stool softener (Isabgole) is the best prevention for this problem. In rare instances, you may require a suppository or enema.

Q19. When can I drive after total hip replacement surgery?

If you had surgery on your right hip, you should not drive for at least 2 month after total hip replacement surgery. After 2 month, you may return to driving as you feel comfortable. If you had surgery on your left hip, you may return to driving as you feel comfortable as long as you have an automatic transmission. Be careful getting into and out of a car, and avoid crossing your operated leg over the other. DO NOT DRIVE IF TAKING NARCOTICS.

Q20. When can I return to work after total hip replacement surgery?

When you can return to work after total hip replacement surgery depends on your profession. Typically, if your work is primarily sedentary, you may return after approximately 2 month. If your work is more rigorous, you may require up to 3 months before you can return to full duty. In some cases, more time may be necessary.

Q21. When can I travel after total hip replacement surgery?

You may travel as soon as you feel comfortable after total hip replacement surgery. It is recommended that you get up to stretch or walk at least once an hour when taking long trips. This is important to help prevent blood clots.

Q22. Will I set off the machines at airport security after total hip replacement surgery? Do I need a doctor’s note about my surgery?

You may set off the machines at airport security depending on the type of hip implant you have and the sensitivity of the security checkpoint equipment. At your follow-up visit you may ask to have a wallet card to carry with you for travel.

Q23. What activities are permitted following total hip replacement surgery?

You may return to most activities as tolerated after total hip replacement surgery, including walking, gardening, and golf. Some of the best activities to help with motion and strengthening are swimming and a stationary bicycle.

Q24. What activities should I avoid after total hip replacement surgery?

You should avoid impact activities, such as running and downhill skiing on expert slopes, and vigorous racquet sports, such as singles tennis or squash. In addition, you should avoid any activity that may put your new hip at risk for dislocation.

Q25. How long should I use compression stockings (TEDS) after total hip replacement surgery?

Compression stockings should be used for the first few weeks in order to help reduce swelling and improve circulation. You may wear them longer, especially if you find that your ankles swell without them.

Q26. Should I use ice or heat after total hip replacement surgery?

Ice should be used for the first several days after total hip replacement surgery, particularly if you have a lot of swelling or discomfort. Once the initial swelling has decreased, you may use ice and/or heat.

Q27. Can I go up and down stairs after total hip replacement surgery?

Yes. Initially, you will lead with your non-operated leg when going up stairs and lead with your operated leg when going down stairs. You can use the phrase, “Up with the good, down with bad” to help you remember. As your leg gets stronger, you will be able to perform on stairs in a more regular pattern (about 1 month).

Q28. Can I kneel after total hip replacement surgery?

Yes, you can kneel 6 weeks after total hip replacement surgery. To kneel, touch down with your operative knee first. To arise from kneeling, use your non-operative leg first.

Q29. What should I expect for my range of motion (ROM) at 6 weeks? At 1 year?

Everyone’s range of motion (ROM) varies and depends on individual factors. Your potential will be determined at the time of your surgery. In most cases, you will have enough motion to put on socks and tie your shoes. Clipping toenails may be difficult.

Q30. Do I need antibiotics before dental work or an invasive procedure after total hip replacement surgery?

Yes. You will be given a letter explaining this in detail at your first follow-up visit. Avoid any dental cleaning or non-urgent procedures for 6 weeks post-operatively.

Q31. I feel depressed after total hip replacement surgery. Is this normal?

It is not uncommon to have feelings of depression after your hip replacement. This may be due to a variety of factors such as limited mobility, discomfort, increased dependency on others, and/or medication side effects. Feelings of depression will typically fade as you begin to return to your regular activities. If your feelings of depression persist, consult your internist.

Q32. I have insomnia after total hip replacement surgery. Is this normal? What can I do about it?

Insomnia is a common complaint following hip replacement surgery. Non-prescription remedies such as Benadryl or melatonin may be effective. If insomnia continues to be a problem, medication may be prescribed for you.

Q33. How long will my total hip replacement last?

This varies from patient to patient. For each year following your hip replacement, you have a 1% chance of requiring additional surgery. For example, at 10 years post-operatively, there is a 90% success rate.

Q34. When do I need to follow-up with my surgeon after total hip replacement surgery?

Follow-up appointments should be made post-operatively at 4-6 weeks, 1 year, 2 years, 5 years, 7 years, and 10 years.

3. Arthroscopic Surgeries

Q1. What is arthroscopic surgery?

Arthroscopic surgery,also known as arthroscopy,is a minimally invasive surgical technique used to diagnose the cause of joint pain and repair joint damage with precision.Arthroscopic techniques are used to treat a variety of joint conditions,including sport-related injuries such as ligament or cartilage tears. During arthroscopic surgery Dr.S.K.Srivastava uses a fiber optic camera.Known as an arthroscope,to see within the interior of the affected joint.The camera sends real-time detailed images of the joint interior to a computer moniter in the operating room,providing Dr.S.K.Srivastava with a greater visualization of the joint interior.He will then insert specialized ,pencil-sized surgical instruments in to small incisions around the affected joint to repair the damaged areas.

Q2. What are the benefits of arthroscopy?

Arthroscopic surgery has several potential advantages for the patients,therefore Dr.S.K.Srivastava is dedicated to using this approach to surgery whenever possible.The smaller incisions,use of specialized instruments,and better visualization of the joint`s interior allows Dr.S.K.Srivastava to perform procedures with decreased disruption to the surrounding tissue and muscle. In addition patients who undergo arthroscopic surgery will often experience decreased scaring,a reduced amount of post-operative pain,less blood loss during surgery,shorter hospital stay,and quicker return to daily activities.

Q3. When is arthroscopic knee surgery recommended?

Knee arthroscopy is used to treat a variety of conditions and injuries,including:
Meniscal tears
Acl(anterior cruciate ligament)tears
PCL(posterior cruciate ligament)tears
Cartilage damage
Patellar(kneecap)balance or tracking problems
Some instances of arthritis

Q4. Who will benefit most from shoulder arthroscopy?

Patients suffering from painful rotator cuff tears,labral tears,recurrent shoulder dislocations,and severe frozen shoulder will often benefit most from arthroscopic shoulder surgery. For patients suffering from rotator cuff tears,Dr.S.K.Srivastava will often recommend shoulder arthroscopy to either debride or reattach the torn tendons. In order to relieve pain or restore joint stability,labral tears may require minimally invasive surgery to debride or repair the torn tissue. Frozen shoulder patients who are unable to restore joint function through physical therapy and anti-inflammatory medications ,will often benefit greatly from arthroscopic shoulder surgery to loosen the tight tendons.

Q5. When is arthroscopic hip surgery recommended?

Hip arthroscopy is often recommended for patients suffering from labral tearing or bone impingement labral tearing of the hip often caused by trauma, dislocation or constant repetitive motion of the hip joint for painful labral tears, Dr.S.K.Srivastava may recommended hip arthroscopy to debride or repair the tissue.For bone impingement removing the bony process (bump) from the hip joint may be indicated.

Q6. When is ankle arthroscopy recommended?

Arthroscopy surgery is used to treat cartilage damage within the ankle or removing bony prominences around the joint that cause pain.