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Post-Operative Process

Will physiotherapy be required after surgery?

Major surgery on a joint usually will require physiotherapy afterwards in order to get full range of motion, strength and flexibility back in the joint following surgery. This process may take a few months. We have physiotherapy clinics within all our practice sites. However, if you prefer a particular physiotherapist Professor Al Muderis would be happy to refer you to the practice you chose.

Wound care

It is important to keep the skin clean and dry. You can have a daily shower as usual and wet the surgical site with warm water and soap. However, make sure you dry the area well with a clean towel using a patting technique – do not wipe the areas – it can increase the risk and spread of infection.

The dressing applied in the hospital is usually waterproof and it should last a few days. However, it may need to be changed if it gets dirty or becomes loose. A community nurse can help you with the change of dressing if you are not able to do it yourself. If the wound is required to stay dry, you will be advised to first bag the area before showering.

Swelling is normal for the first three to six months after surgery. Elevate your leg above the level of your hip when lying down and always put a stool under your heel when sitting on a chair.

Apply an ice pack for 15 to 20 minutes at a time, a few times a day for the first few weeks after surgery to help reduce swelling.

Sutures

In most cases, we use a cosmetic technique and sutures that do not require removal. However, there are certain conditions this technique is not advisable (such as contaminated trauma or surgery in certain parts of the body) so the sutures may need to be removed. This is usually done on your first postoperative visit to the clinic where a wound check and examination of the area will also be performed. Depending on your condition an X-ray may also be taken.

Bruising

Bruising is expected after surgery, and is usually purple in colour, to begin with, then changes to green, and then yellow before it disappears.

First post-operative visit

We will arrange for your first postoperative visit to occur between one to two weeks after your surgery. If you are still in the rehabilitation hospital at this stage, we will communicate with your rehabilitation physician regarding your well-being and visit you there if needed.

Food and Drink

By the time you leave the hospital, you will have returned to eating your normal diet. Continue to drink plenty of fluids and avoid excessive intake of vitamin K while you are taking the blood-thinner medication. It is also advised that you consult with your doctor regarding taking any other vitamins. Try to limit your intake of coffee and alcohol. It is also a good idea to keep an eye on your weight since your body’s metabolism and activity level are different during the recovery stage.

Activity

It is important to try and stay active and mobile when you get home but avoid overdoing your exercises. There will be good days where you feel well and bad days where there may be some pain; this is normal. You will gradually get better over time.

Walking

We recommend mobilisation with a small level of weight bearing by using walking aids such as crutches or a walker. The amount of weight bearing you will be allowed to do will vary depending on the type of your surgery.

Stairs

Depending on your surgery, stairs should be limited if possible until healing has progressed. When ready, the following information may be useful:

  • To climb the stairs: Use the unaffected leg to step up first, bring the affected leg up to the same step and bring your crutches or walking stick up with you.
  • To go down the stairs: Put your crutches or walking stick on the lower step, bring the affected leg down to that step and finally step down with the unaffected leg.

Sitting

Try to organise a comfortable chair with arms and a stool to put under your heels while sitting. The chair should be high enough, especially in the case of hip replacement surgery. It is important not sit on low chairs. If you have had hip or knee replacement surgery it is very important not to sit with your legs crossed at the knees.

When standing up from a chair always use the unaffected leg to push up and keep your affected leg out in front of you. Do not drive with this leg. While you may not always feel like it, it is important for your recovery to ensure you get up and move around on a regular basis, at least once every hour or two. You do not need to do much, a walk around the house or even the room is sufficient. While seated try to keep moving your toes and ankles up and down, this will help pump fluids up your leg and reduce the chance of deep venous thrombosis.

Sleeping

You should avoid sleeping on the side of the wound for the first six weeks after surgery. It is common to get sudden sharp onsets of pain while you are sleeping but the pain shouldn’t last long, typically disappearing after a few minutes.

Driving

You can return to driving an automatic car about six weeks post-surgery provided you are no longer taking narcotic pain medication. If you have a manual car, you may need to wait another few weeks until your leg is strong enough to push the clutch down.

Getting in and Out of Your Car

If you have a normal sedan car you may need to put a pillow on the seat and use the front seat of the car. This is generally not required with a higher car such as a four-wheel drive. We do not recommend getting into a sports car for at least a few months especially if you just had hip replacement surgery, as the angle is too low.

Returning to work

The return to work timeframe will vary depending on the type of surgery you had and the nature of your work. If you have had minor surgery or you work in an office, then you could most likely return to work two to three weeks later. However, if you have had major surgery, or your work requires heavy physical activities, then you may need a few months before returning to work.

Returning to sports

Depending on the type of surgery you had, a return to sport and other physical activities may be appropriate six weeks after surgery.

Joint replacement: Certain sports are not allowed post-surgery as they can result in longer recovery time. Before resuming your sporting activity you will need to discuss it with your doctor.

Swimming:You can begin swimming as soon as the wound has healed. This should occur approximately six weeks after surgery.

Sexual activity

You can resume sexual activity usually four to six weeks after surgery.

Post Operative Red Flags

If you are concerned about your level of pain, have significant bleeding, or have fever or redness around the surgical site please contact your local doctor as well as us immediately to discuss the matter. We always have appointments available in our clinic for urgent matters.

If something happens during a weekend or after hours then you need to contact the hospital emergency department or the hospital where the surgery was performed (numbers are listed on the bottom of the page) and the staff will contact us so we can attend to the matter accordingly. It is very important that if you are concerned that something isn’t right, you must not leave the matter until your next regular visit as these things need to be addressed right away.

The following are some “red flags” that should prompt you to seek medical attention urgently:

  • If you notice fluid discharge is leaking outside the dressing.
  • If the area surrounding the surgical site becomes inflamed (as in red and hot).
  • If you feel feverish or if you get shakes and shivers.
  • Calf pain, chest pain and shortness of breath are signs of a possible blood clot. Notify your doctor immediately if you notice any of these symptoms.
  • Dull chest pain or chest pain with breathing.
  • Significant bleeding.

If the pain in your limb becomes increasingly more severe than when you were in the hospital. Occasionally you may do a sudden movement or accidentally hit the limb with an object, which may lead to a sudden increase in pain, however, this should resolve on its own after a short while of rest. Sudden sharp pain attacks, especially while asleep are expected to happen. But if it continues or increases it may be cause for concern.

Contact Us

For further inquiries or to arrange a consultation, please contact Professor Al Muderis’ office at +61 2 88829011 or book an appointment online.