Joint Replacement Center Johnson City



The Joint Replacement Center at
Johnson City Medical Center
Shoulder Replacement - Post-Op Care

Plan of Care
Hip Fracture Program
 Mountain States Rehab
 Outpatient Therapy
 Hip & Knee Seminar
 Meet Our Team
  Wellness Connection
 Quality Measures
 Helpful Links
Handicap Parking Application Form
Hip Replacement
Knee Replacement
Shoulder Replacement 
Hospital Care
Post-op Care
Photo Gallery of After Surgery Activities
Post-Op Hip Care

Hospital Care

Caring For Yourself At Home

When you go home there are a variety of things you need to know for your safety, your speedy recovery and your comfort.

Control Your Discomfort

  • Take your pain medicine at least 30 minutes before physical therapy.
  • Gradually wean yourself from prescription medication to Tylenol. You may take two extra-strength Tylenol in place of your prescription medication up to four times per day.
  • Change your position every 45 minutes throughout the day.
  • Use ice for pain control. Applying ice to your affected joint will decrease discomfort, but do not use more than 20 minutes at a time each hour. You can use it before and after your exercise program. A bag of frozen peas wrapped in a kitchen towel makes an ideal ice pack. Mark the bag of peas and return it to the freezer (to be used as an ice pack later).
  • Many shoulder surgery patients feel more comfortable if they sleep and rest upright in a recliner, chair or propped up with pillows in a bed. This is normal. It is often hard to get comfortable lying flat in a bed after shoulder surgery. You are free to sleep in bed as soon as you feel comfortable with this. You should wear your sling to bed and obey any restrictions in range of motion, which your surgeon and therapist have explained to you.

Body Changes  

  • Your appetite may be poor. Drink plenty of fluids to keep from getting dehydrated. Your desire for solid food will return.
  • You may have difficulty sleeping. This is normal. Don't sleep or nap too much during the day.
  • Your energy level will be decreased for the first month.
  • Pain medication that contains narcotics promotes constipation. Use stool softeners or laxatives such as milk of magnesia if necessary.

Blood Clots in Legs

Surgery may cause the blood to slow and coagulate in the veins of your legs, creating a blood clot. This is why you take blood thinners after surgery. If a clot occurs despite these measures you may need to be admitted to the hospital to receive intravenous blood thinners. Prompt treatment usually prevents the more serious complication of pulmonary embolus.

Caring For Your Incision

  • Keep your incision dry.
  • Keep your incision covered with a light dry dressing until you do not have any drainage.
  • You may shower 24-48 hours after surgery, unless instructed otherwise. After showering, apply a dry dressing if incision is still draining.
  • Notify your surgeon if there is increased drainage, redness, pain, odor or heat around the incision.
  • Take your temperature if you feel warm or sick. Call your surgeon if it exceeds 101.5° F.


Recognizing & Preventing Potential Complications


Signs of Infection
  • Increased swelling, redness at incision site
  • color, amount, odor of drainage
  • Increased pain in knee
  • Fever greater than 101 degrees F
Prevention of Infection
  • Take proper care of your incision as explained.
  • Take prophylactic antibiotics when having work, other potentially contaminating procedures. This needs to be done for at least two years after your surgery.
  • Notify your physician and dentist that you have a total joint replacement.

Signs of Blood Clots in Legs

  • Swelling in thigh, calf or ankle that does not go down with elevation
  • Pain, tenderness in calf  NOTE: blood clots can form in either leg.

Prevention of Blood Clots

  • Foot and ankle pumps
  • Walking
  • Compression stockings
  • Blood thinners such as Lovenox or Heparin

Pulmonary Embolus

An unrecognized blood clot could break away from the vein and travel to the lungs. This is an emergency and you should CALL 911 if suspected.

 Signs of a Pulmonary Embolus
  • Sudden chest pain
  • Difficult and/or rapid breathing
  • Shortness of breath
  • Sweating
  • Confusion

Prevention of Pulmonary Embolus

  • Prevent blood clot in legs
  • Recognize a blood clot in leg and call physician promptly.


Signs of Dislocation

  • Severe pain
  • Rotation/shortening of leg
  • Unable to walk/move leg



Prevention of Dislocation


  • DO NOT cross legs
  • DO NOT twist side-to-side
  • DO NOT bend at the hip past 90 degrees

Activity Guidelines

Exercising is important to obtain the best results from total knee surgery. You may receive exercises from a physical therapist at an outpatient facility or at home. In either case you need to participate in an ongoing home exercise program as well. After each therapy session ask your therapist to mark in your NoteBook the appropriate exercises for you. These goals and guidelines are listed in your notebook.

Around the House

Safety and Avoiding Falls

  • Pick up throw rugs and tack down loose carpeting.  Cover slippery surfaces with carpets that are firmly anchored to the floor or that have non-skid backs.
  • Be aware of all floor hazards such as pets, small objects, electrical cords or uneven surfaces.
  • Provide good lighting throughout. Install nightlights in the bathrooms, bedrooms and hallways.
  • Keep extension cords and telephone cords out of pathways.  DO NOT run wires under rugs; this is a fire hazard.
  • Sit in chairs with arms.  it makes it easier to get up.
  • Rise slowly from either a sitting or lying position so as not to get light-headed.
  • DO NOT lift heavy objects for the first three months, and then only with your surgeon's permission.
  • Stop and think.  Use good judgement.
  • DO NOT wear open-toe slippers or shoes without backs. They do not provide adequate support and can lead to slips and falls. 

Do's and Dont's For the Rest of Your Life

Whether you have reached all the recommended goals in three months or not, all joint patients need to have a regular exercise program to maintain fitness and the health of the muscles around the joints. With both your orthopedic and primary care physicians'permission you should be on a regular exercise program three to four times per week lasting 20-30 minutes. Repetitive overhead activities and heavy weight-lifting may put too much load on the joint and are not recommended. Activities with a high risk for falling are discouraged because of risks for fractures around the prosthesis. Infections are always a potential problem and you may need antibiotics for prevention. Always ask if antibiotics are needed for any invasive procedures (colonoscopy, dental work, surgeries), and get treated immediately for any suspected infections elsewhere in your body (sinus infections, urinary tract infections, etc.).  

What to Do in General

  • Take antibiotics one hour before you are having dental work or other invasive procedures for two years after surgery.
  • Although the risks are very low for post-op infections, it is important to realize that the risk remains.  A prosthetic joint could possibly attract the bacteria from an infection located in another part of your body. If you should develop a fever of more than 101 degrees F, or suffer an injury such as a deep cut or puncture wound, you should clean it as best you can, put a sterile dressing or Band-Aid on it and notify your doctors.  The closer the injury is to your prosthesis the bigger the concern.  Occasionally, antibiotics may be needed.  Superficial scratches may be treated with tropical antibiotic ointment.  Notify your doctor if the area is painful or reddened.
  • When traveling, stop and change position hourly to prevent your joint from tightening.
  • See your surgeon yearly unless otherwise recommended. 

What to Do for Exercise

Choose a Low-Impact Activity
  • Recommended exercies classes
  • Home program as outlined in Patient Guide
  • Regular one - three mile walks
  • Home treadmill
  • Stationary bike
  • Regular exercise at a fitness center
  • Low-impact sports - gold, bowling, walking, gardening, dancing, swimming, pool exercise, etc.

What Not to Do

  • Do not participate in high-risk activities that put you at risk for falls.
  • Do not get involved in routine repetitive overhead activity (painting ceilings, hanging drywall) or heavy weight-lifting with the shoulders.

Wellness Connection Program

The Wellness Connection Program offers individuals with special medical needs, such as joint replacement, the opportunity to particpate in an individualized, closely supervised exercise program.  :::Learn More::: 

Please feel free to contact us if you have any questions (423)431-6937