The Joint Replacement Center at
Johnston Memorial Hospital
Hip Replacement - Post-Op


Plan of Care
Hip Replacement
 Knee Replacement
 Quality Measures
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Postop Care

Hip Replacement - Preop

Hip Replacement - Hospital Care

Hip Replacement - Postop

Pain Control

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).

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.


Lovenox is a medication that you may be given to prevent a blood clot in your blood vessels. Your physician will prescribe your exact dose. It is given as a subcutaneous injection. You will be instructed on self-administration and possible side effects prior to your discharge from the hospital.


Xarelto ® (rivaroxaban)

Xarelto is an oral coagulant used to prevent blood clots after hip or knee replacement surgery. 

Xarelto is given once a day, with or without food, as directed by your doctor.  You will take one 10mg pill per day for 35 days (Total Hip), or as directed by your doctor.  Do not skip a dose unless advised by your doctor.  Skipping a dose may increase your risk of a blood clot.  If you do miss a dose, take the next dose as soon as possible.

Prior to taking Xarelto, tell your doctor if you have a bleeding disorder or any problems with your liver or kidneys. 

Xalerto may cause you to bruise or bleed more easily and bleeding may take longer than usual to stop.  It may also cause wound leakage and itching.

If you have any additional questions about my procedure, Xarelto, insurance coverage or eligibility for financial assistance ask your doctor or call 1-888-XARELTO (927-3586) or go to


Stockings (TEDS)

You may be asked to wear special white stockings. These stockings are used to help compress the veins in your legs. This helps to keep swelling down and reduces the chance for blood clots.

  • If swelling in the operative leg is bothersome, elevate the leg for short periods throughout the day. It's best to lie down and raise the leg above heart level.
  • Wear the stockings continuously, removing for one to two hours twice a day.
  • Notify your physician if you notice increased pain or swelling in either leg.
  • Ask your surgeon when you can discontinue stockings. Usually, this will be done four weeks after surgery.

Caring for Your Incision

  • Keep your incision dry.
  • You may shower 24-48 hours after surgery, unless instructed otherwise.
  • 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 100.5¡Æ F for more than 24 hours.


Hip Precautions


  • DO NOT cross legs
  • DO NOT turn toes in or out
  • DO NOT bend at the hip past 90 degrees


Signs of Dislocation

  • Severe pain
  • Rotation/shortening of leg
  • Unable to walk/move leg 
Follow specific incision care instructions if given by your surgeon.


Signs of Infection

  • Increased swelling, redness at incision site
  • Change in color, amount, odor of drainage
  • Increased pain in knee
  • Fever greater than 100.5° F

Prevention of Infection

  • Take proper care of your incision as explained.
  • Take prophylactic antibiotics when having dental work or 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.

Recognizing & Preventing Potential Complications

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 ot the hospital to receive intravenous blood thinners.  Prompt treatment usually prevents the more serious complication of pulmonary embolus.

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

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 instruct you on home exercises to do on non-outpatient therapy days.

On the following pages there are home exercises that are essential for a complete recovery from your surgery. Exercising should take approximately 20 minutes and should be done twice daily. If you are recovering quickly, it is recommended that you supplement these exercises with others that your therapist recommends

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