Can I see my own primary care provider for medical clearance? 

No, all patients undergoing joint replacement surgery at HSS must be evaluated by a physician in our perioperative medicine department. 

When is my pre-admission testing (PAT)? 

Pre-admission testing will be scheduled 2-3 weeks prior to your surgical date, as all testing is to be completed within 28 days of surgery 

Our office will schedule a series of appointments for you, which will take place in one day. You should expect to be at the hospital 4-5 hours to complete your scheduled appointments. 

Why do I need a CT before my knee replacement? 

We obtain this CT to be able to build a 3D model of the knee prior to surgery. This study allows us to accurately determine component sizing and position based on your anatomy and ligament tensioning. This 3D model also facilitates the use of a surgical robot during the operation.

At the time of booking your surgery, we will ask you to provide us with several dates you prefer to come in to complete your testing. 

Your PAT itinerary will be emailed to you. Please note that your PAT date is not confirmed until we email you this itinerary. 

PAT’s will include: medical clearance, specialist consultations (if required) joint education class (optional), x-rays/CAT scan, & pre-surgical screening (where labs, urine, EKG are completed). 

What medications do I stop before surgery? 

Your HSS pre-surgical screening (PSS) physician will discuss this with you during consultation.  Please review your medications in your HSS MyChart, or bring a complete list to the visit.

All vitamins/minerals/supplements should stop 14 days prior to surgery. Hormone replacement medications should stop 4 weeks prior to surgery, and should not be restarted until 4 to 5 weeks after surgery due to the risk of blood clot formation.

Can I eat or drink the morning of surgery? 

If instructed at PSS, drink Ensure Clear 3 hours before arriving at the hospital. 

You may only drink clear liquids up to 3 hours before arriving at the hospital. 

Clear liquids include: water, apple/cranberry/grape juice, black coffee or tea, clear broth, ginger ale, seltzer, Ensure Clear (IF instructed at PSS).

NOT allowed: solid foods, milk or dairy products, citrus juices, prune juice, juices with pulp, Ensure meal replacement drink. 

If your PSS physician instructs you to take specific medications on the morning of surgery, you may do so with a small sip of water. 

What time is my surgery? 

The nurse call center will call you between 1 pm & 7 pm the day before surgery to tell you what time to arrive at the hospital. 

Can I request a surgical time? 

Yes, but we cannot guarantee your request will be granted. We do our best to accommodate all requests, but due to varying factors we cannot guarantee a specific surgical time. 

How long am I in the hospital? 

The average length of stay in the hospital is 1-2 nights. Your length of stay depends on your preoperative mobility and other factors.

You must pass physical therapy, be medically stable, and have your pain controlled on oral pain medications before being discharged from the hospital.

Can I leave on the day of surgery?

Possibly. Patients who meet certain medical criteria and are interested in same-day discharge should speak to the perioperative physician and the physical therapists during the preoperative visit. Approximately one-third of patients go home on the day of surgery. 

Will I be able to climb stairs when I get home? 

Yes. Your hospital physical therapist will teach your how to negotiate stairs before you are discharged from the hospital.

Will I go home or to rehab after? 

The vast majority of patients go home and our recommendation is to make all efforts to return home after surgery. Should you desire to go to rehab, please research several locations before surgery, and discuss this with the HSS social worker during your hospital stay. 

Can I request a private room? 

Yes. Please inform our office so we can place the request. On the day of admission, payment information will be collected to secure the room.  

Please note that rooms are based on availability, and not covered by insurance. 

Do I need a private duty nurse? 

This is not required, but available for an additional fee if you desire.  

For more information, please call Private Duty Nursing Services at: 212-774-7187. 

Will I need to make household alterations prior to surgery to prepare for my return home? 

As a part of your preoperative assessment, you will meet with a physical therapist to assess your needs after surgery. If you’re able to, remove tripping hazards and clutter, and set yourself up on the first floor.  Alternatively, if you only need to negotiate stairs at night to get to your bedroom, this is also acceptable.  

Do I need to buy any assistive devices or products beforehand to have at home? 

Please go to www.Shop-Recovery.com for a list of products that Dr. Shen has reviewed, and recommended to assist in your recovery.  These items are optional.  Click on “Dr. Shen”.  If you have questions, please call the office.

Alternatively, many assistive devices will be offered for purchase at the hospital through your insurance.  You may also go to a local surgical supply store, or purchase on Amazon.

What implant manufacturers are used? 

Implant selection depends on the quality and shape of your bone. Dr. Shen may use implants from Stryker, Smith & Nephew, Zimmer-Biomet, DePuy-Synthes, and Medacta. Dr. Shen carefully selects implants and materials with a proven track record. 

What are the implants made of?

The femoral component is typically made from a cobalt chromium alloy, titanium alloy, or oxidized zirconium. The tibial component is typically made from cobalt chromium alloy or titanium alloy. The insert or “bumper” between the femoral and tibial components is made from highly cross-linked polyethylene. All of these materials have undergone extensive testing and have been used in orthopedic implants for decades.

What is “cement” and how are the implants secured?

“Cement” refers to polymethylmethacrylate, which is a synthetic polymer that has long been used to fix orthopedic implants to bone. The material has an excellent track record and remains the most widely used method of fixation for knee replacements today.   

For most patients, Dr. Shen recommends the use of cemented fixation, as this method has excellent long-term data for most types of patients. For some patients, Dr. Shen may elect to use cementless implants. Cementless implants are designed with a porous coating that mimics the natural architecture of your bone. Over time, your own bone will grow into the implant, providing biologic fixation. Modern cementless technology in knee replacements is a relatively recent development with excellent results so far. In general, long-term results for cementless components are excellent.

What type of anesthesia is used? 

Combined spinal/epidural, with sedation. 

If there is a concern about your airway, or you have had extensive spine surgery, the anesthesiologist will discuss other types of anesthesia with you the day of surgery. 

How long is the surgery? 

Surgical time can be variable due to a number of factors often unrelated to the surgery itself, including anesthesia time, transferring, positioning, among others. Most patients are in the operating room 3-4 hours before going to the recovery unit.   

What type of medications will I be given after surgery? 

A typical regime includes: meloxicam (or other anti-inflammatory medication), acetaminophen, a narcotic, an anticoagulant (typically aspirin), and pantoprazole. 

Please note that the above is only a generic example. Your medications will be determined during your hospital stay, and catered to your post-operative needs.   

Do I have to be in a blood thinner after? If so, for how long? 

Yes, for 6 weeks. Knee replacement surgery is associated with a small but unavoidable risk of developing blood clots.  For patients with no other risk factors, aspirin 81 mg twice daily will be prescribed. For patients with other risk factors (i.e. history of blood clots, cancer, stroke, etc.), other anticoagulants will be prescribed (typically apixaban). 

How long will my incision be? 

The incision will be long enough to access the knee joint safely without injuring your skin and soft tissues. A typical incision is around 6 inches, but this is variable depending on your anatomy. You may also have 2 small poke-hole incisions on the front of your shin as this is where the robotic array is placed during surgery.

Who will I speak to if I have questions after surgery?

The office is available between 9am-4pm Monday through Friday. HSS has an experienced group of nurse practitioners that help our office with routine postoperative care, including medication refills, physical therapy prescriptions, and other questions/concerns about recovery. They work closely with Dr. Shen’s team, communicate regularly with him, and will escalate concerns if necessary. 

What do I do if I run out of post-operative medications? 

Call our office at least 24-36 hours before you will run out of pain medication. If you anticipate running out of medication on a Friday, call the office before 12 noon. 

Please note that our goal is to have you off of all narcotic pain medications by 3 weeks post operatively. 

How long will narcotics be prescribed after surgery?

Narcotics will not be prescribed beyond 12 weeks after surgery. Establishment with a pain management physician will be needed beyond this time frame for continued medication weaning. 

I have more pain at night and have trouble sleeping. Is this normal? 

Yes. In many cases, patients experience more pain at night due to not being distracted by external stimuli. This will improve with time. We do not recommend, and will not prescribe, prescription sleeping pills. You may try over the counter Benadryl, Tylenol PM, or melatonin as a sleep aid.  

I have intermittent/random pain in my hip that is similar to before surgery. Is this normal? 

Yes, this is a normal post-operative experience. It takes time for the soft tissues around the hip joint to heal, and for muscles to stretch. Muscles around the hip get quite stiff when you have an arthritic joint—so it takes time for these muscles to stretch out after your hip replacement. If you are ever concerned, please do not hesitate to contact our office. 

Is swelling in my leg after surgery normal? 

Swelling in the leg after surgery is very common. We recommend that you try to get up move at least one time per hour. Perform ankle pumps or heel raises while sitting or at rest.

We recommend elevating the operative extremity and icing. Wearing a thigh-high compression sock (15/20 mmHg) can also help these symptoms. Clean gauze should be placed between the stocking and your incision to prevent excessive friction over the incision. Stockings should be placed in the morning, and removed prior to bed. We recommend asking for help putting these on as these can be cumbersome without assistance. 

Is bruising after surgery normal? 

Yes. Everyone experiences a different level of bruising after surgery, even into the lower leg. This can also be made worse due to the blood thinner you are on, and due to gravity dependent positioning. Bruising patterns can change and may last for months. 

Why am I fatigued after surgery?

Fatigue may be due to blood loss during surgery. Although the overall amount of blood loss is typically low, it may still take 3 months for the body to restore your red blood cell level to its preoperative level. 

What are the signs of infection? 

It is common for the knee to be red and warm after surgery. However, if you experience purulent discharge from the incision, expanding bright redness of the incision, temperature over 101.5⁰F, increased or uncontrolled pain, PLEASE CALL THE OFFICE IMMEDIATELY.  

Can I shower or bathe after surgery? 

You will have a Mepilex dressing that covers your incision for 7 days after surgery.  It is water resistant, and may be get wet in the shower.  Do not fully submerge the dressing in water.  The dressing may be removed by the visiting nurse, or by the patient, at home on post-operative day 7.

Your incision will be closed with water resistant glue and will have white strip that needs to come off day 21 post op .  Avoid submerging the incision in a bathtub, pool, etc. until cleared by Dr. Shen. 

Do not scrub the incision or place any lotions/creams on the incision until cleared by Dr. Shen. 

Do I need my stitches removed? 

Unless otherwise instructed, there are no sutures or staples to remove. Most incisions are closed with buried absorbable sutures. In cases where non-absorbable sutures or staples are used, you will be instructed when to have these removed. 

Is physical therapy (PT) required? If so, for how long? 

Yes. Home physical therapy immediately after surgery is optional. Dr. Shen recommends resting the knee for the first 10 days after surgery to reduce inflammation before increasing the intensity of physical therapy. Outpatient physical therapy usually starts around 2 weeks after surgery with a focus on range of motion and strengthening of the knee.

The first 6-8 weeks after a knee replacement are CHALLENGING! Obtaining good range of motion during the first 6-8 weeks is crucial. Please remember that the overall recovery after a joint replacement is 1 year and that gradual improvement can continue during this time.

Are there any particular exercises that I should be doing?

Your therapist will guide you with regard to specific exercises. Dr. Shen recommends placing a roll of towels or a bump under your ankle with your leg extended. This allows gravity to gently straighten your knee. Avoid placing a pillow under the knee.

My knee feels very stiff, is this normal after surgery?

It is normal for the knee to feel stiff due to post-operative swelling and scar tissue formation. The sensation of stiffness is also highly subjective; it is normal for a prosthetic knee to feel different from before. Stiffness and swelling may wax and wane for several months after surgery.

As a general goal, you should be within 5 degrees of full extension and bending more than 90 degrees by 6 weeks after surgery. 

I lost a lot of muscle tone in my thigh, is this normal?

Yes, atrophy of the quadriceps muscle can occur quickly after surgery. Part of the recovery program is to regain your strength with physical therapy. This will take time and persistence. 

I hear clicking in my knee, is this normal?

Yes, a total knee replacement is an artificial joint made of metal and plastic that will occasionally result in clicking sounds or mechanical sensations. Typically, as the swelling goes down and your strength improves, the clicking sensation is less noticeable. 

What type of exercise can I do after my knee replacement? 

Low-impact exercises are ideal, such as walking, biking, hiking, elliptical, and swimming. Using a stationary bike is also helpful for regaining range of motion.

Do I have any restrictions after surgery?

No, there are no formal precautions or restrictions after a total knee replacement. Repetitive high impact activities (e.g. marathon running) are discouraged as this may lead to wear of the knee replacement components. 

Why does it hurt when I kneel?

Many patients find kneeling uncomfortable due to the fact that there is a scar directly over the knee. Kneeling will not damage the knee replacement in any way, though it may remain uncomfortable. We recommend placing a cushion under the knee when kneeling.

Why is there numbness around my incision?

There are several small sensory nerves that supply sensation to the front of the knee. In order to obtain access to the knee to perform the operation, damage to these small sensory nerves is unavoidable. The recovery of these sensory nerves can take many months. Sometimes, permanent sensory changes remain.  

When do I follow up in the office? 

We recommend follow up at, 6 weeks, 3 months, 6 months, and 1 year after surgery. After this, we recommend routine visits at 3 years, 5 years, and 10 years. Your first follow-up visits will be scheduled at the time of surgery.

How soon can I have my other joint/side replaced? 

We usually recommend waiting 2-3 months between surgeries. It is important to recover from the first operation and feel strong enough before additional surgery.

After having my joint replaced, do I have to take antibiotics before medical procedures? If so, for how long? 

Dr. Shen recommends taking antibiotics before dental procedures only for the first two years after surgery. You do not need to take antibiotics before other minor medical procedures (e.g. colonoscopy). 

The typical antibiotic regimen before dental work is amoxicillin 500mg, 4 tablets taken 1 hour before the procedure. If you have an allergy to penicillin, clindamycin 600mg taken one hour before the procedure is an alternative.

How soon after surgery can I have my teeth cleaned or dental work completed? 

If possible, we recommend waiting at least 6 months  after surgery to complete any dental work. As stated above, we recommend taking an antibiotic before dental work in the first two years after surgery. 

When can I take a flight after surgery? 

Generally, we recommend waiting 6 weeks prior to taking a flight. There is an increased risk of developing a blood clot with air travel in the first 6 weeks after surgery. The overall risk depends on the duration of the flight and additional travel time. Individual circumstances may vary; this can be discussed with the office.   

When can I drive? 

Left-sided surgery: You may drive when you are off all narcotic pain medications and walking primarily without a cane, usually around 3 weeks after surgery. 

Right-sided surgery: The soonest you may drive is 4 weeks after surgery. After four weeks, you will need to personally assess your ability to move your foot from the accelerator to the brake. If you have any concern, then you may need to wait longer. 

When you are ready to start driving, go to a parking lot and practice driving, stopping quickly, parking, etc., to ensure you feel comfortable.  Remember your hip precautions while driving, and entering/exiting your vehicle.

When can I return to work? 

This is highly variable as this depends on your line of work and the difficultly of your commute.  

For sedentary jobs, you can return to work as soon as 2-3 weeks post op. If you are able to work from home, you could likely return to work around this time. 

For jobs requiring heavy labor, your return may be delayed until 12 weeks. 

We recommend patients be off all narcotic pain medications prior to making business decisions.

I have short-term disability benefits. Will you fill out my paperwork? 

Yes. We provide up to 3 months of short-term disability. Our goal is to improve your pain, and get you back to life! 

When can I resume my vitamins and supplements post-operatively?

Vit A, B, C, D, Zinc, and magnesium may be resumed, but all other vitamins/supplements should be held until your 6 week visit. 

Can I see my own primary care provider for medical clearance? 

No, all patients undergoing joint replacement surgery at HSS must be evaluated by a physician in our perioperative medicine department. 

When is my pre-admission testing (PAT)? 

Pre-admission testing will be scheduled 2-3 weeks prior to your surgical date, as all testing is to be completed within 28 days of surgery 

Our office will schedule a series of appointments for you, which will take place in one day. You should expect to be at the hospital 4-5 hours to complete your scheduled appointments. 

Why do I need a CT before my knee replacement? 

We obtain this CT to be able to build a 3D model of the knee prior to surgery. This study allows us to accurately determine component sizing and position based on your anatomy and ligament tensioning. This 3D model also facilitates the use of a surgical robot during the operation.

At the time of booking your surgery, we will ask you to provide us with several dates you prefer to come in to complete your testing. 

Your PAT itinerary will be emailed to you. Please note that your PAT date is not confirmed until we email you this itinerary. 

PAT’s will include: medical clearance, specialist consultations (if required) joint education class (optional), x-rays/CAT scan, & pre-surgical screening (where labs, urine, EKG are completed). 

What medications do I stop before surgery? 

Your HSS pre-surgical screening (PSS) physician will discuss this with you during consultation.  Please review your medications in your HSS MyChart, or bring a complete list to the visit.

All vitamins/minerals/supplements should stop 14 days prior to surgery. Hormone replacement medications should stop 4 weeks prior to surgery, and should not be restarted until 4 to 5 weeks after surgery due to the risk of blood clot formation.

Can I eat or drink the morning of surgery? 

If instructed at PSS, drink Ensure Clear 3 hours before arriving at the hospital. 

You may only drink clear liquids up to 3 hours before arriving at the hospital. 

Clear liquids include: water, apple/cranberry/grape juice, black coffee or tea, clear broth, ginger ale, seltzer, Ensure Clear (IF instructed at PSS).

NOT allowed: solid foods, milk or dairy products, citrus juices, prune juice, juices with pulp, Ensure meal replacement drink. 

If your PSS physician instructs you to take specific medications on the morning of surgery, you may do so with a small sip of water. 

What time is my surgery? 

The nurse call center will call you between 1 pm & 7 pm the day before surgery to tell you what time to arrive at the hospital. 

Can I request a surgical time? 

Yes, but we cannot guarantee your request will be granted. We do our best to accommodate all requests, but due to varying factors we cannot guarantee a specific surgical time. 

How long am I in the hospital? 

The average length of stay in the hospital is 1-2 nights. Your length of stay depends on your preoperative mobility and other factors.

You must pass physical therapy, be medically stable, and have your pain controlled on oral pain medications before being discharged from the hospital.

Can I leave on the day of surgery?

Possibly. Patients who meet certain medical criteria and are interested in same-day discharge should speak to the perioperative physician and the physical therapists during the preoperative visit. Approximately one-third of patients go home on the day of surgery. 

Will I be able to climb stairs when I get home? 

Yes. Your hospital physical therapist will teach your how to negotiate stairs before you are discharged from the hospital.

Will I go home or to rehab after? 

The vast majority of patients go home and our recommendation is to make all efforts to return home after surgery. Should you desire to go to rehab, please research several locations before surgery, and discuss this with the HSS social worker during your hospital stay. 

Can I request a private room? 

Yes. Please inform our office so we can place the request. On the day of admission, payment information will be collected to secure the room.  

Please note that rooms are based on availability, and not covered by insurance. 

Do I need a private duty nurse? 

This is not required, but available for an additional fee if you desire.  

For more information, please call Private Duty Nursing Services at: 212-774-7187. 

Will I need to make household alterations prior to surgery to prepare for my return home? 

As a part of your preoperative assessment, you will meet with a physical therapist to assess your needs after surgery. If you’re able to, remove tripping hazards and clutter, and set yourself up on the first floor.  Alternatively, if you only need to negotiate stairs at night to get to your bedroom, this is also acceptable.  

Do I need to buy any assistive devices or products beforehand to have at home? 

Please go to www.Shop-Recovery.com for a list of products that Dr. Shen has reviewed, and recommended to assist in your recovery.  These items are optional.  Click on “Dr. Shen”.  If you have questions, please call the office.

Alternatively, many assistive devices will be offered for purchase at the hospital through your insurance.  You may also go to a local surgical supply store, or purchase on Amazon.

What implant manufacturers are used? 

Implant selection depends on the quality and shape of your bone. Dr. Shen may use implants from Stryker, Smith & Nephew, Zimmer-Biomet, DePuy-Synthes, and Medacta. Dr. Shen carefully selects implants and materials with a proven track record. 

What are the implants made of?

The acetabular shell is made of titanium. The acetabular liner is made from highly cross-linked polyethylene. Femoral stems are most commonly made from titanium. Certain stems are made from cobalt chromium alloy or stainless steel. The femoral head is most commonly made from an aluminum oxide matrix composite ceramic. Depending on the manufacturer, other femoral heads may be made from oxidized zirconium or cobalt chronium alloy. All of these materials have undergone extensive testing and have been used in orthopedic implants for decades.

What is “cement” and how are the implants secured?

“Cement” refers to polymethylmethacrylate, which is a synthetic polymer that has long been used to fix orthopedic implants to bone. The material has an excellent track record and remains used today.  

For patients with soft or osteoporotic bone, Dr. Shen may choose to use a cemented femoral component. Cemented femoral components have an excellent track record and have been shown to be safer in certain groups of patients. 

For most patients, cementless implants are used. Cementless implants are designed with a porous coating that mimics the natural architecture of your bone. Over time, your own bone will grow into the implant, providing biologic fixation. Long-term results for cementless components are excellent.

Will you adjust my leg lengths during surgery?

For most patients the arthritic leg is shorter than the nonarthritic leg due to the loss of cartilage. Because of this, you may feel that your leg is longer after surgery. Dr. Shen uses full-length radiographs and a CT scan to accurately measure leg lengths before surgery. During surgery, Dr. Shen uses computer navigation to take measurements that help optimize the restoration of your hip geometry, one of which is leg length. The final leg length is determined based on your hip geometry, soft tissue tensioning, range of motion, and stability. 

I had my other hip replaced by a different surgeon. Can you use the same implants as my prior surgeon? 

Possibly. We will select modern components that best fit your anatomy. 

What type of anesthesia is used? 

Combined spinal/epidural, with sedation. 

If there is a concern about your airway, or you have had extensive spine surgery, the anesthesiologist will discuss other types of anesthesia with you the day of surgery. 

How long is the surgery? 

Surgical time can be variable due to a number of factors often unrelated to the surgery itself, including anesthesia time, transferring, positioning, among others. Most patients are in the operating room 3-4 hours before going to the recovery unit.   

What type of medications will I be given after surgery? 

A typical regime includes: meloxicam (or other anti-inflammatory medication), acetaminophen, a narcotic, an anticoagulant (typically aspirin), and pantoprazole. 

Please note that the above is only a generic example. Your medications will be determined during your hospital stay, and catered to your post-operative needs.   

Do I have to be in a blood thinner after? If so, for how long? 

Yes, for 6 weeks. Hip replacement surgery is associated with a small but unavoidable risk of developing blood clots.  For patients with no other risk factors, aspirin 81 mg twice daily will be prescribed. For patients with other risk factors (i.e. history of blood clots, cancer, stroke, etc.), other anticoagulants will be prescribed (typically apixaban). 

How long will my incision be? 

The incision will be long enough to access the hip joint safely without injuring your skin and soft tissues. The size of the hip incision also depends on the amount of soft tissue around the hip and how stiff the hip is. A typical incision is around 5 inches, but this is highly variable. You will also have 3 small poke-hole incisions at the iliac crest (pelvis), as this is where the robotic array is placed during surgery.

Who will I speak to if I have questions after surgery?

The office is available between 9am-4pm Monday through Friday. HSS has an experienced group of nurse practitioners that help our office with routine postoperative care, including medication refills, physical therapy prescriptions, and other questions/concerns about recovery. They work closely with Dr. Shen’s team, communicate regularly with him, and will escalate concerns if necessary. 

What do I do if I run out of post-operative medications? 

Call our office at least 24-36 hours before you will run out of pain medication. If you anticipate running out of medication on a Friday, call the office before 12 noon. 

Please note that our goal is to have you off of all narcotic pain medications by 3 weeks post operatively. 

How long will narcotics be prescribed after surgery?

Narcotics will not be prescribed beyond 12 weeks after surgery. Establishment with a pain management physician will be needed beyond this time frame for continued medication weaning. 

What do I do if I’m constipated? 

It is not uncommon to experience constipation when taking narcotic pain medications. You should take a stool softener regularly (i.e. Colace or Senokot) until you are off all narcotic pain medications. 

If you haven’t had a bowel movement by post-op day 3, you can try one of the following: Milk of Magnesia, Miralax, Dulcolax suppositories or a fleet enema, or magnesium citrate (all available over the counter at your local pharmacy). 

I have more pain at night and have trouble sleeping. Is this normal? 

Yes. In many cases, patients experience more pain at night due to not being distracted by external stimuli. This will improve with time. We do not recommend, and will not prescribe, prescription sleeping pills. You may try over the counter Benadryl, Tylenol PM, or melatonin as a sleep aid.  

I have intermittent/random pain in my hip that is similar to before surgery. Is this normal? 

Yes, this is a normal post-operative experience. It takes time for the soft tissues around the hip joint to heal, and for muscles to stretch. Muscles around the hip get quite stiff when you have an arthritic joint—so it takes time for these muscles to stretch out after your hip replacement. If you are ever concerned, please do not hesitate to contact our office. 

Is swelling in my leg after surgery normal? 

Swelling in the leg after surgery is very common. We recommend that you try to get up move at least one time per hour. Perform ankle pumps or heel raises while sitting or at rest.

We recommend elevating the operative extremity and icing. Wearing a knee-high compression sock (15/20 mmHg) can also help these symptoms.  Stockings should be placed in the morning, and removed prior to bed. Care must be taken when putting on compression stockings to avoid extreme positions for the hip. We recommend asking for assistance if using compression stockings.

Is bruising after surgery normal? 

Yes. Everyone experiences a different level of bruising after surgery, even into the lower leg. This can also be made worse due to the blood thinner you are on, and due to gravity dependent positioning. Bruising patterns can change and may last for months. 

What are the signs of infection? 

It is common for the hip to be red and warm after surgery. However, if you experience purulent discharge from the incision, expanding bright redness of the incision, temperature over 101.5⁰F, increased or uncontrolled pain, PLEASE CALL THE OFFICE IMMEDIATELY.  

Do I need my stitches removed? 

Unless otherwise instructed, there are no sutures or staples to remove. Most incisions are closed with buried absorbable sutures. In cases where non-absorbable sutures or staples are used, you will be instructed when to have these removed. 

Is physical therapy (PT) required? If so, for how long? 

Physical therapy optional after surgery.  Patients may perform an informal walking program for the first 6 weeks. 

Walking program: Take the number of weeks post-op you are, and divide by 2. 

This is the distance you may walk throughout the day (not all at once!)  

For example, 2 weeks = 1 mile/day, 4 weeks = 2 miles/day, 6 weeks = 3 miles/day 

HSS can set up a visiting nurse and physical therapist for 2 to 3 weeks, then outpatient physical therapy may begin.  Or, you may start outpatient physical therapy right away instead of having sessions at your home. After we see you at the 6-week appointment, you will be evaluated and the need for PT, or continued PT, will be discussed. 

Do I have any restrictions after surgery? If so, for how long? 

Yes, for 6 weeks. During this time, soft tissues are healing and you are at higher risk for hip dislocation. We typically discharge patients with pose-avoidance hip precautions. You should avoid combined hip flexion, internal rotation and adduction—this will be taught to you during your hospitalization with physical therapy.

What sleeping positions are okay after surgery? 

You may sleep on your back, non-surgical side with a pillow between your legs, or on your stomach (minding your hip precautions getting into position). This will be reviewed with you by your physical therapist.

When can I resume sexual activity after surgery? 

You may resume sex once you return home and feel up to it.  However, be very careful to maintain your hip precautions in the first 6 weeks after surgery.

When do I follow up in the office? 

We recommend follow up at 6 weeks, 3 months, 6 months, and 1 year after surgery. After this, we recommend routine visits at 3 years, 5 years, and 10 years. Your first follow-up visits will be scheduled at the time of surgery.

What type of exercise can I do after my hip replacement? 

Immediately after surgery, you may do gentle upper body exercises while upholding your hip precautions. Low-impact exercises are ideal, such as walking, biking, hiking, elliptical, and swimming. Patients may get on a stationary bike at 3-4 weeks after surgery.

Higher impact activities such as jogging, plyometrics, jumping, basketball, tennis, etc, may begin at 12 weeks after surgery.

Golfing: putting may begin when comfortable standing.  A chips/wedges may begin at 6 to 8 weeks after surgery, and a full driver swings may start at 8 to 10 weeks after surgery. 

Pilates may begin at 3 months after surgery.  Yoga and extremes of stretching are not recommended, as these exercises can put a lot of torque/rotation through the hip.  

It is not recommended that you participate in high-impact activities such as marathon running, as this will wear out your hip replacement faster. Bungee jumping and sky diving are not recommended.

Can I get a handicap parking placard?

We generally do not advise patients to obtain these placards, as we actually want you to walk. Walking is the best form of therapy after a hip replacement. 

How soon can I have my other joint/side replaced? 

We usually recommend waiting 2-3 months between surgeries. It is important to recover from the first operation and feel strong enough before additional surgery.

After having my joint replaced, do I have to take antibiotics before medical procedures? If so, for how long? 

Dr. Shen recommends taking antibiotics before dental procedures only for the first two years after surgery. You do not need to take antibiotics before other minor medical procedures (e.g. colonoscopy). 

The typical antibiotic regimen before dental work is amoxicillin 500mg, 4 tablets taken 1 hour before the procedure. If you have an allergy to penicillin, clindamycin 600mg taken one hour before the procedure is an alternative.

How soon after surgery can I have my teeth cleaned or dental work completed? 

If possible, we recommend waiting at least 6 months after surgery to complete any dental work. As stated above, we recommend taking an antibiotic before dental work in the first two years after surgery. 

When can I take a flight after surgery? 

Generally, we recommend waiting 6 weeks prior to taking a flight. There is an increased risk of developing a blood clot with air travel in the first 6 weeks after surgery. The overall risk depends on the duration of the flight and additional travel time. Individual circumstances may vary; this can be discussed with the office.   

When can I drive? 

Left-sided surgery: You may drive when you are off all narcotic pain medications and walking primarily without a cane, usually around 3 weeks after surgery. 

Right-sided surgery: The soonest you may drive is 4 weeks after surgery. After four weeks, you will need to personally assess your ability to move your foot from the accelerator to the brake. If you have any concern, then you may need to wait longer. 

When you are ready to start driving, go to a parking lot and practice driving, stopping quickly, parking, etc., to ensure you feel comfortable.  Remember your hip precautions while driving, and entering/exiting your vehicle.

When can I return to work? 

This is highly variable as this depends on your line of work and the difficultly of your commute.  

For sedentary jobs, you can return to work as soon as 2-3 weeks post op. If you are able to work from home, you could likely return to work around this time. 

For jobs requiring heavy labor, your return may be delayed until 12 weeks. 

We recommend patients be off all narcotic pain medications prior to making business decisions.

I have short-term disability benefits. Will you fill out my paperwork? 

Yes. We provide up to 3 months of short-term disability. Our goal is to improve your pain, and get you back to life! 

When can I resume my vitamins and supplements post-operatively?

Vit A, B, C, D, Zinc, and magnesium may be resumed, but all other vitamins/supplements should be held until your 6 week visit.