https://www.niams.nih.gov/health-topics/joint-replacement-surgery

POSTOPERATIVE CARE

• Check vital signs, including temperature and level of consciousness, every 4 hours or more frequently as indicated.Report significant changes to the physician.These routine assessments provide information about the client’s cardiovascular status and can give early indications of complications such as excessive bleeding, fluid volume deficit, and infection.

• Perform neurovascular checks (color, temperature, pulses and capillary refill, movement, and sensation) on the affected limb hourly for the first 12 to 24 hours, then every 2 to 4 hours.Report abnormal findings to the physician immediately.Surgery can disrupt the blood supply to or innervation of the affected extremity. If so, rapid intervention is important to preserve the function of the extremity.

• Monitor incisional bleeding by emptying and recording suction drainage every 4 hours and assessing the dressing frequently.Significant blood loss can occur with a total joint re-placement, particularly a total hip replacement.•Reinforce the dressing as needed.The dressing is usually changed 24 to 48 hours after surgery but may need reinforcement if excess bleeding occurs.

• Maintain intravenous infusion and accurate intake and output records during the initial postoperative period.The client is at risk for fluid volume deficit in the initial postoperative period be-cause of blood and fluid loss during surgery, as well as the effects of the anesthetic.

• Maintain bed rest and prescribed position of the affected extremity using a sling, abduction splint, brace, immobilizer, or other prescribed device.Proper positioning of the affected extremity is vital in the initial postoperative period so that the joint prosthesis does not become dislocated or displaced.

• Help the client shift position at least every 2 hours while on bed rest.Shifting of position helps prevent pressure sores and other complications of immobility.

• Remind the client to use the incentive spirometer, to cough,and to breathe deeply at least every 2 hours.These measures are important to prevent respiratory complications such as pneumonia.

• Assess the client’s level of comfort frequently. Maintain PCA,epidural infusion, or other prescribed analgesia to promotecomfort.Adequate pain management promotes healing andmobility.

• Help the client get out of bed as soon as allowed. Teach and re-inforce the use of techniques to prevent weight bearing on theaffected extremity, such as the over-head trapeze, pivot turn-ing, and toe-touch.Early mobility prevents complications such aspneumonia and thromboembolism, but appropriate techniquesmust be used to prevent injury to the operative site.

• Initiate physical therapy and exercises as prescribed for thespecific joint replaced, such as quadriceps setting, leg raising,and passive and active range-of-motion exercises.These exer-cises help prevent muscle atrophy and thromboembolism andstrengthen the muscles of the affected extremity so that it cansupport the prosthetic joint.

• Use sequential compression devices or antiembolism stock-ings as prescribed.These help prevent thromboembolism andpulmonary embolus for the client who must remain immobilefollowing surgery.

• For the client with a total hip replacement, prevent hip flexionof greater than 90 degrees or adduction of the affected leg.Provide a seat riser for the toilet or commode.These measuresprevent dislocation of the joint.

• Assess the client with a total hip replacement for signs of pros-thesis dislocation, including pain in the affected hip or short-ening and internal rotation of the affected leg.

• For the client with a total knee replacement, use a continuouspassive range-of-motion (CPM) device or range-of-motion exercises as prescribed.Dislocation is not a problem with a kneereplacement, and moreemphasis is placed on range-of-motionexercises in the early postoperative period.

• Maintain fluid intake and encourage a high-fiber diet.Administer stool softeners or rectal suppositories as needed.Immobility contributes to the potential problem of constipation;these measures help maintain regular fecal elimination.

• Encourage consumption of a well-balanced diet with adequateprotein.Adequate nutrition promotes tissue healing.

• Teach or reinforce postdischarge exercises and activity restric-tions. Emphasize the importance of scheduled follow-up physi-cian visits.Clients are discharged from the acute care facilitybefore healing is complete. Exercises are prescribed and activitiesare resumed gradually to protect the integrity of the joint replace-ment and prevent contractures.

• Referrals as needed to home health agencies and physical therapy.Clients often require home health care for both nursing care needs and continued physical therapy following dis-charge from acute or long-term care.

 

https://wps.prenhall.com/wps/media/objects/737/755395/joint_replacement.pdf

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Post disc replacement care:

In order for you to recover after lumbar artificial disc replacement surgery, your spine needs to be properly aligned — so twisting your back and bending at the waist are not allowed.

Your physical therapist will help you learn how to move more safely. Some things to keep in mind:

 

Getting out of bed: You will learn a “log-rolling” technique to get out of bed without twisting the spine.

Heavy lifting: Right after surgery, you shouldn’t lift anything heavier than five pounds. As your muscles grow stronger, you will be able to slowly return to lifting more weight.

Showering: Your surgical incision should stay dry until it is fully healed, about two weeks after surgery. Avoid taking baths and cover the incision with a bandage when you shower. You should use a shower chair and stool while in the shower to protect your spine from falls or sudden movements. You may also want to have someone nearby to help you get in and out of the shower.

Driving: You will not be able to drive until your pain is under control. You also can’t drive while taking opioid pain medications.

 

Returning to Work

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After artificial disc replacement surgery, your main job is to rest, so you should plan to not work right away. How long it takes for you to return to work depends on the type of work that you do.

If your job involves light activities, you may be able to return to work within two to three weeks. For more physically demanding work, expect at least six weeks. If your job includes heavy lifting, you may need to wait at least 12 weeks before going back to work.

Also, if your job involves driving, you will not be able to do it while you are on opioid pain medications.

 

Resuming Physical Activities

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Soon after surgery, your healthcare team will encourage you to start walking to speed up your recovery. From then on, you will need to slowly work up to your regular activities and exercise. While everybody's recovery is a little bit different, many patients can expect something like the following:

Two to four weeks after surgery, a physical therapist will typically start working with you on developing the strength, stability and aerobic fitness that you need to return to your being active. Continue to do your physical therapy activities each day.

Many people will be able to return to light exercise and recreational sports at about six weeks after surgery, although your physical therapist might ask you to wait longer. Avoid impact sports until your healthcare team has told you it is okay. Walking, though, is always a good way to stay active.

After surgery, you can resume sexual activity when you feel ready, as long as it doesn’t involve twisting or bending at the waist. If a position hurts, don’t do it. If you are unsure about any sexual activity or position, talk to your doctor before attempting it.

During recovery, remember not to twist your back or bend at the waist while moving. You should also talk to your doctor or physical therapist about how much weight you can safely lift. It may be less than you expect.

 

Recovering at Home

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You will be sent home a few days after your artificial disc replacement surgery. Your healthcare team will give you instructions on how to take care of yourself during the first couple weeks at home. This includes information on:

Changing your bandage: Your doctor or nurse may show you how to change your bandage, unless you have a health care professional visiting you regularly. The incision should stay clean and dry to avoid getting an infection.

Medications: If you still have pain or nausea, your doctor may prescribe you medications or recommend an over-the-counter drug. If you have questions about your medications, call your doctor’s office.

Follow-up appointments: You will have a follow-up visit with your doctor around three weeks after surgery to check your symptoms and overall health. You may also have X-rays or other medical imaging to check the artificial disc device.

Planning ahead can make your recovery safer and more restful. This includes asking family or friends to take care of your needs at home, drive you when you need to go to your doctor’s appointments, or pick up your prescriptions.

Setting up the space around your bed can also make recovery more restful. Keep everything you will need nearby, such as telephone, books or magazines, clothing, toiletries, snacks and drinks.

Keep your walker or other assistive device near your bed so you can easily get to the bathroom when you need to. Ask your caregiver to be nearby the first few times so they can assist you.

If you develop any of the following symptoms, call your doctor:

Fever

Headache

Bleeding, redness, swelling, or discharge from your incision site

Pain that does not respond to pain medication

Numbness or weakness

Difficulty swallowing

Voice change or hoarseness

Difficulty breathing

 

Recovery Time

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Because artificial disc replacement surgery doesn’t require the bones of the spine to heal, recovery after this procedure is faster than for other back surgeries, including spine fusion.

Full recovery from artificial disc replacement surgery will take anywhere from a few weeks to a few months. This includes a period of limited motion and some discomfort for a few weeks after surgery, followed by several weeks of rehabilitation. As your body heals, you will be able to slowly add more activities to your daily routine.

Artificial disc replacement recovery time depends on many factors, including your overall health, whether you smoke cigarettes, and how well you are able to follow the instructions and rehabilitation program prescribed by your physician and physical therapist.

 

Success over the long-term

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Once you have resumed your normal activities, there are other lifestyle changes that you can make to ensure your long-term success. These include:

Quit nicotine: Smoking contributes to back pain, and nicotine can interfere with the healing process.

Avoid excess alcohol: Alcohol is a depressant that can affect your moods. It can also interact with certain medications.

Drink water: Some medications can cause constipation, so drink plenty of water throughout the day.

Mange your weight: Excess weight can put more pressure on the discs in your low back. Eat healthy and stay physically active to maintain a healthy weight.

Get plenty of sleep: Sleep is essential for the healing process. It will also keep you healthy long-term.

 

https://spinenation.com/treatment/lumbar-artificial-disc-replacement/post-operative-care-for-lumbar-artificial-disc-replacement-surgery