Patients and their families should actively participate in the recovery process, which will significantly contribute to a smoother healing experience. This article will cover what happens during the postoperative hospital stay, transitioning to home care, rehabilitation, physiotherapy, dietary and nutrition considerations, potential complications, long-term recovery, and follow-up care.
Hospital Stay: Immediate Postoperative Period
- Monitoring Vital Signs and Pain Management: Patients may be prescribed medications and therapy to manage postoperative pain. Vital signs are closely monitored.
- Incision Care and Wound Healing: Different dressings and topical agents may be used for surgical wound care.
- Early Mobilisation and Physiotherapy: Moving around as soon as it is safe to do so helps in the healing process, and physiotherapy aims to improve one’s strength and range of motion in a safe and progressive manner.
- Introduction to Assistive Devices: In some cases, patients may require assistive devices such as crutches or walkers to aid in their mobility.
- Dietary Considerations: Patients normally return to solid foods within 24 hours post-surgery.
- Medication Management: Certain medications such as stool softeners, analgesics, antibiotics, anti-nausea medication, and anticoagulants may be prescribed, depending on the patient’s needs.
- Preparing For Discharge: Once cleared for discharge, patients will receive their prescriptions, medication counselling, and guidance on their recovery plan.
Transitioning to Home Care
Discharge Planning and Instructions
Key elements include assessing the patient's needs, coordinating with family and transport services, ensuring patient and family understanding, providing necessary medication, and offering follow-up care guidelines.
Managing Pain and Discomfort
Pain relief medication is prescribed based on a patient’s type of pain, pain level, and personal medical history. This may include one or more of the following nonsteroidal anti-inflammatory drugs (NSAIDs) help reduce pain and inflammation; as well as a range of pain relief medications (where suitable).
Follow-up Appointments
At the first follow-up appointment, the surgeon evaluates the surgical site, reviews the patient’s progress, and addresses any immediate concerns. X-rays or other diagnostic tests may be conducted to monitor healing.
Depending on the type of surgery, subsequent follow-up appointments will be scheduled at specific intervals to coincide with recovery milestones. During these appointments, the surgeon may adjust pain medications or other prescribed drugs in response to the patient's progress and pain levels. The surgeon will also address any concerns and provide further guidance on the recovery journey.
Rehabilitation and Physiotherapy
Physiotherapy is crucial for recovering strength, endurance, and flexibility after orthopaedic surgery. Since each patient is unique, the physiotherapist will tailor a customised exercise regimen that aligns with the patient's unique needs and recovery objectives. Generally speaking, these may include:
Types of Physiotherapy Exercises
Knee Surgery
- Thigh Squeezes
- Heel Slides
- Knee Bending Stretches
Shoulder Surgery
- Pendulum (Circular)
- Supported Shoulder Rotations
- Shoulder Extensions (Isometric)
Bunion Surgery
- Short-Foot Exercises
- Toe-Spread-Out Exercises
- Heel-Raise Exercises
Hip Surgery
- Supine Bridges
- Wall Squats
- Step Ups
Diet and Nutrition
Eating the right foods is crucial for regaining strength and aiding the body's healing after surgery. Since everyone's nutritional needs are different, it is crucial to consult a doctor for personalised post-surgery dietary advice. Generally, more calories, protein, fluids, vitamins, and minerals are needed during recovery.
- Protein-rich foods help wounds heal and build strength.
- Whole grains reduce inflammation and prevent constipation.
- Fruits lower inflammation, boost immunity, and aid wound recovery.
- Vegetables prevent constipation and reduce inflammation.
- Healthy fats provide energy, reduce inflammation, and control blood sugar.
- Iron-rich foods prevent fatigue and weakness.
- Calcium-rich foods strengthen bones, prevent blood clotting, and support muscle and heart function.
- Water is important for staying hydrated and preventing skin issues.
To speed up the recovery process, try to avoid certain foods that can hinder progress:
- Sugary foods can cause energy crashes and blood sugar levels to rise.
- Alcohol can reduce the potency of medicine and cause dehydration.
- Highly processed foods contain low nutritional value and may contain high levels of preservatives, sodium, fat, and sugar, which can lead to health problems.
Potential Complications
Keeping the wound dressing clean and dry is crucial during recovery. Immediate medical attention should be sought if signs or symptoms of infection or complications are experienced:
- Increased redness
- Foul odour
- Swelling or warmth
- Fever
- Discharges (Blood, pus, or fluids)
- Increased numbness or weakness
- Worsening pain
- Any unusual or prolonged symptoms that raise concern.
Early identification and treatment of complications support faster healing and prevent potential escalation of health issues.
Long-Term Recovery and Follow-Up Care
Orthopaedic surgery encompasses a wide range of procedures and the recovery process can vary depending on the specific type of surgery performed. For some patients, recovery takes a few weeks. For others, it can take several months. This is why it is important to consult with your orthopaedic surgeon as often as needed.
ThFollow-up appointments will address some of the following issues and possible concerns as patients progress with their rehabilitation and recovery.
References
- Akagi, I., Furukawa, K., Miyashita, M., Kiyama, T., Matsuda, A., Nomura, T., Makino, H., Hagiwara, N., Takahashi, K., & Uchida, E. (2012). Surgical wound management made easier and more cost-effective. Oncology letters, 4(1), 97–100. https://doi.org/10.3892/ol.2012.687
- Big toe joint exercises to restore movement after bunion surgery. (2019, August 12). The Orthopaedic Foot & Ankle Center. https://www.footankledc.com/news/big-toe-joint-exercises-to-restore-movement-after-bunion-surgery/85
- Briguglio, M., Wainwright, T. W., Southern, K., Riso, P., Porrini, M., & Middleton, R. G. (2023). Healthy eating for elective major orthopedic surgery: quality, quantity, and timing. Journal of multidisciplinary healthcare, 16, 2081–2090. https://doi.org/10.2147/JMDH.S415116
- Bunion: strengthening foot muscles to reduce pain and improve mobility. (2016). Journal of Orthopaedic & Sports Physical Therapy, 46(7), 606. https://doi.org/10.2519/jospt.2016.0504
- Choi, Y. S., Kim, T. W., Chang, M. J., Kang, S. B., & Chang, C. B. (2022). Enhanced recovery after surgery for major orthopedic surgery: a narrative review. Knee surgery & related research, 34(1), 8. https://doi.org/10.1186/s43019-022-00137-3
- Cluett, J., MD. (2022, July 18). Follow-Up appointments after knee or hip replacement surgery. Verywell Health. https://www.verywellhealth.com/follow-up-after-joint-replacement-surgery-4164748
- Going home. (n.d.). Singapore General Hospital. https://www.sgh.com.sg/patient-care/inpatient-day-surgery/discharge-time-and-procedures-singapore-general-hospital
- Hirsch, K. R., Wolfe, R. R., & Ferrando, A. A. (2021). Pre- and post-surgical nutrition for preservation Of muscle mass, strength, and functionality following orthopedic surgery. Nutrients, 13(5), 1675. https://doi.org/10.3390/nu13051675
- Home exercise program. Allina Health. (2000, January 10). https://www.allinahealth.org/health-conditions-and-treatments/health-library/patient-education/total-knee-replacement/after-surgery/knee-exercises
- Hong, L. B. (2023, September 7). How to eat well for post-surgery recovery. Mount Elizabeth Hospital. https://www.mountelizabeth.com.sg/health-plus/article/best-foods-post-surgery-diet
- How to prepare for hospital discharge in Singapore. (n.d.). Agency for Integrated Care. https://www.aic.sg/caregiving/prepare-hospital-discharge
- Madara, K. C., Marmon, A., Aljehani, M., Hunter-Giordano, A., Zeni, J., Jr, & Raisis, L. (2019). Progressive rehabilitation after total hip arthroplasty: a pilot and feasibility study. International journal of sports physical therapy, 14(4), 564–581.
- Medicines that may be used during your recovery after surgery. Allina Health. (2000, January 10). https://www.allinahealth.org/health-conditions-and-treatments/health-library/patient-education/total-knee-replacement/surgery-and-beyond/medicines-that-may-be-used-during-your-recovery-after-surgery
- Nutrition after Orthopedic Surgery. (2022, March 15). Reno Orthopedic Center. https://www.renoortho.com/specialties/general-orthopedic-surgery/nutrition-for-healing/
- Pain management after orthopedic surgery. (2022, July 5). Union Health. https://www.myunionhealth.org/blogs/pain-management-after-orthopedic-surgery
- Sampognaro, G, & Harrell, R. (2023). Multimodal postoperative pain control after orthopaedic surgery. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK572072/
- Shoulder surgery exercise guide. OrthoInfo. https://orthoinfo.aaos.org/en/recovery/shoulder-surgery-exercise-guide/
- Whitlock, J. (2022, January 8). These are the commonly used medications before and after surgery. Verywell Health. https://www.verywellhealth.com/drugs-used-before-during-and-after-surgery-3156830
- Why post-operative vital sign monitoring is critical. (2023, April 13). Sotera Digital Health. https://soteradigitalhealth.com/blog/why-post-operative-vital-sign-monitoring-is-critical
Dr Yung Shing Wai, Consultant Orthopaedic Surgeon: With his decades of specialist experience, Dr Yung is committed to providing not only high-quality, personalized and modern orthopaedic treatments; he also shares his knowledge by reviewing and contributing informative articles to provide patients with trustworthy and up-to-date orthopaedic insights.
