A companion's guide after a joint replacement

If someone you love is going to have a knee or hip replaced, you are probably their most important help in the first weeks. The treatment team does the surgery, but a large part of recovery happens at home. This guide is for you: the companion who stays beside the patient.

Before the operation

• Go to the visits. Write down the questions, note the answers, and if the patient is anxious, help them ask their questions.
• Medicine list and documents. Gather the names of medicines, long-term conditions, allergies, and earlier scans and reports.
• Get the house ready. Take up small rugs, make the bathroom non-slip, put frequently used things within reach, and freeze ready meals. The details are in the guide “Preparing your home”.
• Write down the help plan. Who stays with the patient for the first days? Who does the driving? Share the load between several people.

The day of surgery and the hospital

• After the anaesthetic the patient may be drowsy, confused or unwell. This is usually temporary.
• Ask the nurse when physiotherapy starts. The patient often has to stand and take steps very soon, even the same day. This is normal and helps prevent clots and aids recovery.
• Help them take painkillers on schedule and not hide their pain. If pain is not controlled, tell the nurse.
• At discharge, write down the instructions: medicines, physiotherapy, when stitches come out, restrictions, contact number. If you did not understand something, ask.

The first weeks at home

Movement

The patient must walk every day and do the exercises the physiotherapist has given. Your role is to be beside them, encourage them, and not let them sit or lie down too much. But do not push. If swelling or pain increases, rest and keeping the leg raised help. Sources warn against doing “too much, too soon”.

Avoiding falls

Falls are one of the main risks in the first few weeks. Help to make sure that:

• Routes are free of obstacles and well lit
• The patient wears closed, non-slip shoes
• The walker or stick is always close by
• They are never alone on the stairs or in the bathroom (especially in the first week)

Wound care

Until the treatment team allows it, the wound must stay dry. Look at it every day: redness, swelling, discharge or smell. Wash your hands. Do not change the dressing without instruction. The details are in the guide “Caring for your wound”.

Special movements after a hip operation

After a hip replacement it is usually necessary for a few weeks to avoid certain positions, such as crossing the legs or bending too far. The surgeon gives the exact list. You remind and help, for example by putting on their socks or picking things up from the floor.

Driving and transport

The patient must not drive for a few weeks, and the surgeon must give permission. Arrange transport to physiotherapy and visits.

Which signs should you watch for?

Companions sometimes notice a change before the patient does. Tell the treatment team at once if:

• The patient has a temperature or shivers
• The wound is red, hot, swollen or has discharge
• The calf has pain, cramp or new swelling, or has become red and hot
• Pain is getting worse and is not controlled by painkillers
• After a hip operation, the shape or length of the leg has suddenly changed, or the patient cannot put weight on it
• The patient has fallen or been knocked

Call 115 at once (the emergency number in Iran) if the patient has sudden shortness of breath, chest pain, coughing up blood, fainting or confusion. A clot may have reached the lung. Do not drive yourself, and take their medicines with you. The details are in the guide “When should I call urgently?”.

Mood may change after the operation

Some patients become sad, low in energy or anxious after the operation, especially when recovery is slower than expected. Listening to them helps. Remind them that recovery takes months and has good days and bad days. If sadness or lack of motivation becomes severe and lasts long, talk to the doctor.

Look after yourself too

Caring for a patient is tiring. So that you do not run out of energy:

• Share the work and ask others for help
• Sleep, eat properly and get out a little
• If you are tired or anxious, talk to someone
• Do not commit beyond your ability. If needed, ask about home nursing or the hospital social worker

Summary

You do not take the place of the surgeon and physiotherapist, but you are the patient’s second pair of eyes and hands. By watching for signs, helping with movement and preventing falls, you make recovery safer. Each patient’s exact plan is set by their own treatment team.