From the Guidelines
On day one after joint surgery, patients should be mobilized actively from the morning and encouraged to meet daily targets for mobilization. This approach is supported by the most recent and highest quality study available, which emphasizes the importance of early mobilization in postoperative care 1. The study suggests that early accelerated rehabilitation, characterized by joint mobilization and weight-bearing within 3 days after surgery, should be the mainstream approach in isolated joint surgeries.
When considering postoperative management, it's essential to prioritize pain management, gentle movement, and rest as tolerated. Patients should take prescribed pain medications as directed, typically every 4-6 hours as needed, and supplement with non-prescription medications like acetaminophen and NSAIDs if approved by their surgeon. Applying ice to the surgical site for 20 minutes every 2-3 hours can help reduce swelling and pain.
Key aspects of postoperative care include:
- Keeping the surgical dressing clean and dry
- Following the surgeon's specific instructions regarding wound care
- Beginning prescribed gentle range-of-motion exercises if instructed
- Avoiding putting weight on the joint unless specifically permitted
- Elevating the affected limb above heart level when resting to minimize swelling
- Staying hydrated and eating nutritious foods to support healing
It's crucial to watch for warning signs, including excessive pain, fever above 101°F, unusual drainage, increasing redness, or numbness in the extremity, and contact the healthcare provider immediately if these occur. Early post-operative care is vital for preventing complications and establishing the foundation for successful rehabilitation, as highlighted in the study 1.
From the Research
Day One Joint Post-Op Pain Management
- Postoperative pain management is a crucial aspect of patient care, with nearly 20% of patients experiencing severe pain in the first 24 hours after surgery 2.
- Multimodal pain regimens (MPRs) are recommended for effective pain management, combining different agents and modes of delivery to address pain at various levels of the pain pathway 3, 4.
- MPRs may include a combination of:
- Acetaminophen
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Gabapentinoids
- Opioids (short- and long-acting)
- Spinal/epidural analgesia
- Regional nerve blocks
- Local anesthetics
- The use of perioperative acetaminophen has been shown to decrease opioid consumption and improve overall pain control in patients undergoing rotator cuff repair 5.
- Naproxen, an NSAID, has been found to have significant efficacy in treating pain following different surgical interventions, eliminating or reducing the use of rescue opioids in many trials 6.
- Effective postoperative pain management should be tailored to the individual and the surgical procedure involved, taking into account the patient's biological, psychological, and social dimensions of the pain experience 4, 2.