Pain Medications
Dr. Zalikha uses a multimodal pain management protocol designed to minimize opioid use while keeping you comfortable enough to participate in physical therapy.
Wound Care
Your incision is closed with a layered technique and covered with a sterile dressing.
- Keep the dressing clean and dry for the first 48 hours after surgery unless instructed otherwise
- After dressing removal: you may shower and allow water to run over the incision. Do not scrub, soak, or submerge the incision in water (no baths, pools, or hot tubs) until the wound is fully healed (typically 3 to 4 weeks)
- Pat the incision dry gently after showering
- Do not apply lotions, creams, or ointments to the incision unless directed by Dr. Zalikha's office
- Staples or sutures are typically removed at your first post-operative visit, approximately 2 weeks after surgery
Signs of wound problems to report:
- Increasing redness, warmth, or swelling around the incision
- Drainage that is cloudy, thick, or foul-smelling
- Wound edges separating
- Fever above 101.5°F
Medication Management
Scheduled medications:
Take your pain medications on the prescribed schedule for the first several days, rather than waiting until pain becomes severe. Staying ahead of the pain is essential
Transition to over-the-counter:
Most patients transition from prescription pain medication to acetaminophen and/or ibuprofen within 7 to 14 days. Wean off prescription medications as comfort allows
Ice:
Apply ice to the surgical area for 20 minutes at a time, multiple times per day. Ice is one of the best pain management tools and has no side effects
Blood Clot Prevention
- A blood thinner (anticoagulant) will be prescribed for a period after surgery (typically 2 to 4 weeks) to reduce the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE). Take this medication exactly as prescribed. Additional measures to prevent blood clots:
- Walk regularly. Do not stay in bed or sit for prolonged periods
- Perform ankle pump exercises frequently (pumping the foot up and down)
- Wear compression stockings if provided
- Stay hydrated
Other Medications
- Continue your regular home medications unless Dr. Zalikha or your primary care physician instructs otherwise
- If you were taking blood thinners before surgery, follow the specific instructions provided for when to resume them
Activity Guidelines
Walking
- Walk multiple times per day, starting the day of surgery
- Use your walker or cane as instructed. Do not try to walk without it until cleared
- Gradually increase walking distance as tolerated
- Walk on flat surfaces initially; stairs can be navigated with instruction from your physical therapist
Stairs
- Use the railing for support
- Lead with the non-operative leg going up ("good leg goes up to heaven")
- Lead with the operative leg going down ("bad leg goes down to... the other place")
- Take one step at a time initially
Sleeping
- You may sleep in any comfortable position
- A pillow between the legs may be comfortable, especially in the first week
- Many patients find sleeping on their back or non-operative side most comfortable initially
Driving
- Do not drive while taking narcotic pain medication
- Left hip or knee replacement: many patients resume driving an automatic transmission vehicle at 2 to 3 weeks
- Right hip or knee replacement: typically 4 to 6 weeks
- Resume driving only when you can react safely in an emergency situation
Return to Work
- Sedentary/desk work: 2 to 4 weeks for many patients
- Light-duty work: 4 to 6 weeks
- Moderate-duty or physical work: 6 to 12 weeks
- Heavy labor: 3 months or longer, depending on the job requirements
Specific return-to-work timelines are discussed during your post-operative visits.
Exercise and Physical Therapy
Exercises are essential for recovery. Perform your prescribed exercises as directed, typically two to three times daily.
- Begin exercises the day of surgery
- Follow the prescribed rehabilitation protocols provided by Dr. Zalikha’s team
- Outpatient physical therapy typically begins within the first 1 to 3 weeks after surgery
- Consistency matters more than intensity. Regular, moderate exercise is better than occasional aggressive sessions
Detailed rehabilitation programs are available on the rehab protocols page. Recovery timelines are described on the hip replacement recovery and knee replacement recovery pages.
Swelling Management
Swelling is expected after joint replacement and can persist for weeks to months. It is most pronounced in knee replacement patients.
- Ice: 20 minutes on, 20 minutes off, multiple times daily
- Elevation: Elevate the leg above heart level when resting (especially important in the first 2 weeks)
- Compression: Wear compression stockings as recommended
- Movement: Walking and ankle pumps promote circulation and reduce swelling
When to Call Dr. Zalikha’s Office
Contact (562) 362-5024 if you experience:
- Temperature above 101.5°F
- Increasing pain or swelling that is getting worse rather than better
- Redness, warmth, or drainage from the incision
- Calf pain, swelling, or tenderness
- Shortness of breath or chest pain (call 911 if severe)
- Any sudden change in your condition
Follow-Up Schedule
2 weeks:
First post-operative visit. Wound check, staple/suture removal, X-rays, review of progress
6 weeks:
Progress evaluation, activity advancement, review of X-rays
3 months:
Functional assessment, continued activity guidance
1 year:
Annual follow-up with X-rays
Annually thereafter:
Periodic monitoring of the implant with X-rays
For questions after your surgery
Contact Dr. Zalikha’s office at (562) 362-5024.