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I fell after my joint replacement. What should I check first?
Take a breath. Most falls after a knee or hip replacement cause soreness and a scare, not damage to the new joint. Then check two things.
1. The incision. In the first weeks, the incision is held together by stitches while it heals. A fall directly on it can pull it open. If the incision has opened, or it is draining more than before, it needs to be seen right away.
2. The leg. Does it look normal? Can you put some weight on it? A dramatic change, such as a leg that suddenly looks shorter or turned, or one you cannot put any weight on, needs to be checked the same day.
When is it okay to watch it at home?
If the incision is intact and nothing about the leg looks dramatically different, it is reasonable to see how you feel over the next 6 to 12 hours. Expect soreness; you just fell. Rest, ice with a barrier on your skin, and then gradually try putting weight on the leg again.
If you are steadily improving over those hours, that is reassuring. If the pain is getting worse, or you still cannot bear weight, call.
Do I need an X-ray after a fall?
Not always. Many falls do not need one. An X-ray makes sense if:
- You suddenly cannot put weight on the leg, or
- Even gentle movement of the joint is difficult
And any time you are worried, an X-ray is a reasonable thing to ask for.
What can a fall actually do to a joint replacement?
The thing surgeons worry about most after a fall is a fracture of the bone around the implant. The implant itself is very strong; the bone holding it is what can break.
A hard fall could, in theory, loosen an implant, but that is a smaller concern.
After a hip replacement, there is one more thing to watch for: dislocation, when the ball comes out of the socket. It usually comes with a fall and a leg that ends up in an abnormal position: shorter, or turned in or out, with severe pain and no ability to bear weight. That is an emergency. More on what happens next in dislocated hip replacement.
“The thing we worry about most with a fall is breaking the bone around the implant. It could theoretically loosen the implant, but we worry about that less. With a hip, there’s the special concern of dislocation, which usually comes with a fall and an abnormal position of the leg. So that’s something to watch for.”
Should I call my surgeon or go to the emergency room?
Go to the emergency room, or call 911, for a hip that looks dislocated, a leg you cannot move at all, a bone that looks deformed, or a head injury from the fall.
For almost everything else, call us first. Our clinic number is answered 24 hours a day; after hours it reaches the on-call provider. That provider may not have every detail of your case, but calling is better than going straight to the ER. During the day, you reach the team that knows your surgery best.
And if you’re worried, I’m worried. You never need a perfect reason to call.
How do I avoid falling after joint replacement?
The best treatment for a fall is not having one. Two habits prevent most early falls.
Use your walker until you are steady, then your cane. Everyone starts on a walker after surgery, for balance, not because the new joint cannot take your weight. Keep using it until you are truly steady, then move to a cane. More on when to switch in walker or cane.
Pause before you move. When you get up from lying down or from a chair, stand for a second before you walk. In the early days after surgery your blood pressure can dip when you stand, and your muscles need a moment to be ready.
Setting up the house before surgery helps too: clear paths, good night lighting, and nothing to trip on between the bed and the bathroom. See preparing your home.
“The key is to not fall. That’s why we start everybody on a walker, for balance, and I encourage them to use it until they’re nice and steady before going to a cane. And when you get up from lying down or sitting, give yourself a second. Your blood pressure and your muscles need a moment to be ready.”
Joint replacement care in Franklin, Nashville, and Middle Tennessee
I perform hip and knee replacements at the Bone and Joint Institute of Tennessee in Franklin, on the Williamson Health campus, for patients from Franklin, Brentwood, Nashville, Spring Hill, Nolensville, Murfreesboro, and across Middle Tennessee. If you have fallen and are not sure what to do, call us.
This article is for educational purposes only and does not replace personalized medical advice. If you have fallen and are unsure what to do, contact your own surgical team. In an emergency, call 911.
