The Joint Replacement Home Handoff Passport: What the Next Clinician Should Not Have to Guess

After a knee, hip or shoulder replacement, the people caring for you at home start with only what you hand them. This guide sets out a ten-section handoff passport, with special attention to medicines, the wound, activity orders and warning signs, and explains how to collect it before you leave hospital.

Who the "next clinician" actually is

After a joint replacement, the surgeon who operated is rarely the only person who looks after you. In the first weeks you may see a physical therapist, your primary care doctor, a nurse checking the wound, a pharmacist filling a blood thinner, and possibly an urgent care or emergency doctor if something worries you at night. If the surgery happened in another city or another country, every one of those people starts with nothing but what you hand them.

A handoff passport is that hand-off: a short, organized packet that lets each of them understand what was done, what you are taking, what you are allowed to do and who to call, without phoning a hospital abroad or reading a chat history. The builder above produces a one-page cover sheet. This guide covers what should sit behind it.

The CDC's medical tourism guidance recommends requesting copies of overseas medical records in English and sharing them with follow-up providers, and cites American College of Surgeons advice to obtain a complete set of records before returning home (CDC Yellow Book, 2026). The passport is a way of making that advice concrete.

The passport, section by section

The implant record has its own guide, your joint implant passport, because it matters for decades rather than weeks. The rest of this page focuses on the sections that matter most in the first months.

The medication plan: the page most likely to be wrong

Discharge medicines change fast and often come with verbal instructions that are forgotten by the time you land. Ask for a written list that names each drug, the dose, how often, why it was prescribed and the date it should stop. Pay special attention to clot prevention. After hip replacement, MedlinePlus describes blood thinners for 2 to 4 weeks and compression stockings for about 6 weeks, as directed by the surgeon (MedlinePlus, reviewed 2024). Your own surgeon's plan may differ, which is exactly why it needs to be written down.

Include the medicines you were taking before surgery and note which were paused, which were restarted, and when. If a medicine prescribed abroad is sold under a different brand name at home, write the generic name next to it so your pharmacist can match it.

The wound plan

Your home clinician needs to know how the incision was closed. MedlinePlus says stitches or staples after hip replacement are removed about 10 to 14 days after surgery (MedlinePlus, reviewed 2024). For knee replacement, OrthoInfo notes that sutures placed under the skin do not need to be removed (AAOS OrthoInfo, 2026). The passport should say which you have, who is expected to remove them and on what date, plus the dressing and showering instructions you were given.

Activity orders the physical therapist will ask about

A therapist cannot safely progress your exercises without knowing what your surgeon allows. MedlinePlus advises not putting full weight on a new hip until the surgeon says it is OK, and describes avoiding bending the hip past 90 degrees (MedlinePlus, reviewed 2024). Precautions vary by surgeon and approach, so the passport should state:

• Weight-bearing status for the operated leg, in the surgeon's words.
• Any movement precautions and when they will be reviewed.
• The walking aid you were discharged with.
• Range-of-motion or strength targets, if the surgeon set any.
• Anything you must not do, such as driving, until a named review visit.

Warning signs, mapped to a phone number

A list of warning signs is only useful if it also says who to call. MedlinePlus lists reasons to contact the surgeon after hip replacement, including a fever above 101°F (38.3°C), redness, increasing pain or drainage at the incision, calf pain or leg swelling that is red and warmer than the other leg, chest pain or shortness of breath, and a fall or a feeling that the hip has slipped out of position (MedlinePlus, reviewed 2024). For each, the passport should give a route:

• Emergency now: chest pain or sudden shortness of breath. Local emergency services first, then tell the surgical team.
• Same day: wound changes, fever, calf pain or swelling, a fall. Name the home clinician who has agreed to see you, plus the surgical team's contact.
• Routine: medication questions, therapy progression, paperwork. Name who answers and how quickly.

Write the time-zone difference next to any number abroad. It saves a confused call in the middle of the night.

Getting the records: ask before discharge, not after

The easiest moment to collect the passport is while you are still in the hospital and the people who wrote the records are nearby. Ask on admission what will be included in your discharge packet, in which language, and in what format. Request the operative report and imaging on a disc or as a download, not only printed summaries.

In the United States, HHS explains that patients generally have the right to inspect and get copies of their medical and billing records, that a provider may charge reasonable copying and mailing costs, and that records cannot be withheld because a bill is unpaid (HHS, reviewed 2025). Rules in other countries differ, so if you are having surgery abroad, ask the hospital directly how and when records are released, and get that answer before you pay a deposit.

Gaps to check before you leave the ward

Discharge packets are often written for the hospital's own follow-up, not for a clinician somewhere else. Before you leave, check the folder for these common gaps:

• A medication list with no stop dates, or with brand names only.
• "Usual precautions" with no description of what they are.
• No mention of how the wound was closed.
• Images described in a report but not supplied.
• A phone number for the hospital switchboard instead of a person or team who knows your case.

Each of these takes minutes to fix while you are still there and much longer from home.

Book the home side before you leave

A passport needs someone to receive it. Before surgery, confirm which home clinician will see you after you return and when, whether your physical therapist can start on the date you land, and whether your home orthopedist is willing to take on follow-up for an operation done elsewhere. If anyone says no, you want to know that while you can still change the plan. The caregiver task map can help you assign who chases each appointment.

Format: one folder, two copies

• A printed folder in your carry-on, with the cover sheet on top.
• A single digital file (or a small set of clearly named files) on your phone and with your caregiver.
• Imaging on a disc or download link, with the reports printed.
• Translations clearly marked as translations, kept alongside the originals.

Keep the folder where your caregiver can find it. If you end up in an emergency room, it is more useful in their hand than in your suitcase.

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Orthopedic lead network