We examined the effect of telephone follow-up on surgical orthopedic patients' postdischarge recovery. The sample consisted of 438 patients randomly assigned to receive routine care with or without telephone follow-up 24 to 72 hours after discharge (intervention). During the intervention, the nurse caller assessed each patient's status, identified problems, and provided needed follow-up care. Structured telephone interviews were conducted with all participants during the third week after their discharge. Key outcomes were self-reports of problems, progress, and unanticipated contact with the health care system. The primary self-reported problems were mood changes, constipation, pain, and swelling. Women and younger participants tended to report more problems. Availability of help was positively associated with progress. Although telephone follow-up did not affect the first two outcomes, it was associated with increased occurrence of health care contacts, as was living farther from the hospital. The study findings highlight the need to clearly explicate the requirements and outcomes for nurse-initiated telephone follow-up programs.