Post-Operative Instructions for Total Knee Replacement
- After Surgery
You will remain in bed until the evening or the first day after surgery. While you are in the hospital bed, you should perform deep breathing and coughing to prevent congestion in your lungs. These exercises should be performed every hour while you are awake.
After surgery, we do several things to reduce the risk of blood clots forming in the veins of your legs. We may place you on medication to thin your blood to reduce the risk of clot formation. In addition, you will perform exercises in bed to maintain the blood flow in your legs and to keep your heart and muscles strong. Pump your feet up and down 20 times each hour while awake.
- Pain Medication
After surgery the operative site will be significantly painful for the first one or two days. You will be able to control your pain with the PCA. This is a machine that releases strong pain medication into your I.V when you press a button. More traditional methods of pain management, such as intermittent injections of medication, can be provided instead of a PCA.
After two days, the PCA or injections should no longer be necessary and oral medications will provide satisfactory pain relief. You will be given a prescription for pain medication when you are discharged from the hospital.
- Dressing & Sutures
The postoperative dressing will remain in place for two or three days unless it becomes soiled. After the initial dressing is removed, it will be replaced with a dry gauze dressing daily until all drainage stops (approximately three to six days after). The staples will be removed approximately 7-14 days after the surgery. This may require you to return to the surgeon’s office for staple removal after discharge from the hospital. It is common to feel some superficial numbness on the outside part of the knee, and this may persist for several months. You should keep your wound dry until after the staples are removed. If you note any new redness, swelling or drainage from your incision, please call the office.
Your temperature may be slightly elevated for several days after surgery. However, if fever persists above 101°F and is accompanied by chills, sweats, increased pain or drainage at the incision, you should call the office. These may be signs of infection.
Swelling in the operative leg is normal after knee replacement. Normal swelling is reduced in the morning when awakening, and gradually accumulates throughout the day as you are active and on your feet. This can be reduced by elevating your legs. Any activity that leaves your feet on the floor, such as sitting in a chair or walking can lead to swelling.
- Physical Therapy
The primary objective of knee replacement is to eliminate your knee pain in order to allow you improved mobility. Physical therapy will begin on the first day after surgery. It is important to follow the instructions carefully while you are in the hospital and after you are discharged. The continuous passive motion (CPM) machine is an important piece of equipment for your rehabilitation. You may bear your full weight on the operative leg, as tolerated. The use of a walker or cane is helpful while you regain strength in the leg.
Getting out of bed begins the day after surgery. You will begin walking with a walker. You may bear as much weight as tolerable. Remember, walking is one of the best exercises for your rehabilitation.
- Activities During Rehabilitation
You should not drive for at least 6 weeks after surgery. When ascending or descending stairs, use the handrail or banister for stability. Lead off with your good knee to go up stairs, and lead with your operative leg to go down stairs. Go up or down stairs one at a time. You will not be able to take a bath for 6 weeks. Plan to use a shower or sponge bath at home. A shower seat may also be useful if applicable to your bathroom.
Prior to any dental, urological, gastrointestinal or surgical procedure you must notify your doctor that you have a joint replacement. You may need to take antibiotics to protect the joint replacement from infection.
If you have any further questions or concerns, please feel free to contact the office.