Total Knee Replacement Surgery
After Total Knee Replacement Surgery
Expect to spend about three days in the hospital for surgery and recovery. In most cases, you will not be released until you have reached certain milestones: standing, getting around with the assistance of a walking device, and sufficiently flexing and extending your knee. Patients who have issues with mobility or other complications may sometimes stay as long as five days, but others can be released from the hospital in as little as 2.5 days.
In the Recovery Room
After surgery, you will be transferred to a recovery room as you are eased out of anesthesia. At this point, you will receive pain medication. Initially, the medication will be delivered via an intravenous (IV) tube and later either through injections or orally. You will also receive blood-thinners to prevent blood clots from forming in the veins in your thighs and calves. In addition, because you may be physically unable to get up to use the restroom for a short time, your doctor may provide you with a catheter during and immediately after surgery.
Normal/Minor Side Effects
You may feel somewhat nauseous and constipated following the surgery. This is a normal result of anesthesia, and typically lasts for a day or two. If so, your doctor may give you laxatives or stool softeners. Also, you will be asked to do breathing exercises after surgery in order to avoid fluid buildup and keep your lungs and bronchial tubes clear.
After surgery, you will wear a bulky dressing over your knee in order to keep it from being disturbed as it sets. You will also be fitted with a drain to remove fluid buildup around the wound. In most cases, your doctor will remove the drain after a couple of days.
Preventing Blood Clots
Orthopedic surgeons often recommend pedaling your feet in the air (as though riding an invisible bike) and moving your ankles while you’re lying in bed after surgery. This helps improve blood flow to your knee and reduce the chances of a blood clot in your leg, referred to as deep vein thrombosis (DVT). You will likely be asked to wear compression hose or a special stocking in order to further minimize the risk of clots.
Your doctor or physical therapist may recommend that you use a continuous passive motion (CPM) machine. In fact, the odds are high that you will exit the recovery room with your leg in this machine. As the name suggests, this device continuously bends and straightens your knee while you lie flat and do nothing. In addition to aiding blood flow around your knee and reducing the formation of scar tissue, it is designed to help your artificial knee achieve the desired range of motion (flexion and extension angles). The amount it bends your knee is adjustable, and can be increased gradually.
Getting Back on Your Feet
Set a goal to get up on your new knee as soon as possible. A physical therapist will assist you in standing and moving around no later than the day after surgery. The stronger your muscles, the more equipped you will before rehabilitation. So, if recommended by your doctor or physical therapist, it is important that you do what you can to build muscle strength prior to surgery with the recommended pre-surgery exercise.
Your physical therapy regimen will begin immediately after the surgery. In addition to helping you stand up as soon as possible and use the CPM machine, a physical therapist (PT) will visit you in your hospital room several times and record your progress with mobility, range of motion, and exercise. It is important to get the most from inpatient PT visits. The sooner you begin your rehabilitation, the better your chances for a successful outcome and a speedier recovery.
After you are discharged from the hospital, it’s important to resume normal activities as soon as possible. Try to get in and out of bed by yourself, work on bending your knee and fully straightening it, and attempt to walk for long periods (as long as possible), even if it is with crutches or a walker. Attend all of your prescribed appointments with your physical therapist (PT) over the next two months or so, and be consistent about doing the exercises your PT has prescribed on your own.
Follow Up With Your Doctor
If at any point your wound looks or feels like it is not improving (i.e. redness or inflammation), or if your body temperature rises or you don’t feel well—including suffering from chest pains or shortness of breath—consult your doctor immediately. Also, be sure to follow up with your doctor if you have any issues with your knee or sense something is wrong. Note that most post-TKR complications occur within six weeks of surgery, so be vigilant in the early weeks.
Expect to stay in touch with your surgeon in the future. The frequency of follow-up appointments depends on the surgeon, the medical institution, the patient, and insurance plan. However, a typical scenario would be a surgical follow-up appointment at six weeks, three months, six months, one year, two years, five years, 10 years, and thereafter as appropriate. This is modified for each patient based on age, degree of activity, and any complications.
Back to Normal
Expect to resume everyday activities such as driving, working, and sexual activity within four to eight weeks of surgery. It’s important to stay on your exercise and rehab program but also to not overexert yourself. It might take six months to a full year to get back to the activity level you desire. Make sure you are aware of the dos and don’ts after knee replacement, including avoiding high impact activities.Your goal is to ensure the long-term success of your implant and surgery.
Elevate the knee, apply an ice pack, and use the CPM at home, per your doctor’s suggestions. Continue to take all medications prescribed by your doctor. Do not stop taking antibiotics, blood thinners, and other meds simply because you feel better—doing so could slow your recovery orcause a setback. Wear compression hose for as long as your doctor deems necessary after surgery. Lastly, communicate with your doctor about how to manage post-operative pain.