What Happens After Total Knee Replacement Surgery?

Medically reviewed by William Morrison, MD on December 12, 2016Written by Samuel Greengard and Tricia Kinman

Overview

The number of total knee replacement (TKR) surgeries has tripled during the past 20 years, according to the American Academy of Orthopaedic Surgeons. Having an idea of what’s coming after this surgery can help you prepare for it. Read more to learn about what to expect from your hospital stay and beyond.

In the hospital

Expect to spend about three days or less in the hospital for surgery and recovery after total knee replacement. In most cases, you won’t be released until you have reached certain milestones.

These milestones include:

  • standing
  • getting around with the assistance of a walking device
  • sufficiently flexing and extending your knee

Those who have issues with mobility or other complications sometimes stay longer. Others may be released from the hospital in as little as two days. In some centers, the surgery is done on an outpatient basis.

After surgery, you’re transferred to a recovery room as you’re eased out of anesthesia. At this point, you receive pain medications as necessary. The medications are initially delivered via an intravenous tube and later either through injections or orally. You also receive blood thinners to prevent blood clots from forming in the veins in your thighs and calves.

A large, bulky dressing may be applied in the operation room to help control swelling. A drain to remove fluid buildup around the wound may be inserted during your operation. In most cases, your doctor will remove the drain after two to four days.

Dealing with side effects of TKR surgery

Possible side effects from TKR surgery include:

  • nausea and constipation
  • fluid buildup in your lungs
  • blood clots

Nausea and constipation

You may feel somewhat nauseated and constipated following your surgery. This is a normal result of anesthesia. It typically lasts for a day or two. If so, your doctor may give you laxatives or stool softeners.

Breathing exercises

Your doctor or nurse will show you breathing exercises that you need to do after surgery. This helps to avoid fluid buildup and keep your lungs and bronchial tubes clear.

Blood clots

The American Academy of Orthopaedic Surgeons recommends moving your ankles and doing some small leg-lift exercises 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. You may be asked to wear compression hose or a special stocking to cut down on the risk of clots.

Physical therapy regimen after TKR surgery

Your physical therapy regimen will begin immediately after your surgery. In addition to helping you stand up as soon as possible, a physical therapist (PT) will visit you in your hospital room several times and record your mobility, range of motion, and exercise progress. It’s important to get the most from inpatient PT visits. The sooner you begin your rehabilitation, the better your chances for a successful outcome and speedy recovery.

Rehabilitation at home

It’s important to resume normal activities as soon as possible after you’re discharged from the hospital. Try to get in and out of bed by yourself, and work on fully bending and straightening your knee. You should also take walks for as long a period of time as possible, even if you need to use crutches or a walker.

Elevate your knee and apply an ice pack per your doctor’s suggestions.

Attend all of your appointments with your PT. Be consistent about doing the exercises your PT has prescribed on your own.

Also, continue to take all medications prescribed by your doctor. Don’t stop taking antibiotics, blood thinners, or other medications simply because you feel better. Such medications should be stopped only on the advice of your physician.

Wear compression hose for as long as your doctor thinks is necessary after surgery.

Lastly, communicate with your doctor about how to manage post-operative pain.

Follow-up for TKR surgery

If at any point your wound looks or feels like it isn’t improving (for example, there is redness or inflammation), talk to your doctor immediately. Also contact your doctor if your body temperature rises or you don’t feel well — including suffering from chest pains or shortness of breath.

In addition, 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 for the next year. The frequency of follow-up appointments depends on your surgeon, medical institution, and insurance plan, as well as your specific condition. However, a typical scenario would be a surgical follow-up appointment at three and six weeks, three and six months, and one year. After that, expect to see your doctor annually to assess how well your new implant is doing. This schedule will be modified based on your age, degree of activity, and any complications.

Resuming activities after TKR surgery

Expect to resume everyday activities such as driving, working, and sexual activity within three to six weeks of surgery, according to USCF Medical Center. It’s important to follow your exercise and rehab program without overexerting yourself. It might take six months to a full year to get back to the activity level you desire.

Takeaway

Make sure you’re aware of the dos and don’ts of recovering from TKR surgery before you undergo the procedure. This includes avoiding high-impact activities and staying on top of your physical therapy. Your goal is to ensure the long-term success of your implant and surgery. If you have any questions or concerns about your recovery, consult your doctor.

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