Anyone considering a total knee replacement is wondering what they should expect after the surgery is completed. While everyone’s experience is unique, this is a basic idea of the process of recovery.
In most cases you will start working with physical therapy the day of surgery or the very next day. The first step seems simple but is literally your first step towards proper healing, that first step is the physical therapist getting you out of bed. It may seem hard to believe but you will be able to put full weight on your operative leg. However, we will start you out using a walker for balance.
One of the most important steps in your path to healing is having the ability to completely straighten your leg. For this reason you will not be able to place a pillow below your knee, but you will be able to elevate your leg with a pillow under your ankle. While it may seem like a good way to lessen the pain, putting a pillow under your knee will keep it slightly bent. Since you will be in a chair much of the time you are awake you will have it bent then too. So if your knee bent most of the time, it will contribute to making it more difficult for you to straighten it fully as you heal.
Pain control is important for your recovery and will enable you to participate more fully in physical therapy. People respond differently to medication, so we ask you to let us know how the pain medicine is working. The goal is to find the right medicine for you so that we can minimize your pain while maximizing your ability to do your physical therapy. So don’t get discouraged if you are having pain issues, just let us know and we can always make changes.
Unless told otherwise you will be able to shower after your surgery and it is okay to get your incision wet. This is as long as you do not submerge the incision as you would taking a bath, sitting in a hot tub, or swimming.
It is important NOT to take any non-steroidal anti-inflammatory medications (such as Advil, Motrin, or Aleve) because these can thin the blood and cause bleeding problems. This includes the generic forms like ibuprofen and naproxen or anything containing them. So be sure to check any over the counter medications before you take them to see if they contain these as ingredients. If you ever have any questions just call us!
Generally, most patients stay in the hospital 2-3 days after a total knee replacement. Of course your stay will depend on how well your recovery is going, based on the condition of the wound and milestones reached in physical therapy.
After Being Discharged from the Hospital
I have found that most of my patients are able to get around well 2 weeks after surgery. In most cases total knee replacement patients are able to get back to walking without any aids or assistance after 6 weeks. Patients can expect to continue to see improvements for a full year after the replacement.
For the first 4-6 weeks after surgery you will need to wear tight stockings (TED hose) until the swelling of your leg resolves. This keeps fluid from pooling in your legs and also helps to prevent blood clots. Additionally, you will also be placed on a blood thinning medication for about 3 weeks after surgery. This too is a preventative measure to help prevent blood clots.
In general, most patients qualify for home health care after a total knee replacement. The social worker and case managers at the hospital will talk to you about this and help set it up for you. Once it is arranged, a physical therapist (or possibly occupational therapist and nurse) will come to your house for the first few weeks after surgery to help you with your rehabilitation.
You will follow-up with me about 2 weeks after your knee replacement and we will remove the staples at that first visit.
Things to remember:
1. If you notice any fever (greater than 100.5°), increasing drainage from the incision, or have any other concerns, we want you to call us!
2. Remember NOT to take any non-steroidal anti-inflammatory medications (such as Advil, Motrin, or Aleve) to lessen the chance of bleeding until we let you know that it is okay to do so.
3. Keep in mind that everybody heals differently, but the timeline I have outlined here is based on averages, so some people move along faster and some take more time.