Post-Operative Care for Total Knee Replacement Surgery

Total knee replacement is a common surgical procedure, with hundreds of thousands of adults having the operation each year. It is a major procedure and recovery will not occur overnight. Post-operative care following knee replacement begins immediately and involves basic wound care, a step-wise activity regimen, and prevention of complications.

Hospital Stay

• Most patients stay in the hospital for three to seven days following total knee replacement surgery. You will be able to go home when the surgeon believes your joint is stable, you are able to sufficiently bend and straighten the leg, and you can demonstrate an ability to perform an initial exercise regimen.

Wound Care

• You will have an incision over your knee that has been closed with sutures and wrapped with dressing. The sutures will generally be removed between one and two weeks after surgery. In the meantime, the wound site should remain clean and dry. Do not shower or bathe the joint until the sutures have been removed. Instructions for changing the dressing will be provided before your discharge from the hospital.

Pain

• Expect to experience discomfort, including some pain, after total knee replacement. Aches and soreness are common as you progress through recovery, but your pain should not prevent you from performing your physical therapy regimen. Medication will be prescribed to alleviate some of your discomfort. Take this medication as prescribed and notify your doctor if you feel your pain is not under control.

Medications

• In addition to pain medication, you will be given antibiotics and a blood-thinning drug after surgery. These medications are designed to prevent some of the complications of knee replacement surgery. You will receive written instructions about how and when you should be taking each medication. Following those instructions is important for your recovery.

Activity

• Your activity in the weeks after surgery will be limited. Physical therapy begins immediately and is designed to protect the knee joint, improve strength, and facilitate recovery. You will work with a physical therapist to determine the best activities to perform with assistance and at home. These activities occur in a step-wise fashion, gradually increasing the workload placed on the knee joint. Physical therapy is critical to your recovery, but bear in mind that your knee is healing. Working the joint too hard could lead to further injury that will ultimately hurt your recovery.

Complications

• Complications are uncommon. The most serious are infection and blood clots. Signs of infection include fever, prolonged swelling/redness of the joint, excessive drainage from the wound site, and pain that did not previously exist. Blood clots that develop in the leg can travel to the lungs and cause shortness of breath, chest discomfort, or a fast heartbeat. Other complications include loosening of the prosthetic knee, fracture, and knee instability. These will generally cause pain and difficulty progressing through your physical therapy program. If you are concerned that you are experiencing any of these complications, call your doctor immediately.

Follow-up

• After you are discharged home, you will meet with your doctor to discuss your progress. Follow-up appointments are important since they allow your doctor to assess the stability of your prosthetic knee and address any concerns about your recovery. Your visit may include a physical exam and X-rays to help assess your knee joint.