Most knee replacement surgeries are followed by a few days in the hospital. The doctors and nurses and will continue to make sure you have gone through the surgery without difficulty. Physical therapists will visit you in the hospital several times to show you how to get around on your new knee, as well as how to use an appropriate assistive device (walker, crutches or cane).
After any surgery, some pain or discomfort is expected. This should be controllable with pain medications, rest and ice. You should contact your surgeon if you have severe or uncontrollable pain. If you are not experiencing much pain and do not want to take pain medication, please talk to your surgeon (his assistant or nurse) prior to stopping as they may have safety instructions or have other non-prescription drug alternatives. If you have unused opioid pain medication, please dispose of properly, most police stations are drop off sites. Saving for a “rainy day” can lead to someone other than you taking it. Opioid abuse is an epidemic and the fastest growing drug taken by middle-schoolers.
After a few days, you should be able to take a shower and let water run over the incision. Baths, Jacuzzis and swimming pools should be avoided until the stitches or staples are removed and the incision is well healed.
Your physician may prescribe TED hose (white hose) that are used to prevent DVT (blood clot). It is important to wear these 24 hours per day. Your therapist or nurse should instruct in how to put these on, it is similar to a tough pair of panty hose. Avoid any rolling or gathering. You should start with ankle rolling/pumping early as muscle pumping is also preventative of DVT.
If all goes well in the hospital, you should be discharged in a few days and are usually sent home. A home health physical therapist may visit you in your home to assist you with range of motion and strengthening exercises, as well as help teach you how to get around with your new knee.
Warning signs to look out for include: high fever (over 100 degrees), difficulty breathing and severe pain/ swelling/ redness around or beyond the surgical site. If you experience any of these call your doctor immediately.
If you did not start outpatient physical therapy right away, your home health PT will assist you with the transition to an outpatient facility.
Once you get to an outpatient facility, expect your PT to begin or continue your range of motion and strengthening activities. Controlling your pain and swelling are primary goals early on. Restoring your motion can be uncomfortable but vital to return to normal walking and daily activities. Getting your muscles to function appropriately can also be a challenge, sometimes they stubbornly want to continue their rest.
Your PT will wean you off of any assistive device and begin progressing your activity level as tolerated. Occasional flare-ups occur as you progress back to full function, but remember that you are not going it alone. If you have questions as you progress, ask your PT. They have seen many of these surgeries and are experts at handling the ups and downs after knee replacements.