At Home After a Knee Replacement

Strengthen and Heal to Avoid Complications

Returning to your daily activities after a knee replacement takes time, but active rehabilitation can help speed the process. 

What to Expect After Surgery

After a knee replacement surgery, you may be discharged the same day or spend 1 to 4 days in the hospital. Your surgeon will consider your overall health and if you have help at home when deciding which path is best for you. If you go home directly after surgery, you will need a friend or family member to help you at home for at least several days, and up to several weeks, after discharge.

If you stay in the hospital, you will be able to go home once you:

  • Have good pain control

  • Can urinate without problems

  • Can eat and drink

  • Can get in and out of bed by yourself

  • Can perform rehabilitative exercises 

  • Have no signs of complications, such as unstable vital signs

  • Understand precautions to protect your new knee

  • Can walk with an assistive device

A stay in a skilled nursing facility can help if you have difficulty meeting these goals or do not have help at home. 

Managing Pain

After a knee replacement, it’s normal to feel soreness. Medication can make this discomfort tolerable and help you get moving. 

Opioid Medication

Opioid pain medications are most often used for short-term relief when non-opioid options are not adequate. Be careful and don’t take more than prescribed. Let your surgeon know if the prescribed dose does not help your pain; it may be a sign of a complication. 

Non-Opioids

Over-the-counter pain medications such as aspirin, ibuprofen, and acetaminophen can reduce swelling and control mild to moderate pain. 

Non-Medication

Medication is not the only strategy to manage discomfort. You can also:

  • Use ice every 2 hours for 20 minutes on and 20 minutes off to reduce swelling, which is normal after knee surgery and can continue for 3 to 6 months 

  • Try wearing compression stockings to reduce swelling 

  • Get regular activity to avoid stiffness, which can increase discomfort 

  • Apply heat for 15 to 20 minutes before exercising to relax your muscles and improve mobility 

Taking Care of Your Incision

To prevent infection in your healing wound:

  • Keep your incision clean and dry and follow your surgeon's instructions on how and when to change your dressing

  • Ask your surgeon when you can safely shower or bathe 

  • Watch for signs of infection, such as drainage or redness at your incision

Infection: Warning Signs

Your knee can develop an infection even after the initial recovery period.

Get immediate medical attention if you experience:

  • A fever over 100 degrees

  • Chills

  • Redness and heat 

  • Increased pain at your surgical incision

  • Drainage from your incision

Some patients may need to take antibiotics before all future dental procedures to avoid infection.

Activities 

Avoid activities that put stress on your knee, including:

  • Skiing

  • Jogging

  • Jumping

Walking and riding a stationary exercise bike are excellent activities after a knee replacement. Swimming is another low-impact option. Ask your surgeon when it is safe to swim. Your physical therapist will also recommend daily exercises to strengthen your knee.

You can sleep on your back, side, or stomach as long as it is comfortable. You will be able to resume driving when you are no longer taking opioid pain medications and can move your leg quickly to operate the brakes. 

Knee Rehabilitation

You will work with a physical therapist to learn rehabilitative exercises during your hospital stay or as an outpatient. In your early recovery, they may recommend 20 to 30 minutes of strengthening exercise, plus 20 to 30 minutes of walking 2 to 3 times a day. Use an assistive device such as a cane, crutches, or a walker as needed. 

Early Recovery

The sooner you begin to move, the faster you will recover. To increase circulation, start with simple, supported exercises and progress gradually. 

As your surgeon recommends, you may perform these exercises in bed or seated right away after surgery:

  • Ankle pumps and rotations

  • Quadriceps sets: tightening your thigh muscle to straighten your knee

  • Straight leg raises

  • Knee-straightening exercises and knee bends

You may begin walking with an assistive device shortly after surgery. Ask your surgeon how much weight you should put on your leg. 

Your physical therapist will also instruct you in the following:

  • Climbing stairs one step at a time with support. Lead up with the good leg and down with the affected leg

  • Standing supported exercises, such as knee bends

  • Using an exercise bike for 10 to 15 minutes, 2 to 3 times a day

  • Exercising against resistance, such as with light ankle weights

Later recovery

As you get stronger, you can gradually begin exercising harder. You may:

  • Increase the tension on your exercise bike 

  • Use an exercise bike up to 20 to 30 minutes, 2 to 3 times a week

  • Increase the weight of ankle weights

  • Climb stairs foot over foot

Deep Vein Thrombosis

After surgery, one of the most significant risks is developing a deep vein thrombosis (DVT), a blood clot that forms in a vein, usually in your leg. It can get dislodged and travel to your lungs, which is a medical emergency called a pulmonary embolism (PE). 

Get emergency care if you have any of the following signs of DVT or PE:

  • Pain in one calf and leg not related to your incision 

  • Redness, heat, or swelling in your leg

  • Sudden difficulty breathing

  • Chest pain when breathing

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