Total Knee Replacement Surgery Home Care Instructions
Surgery: _____________________________________
Date: ________________________________________
Doctor: ______________________________________
This handout will review the care you need to follow once you are home. If you have any questions or concerns, please ask your nurse or doctor. Our staff is here to help you. If you have questions after you are at home, please call the numbers at the end of this handout.
Activity
The recovery time after a total knee replacement varies from person to person. On average, recovery is a six to eight week process. Surgery can cause you to feel weak and tired. In most cases, common sense will tell you when you are doing too much. On the other hand, too little activity can delay the return of your strength and stamina. Follow these guidelines to help keep your recovery on track.
- Follow the home exercise program your therapist (PT) has shown you.
- The correct use of your crutches or walker will prevent injury to your knee. You may need to use a cane until you can walk without a limp. By six to eight weeks most patients no longer need to use a cane, walker, or crutches.
- Walking is important. Set a time to walk, at least twice each day. Let pain be your guide. As you get stronger, increase the distance you walk each day.
- Keep doing your exercises 3 times a day for 3 months. Then, switch to a maintenance program doing the same exercises 3 times a week for at least one year.
Sitting
It is fine for you to sit in a comfortable chair. You may wish to use chairs with side arms or a pillow on the seat to make it easier to get out of the chair. Avoid sitting for long periods of time.
Sleeping
If you sleep with a pillow under your leg to raise it, do not place the pillow under your knee. You may place the pillow under your calf or ankle.
Lifting
Extra weight increases the force on your new knee. You should not gain or lift over 30 pounds.
Housework
You may do light housekeeping.
Sports
If you wish, you may resume using an exercise bike with no resistance three weeks after surgery. Do not play any impact sports like tennis, jogging, or volleyball, etc. Please check with your doctor before you resume sports.
Sexual Activity
When you are ready, you may resume having sex. Take it easy and adjust your positioning to keep pressure off your knee while it is healing. Consult your doctor if you have any questions or concerns.
Bathing
Sponge bathe for two weeks after surgery to avoid getting the incision wet. Your incision may be closed with staples or sutures. If you have staples, your doctor will decide when you can shower. In most cases, this is 24 to 48 hours after your staples are removed. If your incision is closed with sutures, it may be covered with steri-strips (small pieces of tape) on the skin. The steri-strips will slowly peel off. If the steri-strips are still in place after 10 days, you may gently remove them.
Care of Your Incision
Proper care of your incision helps to prevent infection.
- Keep your incision clean and dry.
- Change your dressing every other day and as needed. You may leave it open to air when the incision is dry.
- Do not wash directly on the incision. Wash around the incision gently with soap and water and then let air dry.
- Do not use any creams, lotions, ointments, or alcohol near or on the incision.
- Check the incision daily to be sure it is clean and dry and check for redness, swelling, and drainage.
- Some redness and swelling is normal.
- A small amount of clear or slightly blood tinged drainage from your incision is normal.
- If you have a brace, you will also be given brace care instructions.
Check for Signs and Symptoms of Infection
- A fever of 100.5ºF or 38.1° C for 24 hours.
- Increase in swelling.
- Increase in redness around the site.
- Increase in drainage from the site.
A mild fever is common after joint replacement surgery. A fever does not always mean infection. The fever should slowly decrease in time.
Swelling
As you become more active, you may notice more swelling in your leg or foot. There are some things you can do to prevent or decrease this swelling.
- Raise your leg between periods of walking. Lie flat on your back, place pillows under your ankle or calf. Keep your foot higher than the level of your heart.
- Keep doing your ankle pumps and quad sets. (See PT exercise sheet.)
- If you have an ace wrap around your knee, rewrap it daily as you have been shown.
- If swelling occurs after you exercise, use the ice therapy method (an ice pack or cryo-cuff).
Ice Therapy Method
Ice the incision site for 20 minutes as often as needed. Do not put the ice directly on the skin. Use a ready-made ice pack or put ice in a plastic bag and wrap in a towel before you use it. If you received a cryo-cuff, someone will teach you how to use it before you are discharged.
Pain Management
You may need to use pain medicine at home. Do not drive if you are taking narcotic pain medicine. If needed, take it as prescribed. The pain medicine can cause you to be unsteady on your feet. To prevent falls, use caution when getting up too quickly after eating, lying down, resting, or using the toilet.
In most cases, you should not take Non-Steroidal Anti-Inflammatory (NSAIDS) medicines (i.e., ibuprofen, Motrin®, Advil®, Aleve®) for 6 weeks after your surgery or until your doctor tells you it’s okay. Do not take aspirin unless prescribed by your doctor. If you aren’t sure about a medicine, please call the Orthopedic Clinic.
Some patients find pain relief from methods other than pain medicine.
These include:
- Ice therapy.
- Deep breathing exercises.
- Distraction.
- Repositioning.
Constipation
The combination of surgery, narcotic pain medicine, decreased activity level, and a change in your diet can play a role in getting constipated. Please see Health Facts For You Constipation from Opioids (Narcotics) located in the Post-Operative Total Knee Replacement Surgery Packet.
Deep Vein Thrombosis (DVT or blood clot)
Patients who have total joint replacement are at an increased risk of getting a deep vein thrombosis or blood clot. Symptoms of a dangerous blood clot include:
- severe leg swelling.
- pain, redness and/or tenderness in your calf.
A blood clot in your leg can break off and travel to your lungs. This is called a pulmonary embolism. Symptoms of a pulmonary embolism include:
- shortness of breath.
- chest pain when you inhale.
Blood Clot Prevention
To decrease the risk of a blood clot, you may be taking medicine to thin the blood for 2 to 4 weeks after surgery. Your doctor will decide how long you will need to take this medicine. Blood draws may be needed to check how well the blood thinner is working. This depends on the blood thinner medicine your doctor orders.
1. ________________________ is your blood thinner medicine.
2. ________________________ is checking your blood thinner medicine.
Elastic Stockings (TED hose)
To improve blood flow and decrease the risk of getting a blood clot, you will need to wear elastic stockings for 6 weeks. You should remove them 2 times each day for one hour at a time. You should sleep with them on. Please wear them until your doctor tells you otherwise. You may wash the elastic stockings with soap and water. Let them air dry.
Driving and Travel
Do not drive for two weeks after surgery or while taking narcotic pain medicine. At your two week check up, your doctor will let you know when you can drive. You may travel over two hours 6 to 8 weeks after your surgery. Stretching every hour will decrease stiffness as you travel.
Metal joint implants may trigger metal detectors in airports. You will receive a joint replacement card at your first clinic visit. This card does not guarantee you will be able to pass through airport security without being searched. It will simply provide information to airport security.
Future Medical or Dental Treatment
Please check with your orthopedic doctor before dental visits or other surgery. It is likely you will need a dose of antibiotics to protect your knee joint from infection. Your doctor will tell you if you will need this before certain procedures for the rest of your life.
Always tell your doctor or dentist before you go in for treatment for:
- Dental care (includes routine cleaning).
- Major or minor surgery.
- Colonoscopy, endoscopy, rectal exams.
Disabled Parking
If needed, the clinic staff can provide you with information to receive a temporary permit at your first clinic visit.
When to Call the Doctor
- If you have an infection in other places (bladder, throat, lungs, etc), these infections can “travel” to the knee and cause problems. Please call your primary medical doctor and call your surgeon.
- Increased tingling or numbness in your leg or foot.
- Increased pain, swelling, or redness in or around your incision site.An increase in the amount of drainage, change in the color of drainage, or any odor from your incision. Be ready to describe what the drainage looks like, how it smells, and how much there is.
- A temperature above 100.5ºF or 38.1° C for 24 hours.
- Sudden increase in pain or pain not relieved by medicine.
- Severe leg swelling, pain, redness and/or tenderness in either calf.
- Shortness of breath or chest pain when you inhale.
- A new chest pain, new problem with breathing.
Future Visits
The nursing staff will help you schedule your first clinic visit in two weeks. All other clinic visits will be as needed. Most often, your first outpatient PT visit should be scheduled for 10-14 days after you leave the hospital. You will be given a prescription for your outpatient PT visit at your two week follow up visit.
Refills
If you need a refill on your pain medicine, call the Orthopedic Clinic at
(608) 263-7540, Monday through Friday, 8:00 a.m. to 4:00 p.m. and ask for the nurse. Please call when you have a 2 to 3 day supply left of your medicine. Be ready to give the name and phone number of the drugstore where you want to pick up a refill.
Phone Numbers
If you have questions or concerns, please call the Orthopedic Clinic.
Monday through Friday between 8:00 AM and 5:00 PM at (608) 263-7540.
Nights and Weekends
Call (608) 262-0486. If you live out of the area, call 1(800) 323-8942. This will give you the paging operator. Ask for the “orthopedic resident on call.” Leave your name and phone number with the area code. The doctor will call you back.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 12/29/2009
Copyright © 12/29/2009 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6288
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