Total Knee Replacement: What to Expect at Home

Your Recovery

When you leave the hospital, you should be able to move around with a walker or crutches. But you will need someone to help you at home for the next few weeks or until you have more energy and can move around better. If there is no one to help you at home, you may go to a rehabilitation centre.

You will go home with a bandage and stitches, staples, tissue glue, or tape strips. Change the bandage as your doctor tells you to. If you have stitches or staples, your doctor will remove them 10 to 21 days after your surgery. Glue or tape strips will fall off on their own over time. You may still have some mild pain, and the area may be swollen for 3 to 6 months after surgery.

Your knee will continue to improve for 6 to 12 months. You will probably use a walker for 1 to 3 weeks and then use crutches. When you are ready, you can use a cane. You will probably be able to walk on your own in 4 to 8 weeks.

You will need to do months of physical rehabilitation (rehab) after a knee replacement. Rehab will help you strengthen the muscles of the knee and help you regain movement. After you recover, your artificial knee will allow you to do normal daily activities with less pain or no pain at all. You may be able to hike, dance, ride a bike, and play golf. Talk to your doctor about whether you can do more strenuous activities. Always tell your caregivers that you have an artificial knee.

How long it will take to walk on your own, return to normal activities, and go back to work depends on your health and how well your rehabilitation (rehab) program goes. The better you do with your rehab exercises, the quicker you will get your strength and movement back.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

Rest when you feel tired. You may take a nap, but do not stay in bed all day. When you sit, use a chair with arms. You can use the arms to help you stand up.
Work with your physiotherapist to find the best way to exercise. You may be able to take frequent, short walks using crutches or a walker. What you can do as your knee heals will depend on whether your new knee is cemented or uncemented. You may not be able to do certain things for a while if your new knee is uncemented.
After your knee has healed enough, you can do more strenuous activities with caution.
- You can golf, but use a golf cart, and do not wear shoes with spikes.
- You can bike on a flat road or on a stationary bike. Avoid biking up hills.
- Your doctor may suggest that you stay away from activities that put stress on your knee. These include tennis or badminton, squash or racquetball, contact sports like football, jumping (such as in basketball), jogging, or running.
- Avoid activities where you might fall. These include horseback riding, skiing, and mountain biking.
Do not sit for more than 1 hour at a time. Get up and walk around for a while before you sit again. If you must sit for a long time, prop up your leg with a chair or footstool. This will help you avoid swelling.
Ask your doctor when you can drive again. It may take up to 8 weeks after knee replacement surgery before it is safe for you to drive.
When you get into a car, sit on the edge of the seat. Then pull in your legs, and turn to face the front.
You should be able to do many everyday activities 3 to 6 weeks after your surgery. You will probably need to take 4 to 16 weeks off from work. When you can go back to work depends on the type of work you do and how you feel.
Ask your doctor when it is okay for you to have sex.
Do not lift anything heavier than 5 kilograms and do not lift weights for 12 weeks.

Diet

By the time you leave the hospital, you should be eating your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt. Your doctor may suggest that you take iron and vitamin supplements.
Drink plenty of fluids (unless your doctor tells you not to).
Eat healthy foods, and watch your portion sizes. Try to stay at your ideal weight. Too much weight puts more stress on your new knee.
You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fibre supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if and when to start taking those medicines again. Make sure that you understand exactly what your doctor wants you to do.
Your doctor may give you a blood-thinning medicine to prevent blood clots. If you take a blood thinner, be sure you get instructions about how to take your medicine safely. Blood thinners can cause serious bleeding problems. This medicine could be in pill form or as a shot (injection). If a shot is necessary, your doctor will tell you how to do this.
Be safe with medicines. Take pain medicines exactly as directed.
- If the doctor gave you a prescription medicine for pain, take it as prescribed.
- If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
- Plan to take your pain medicine 30 minutes before exercises. It is easier to prevent pain before it starts than to stop it once it has started.
If you think your pain medicine is making you sick to your stomach:
- Take your medicine after meals (unless your doctor has told you not to).
- Ask your doctor for a different pain medicine.
If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

If your doctor told you how to care for your cut (incision), follow your doctor's instructions. You will have a dressing over the cut. A dressing helps the incision heal and protects it. Your doctor will tell you how to take care of this.
If you did not get instructions, follow this general advice:
- If you have strips of tape on the cut the doctor made, leave the tape on for a week or until it falls off.
- If you have stitches or staples, your doctor will tell you when to come back to have them removed.
- If you have skin adhesive on the cut, leave it on until it falls off. Skin adhesive is also called glue or liquid stitches.
- Change the bandage every day.
- Wash the area daily with warm water, and pat it dry. Don't use hydrogen peroxide or alcohol. They can slow healing.
- You may cover the area with a gauze bandage if it oozes fluid or rubs against clothing.
- You may shower 24 to 48 hours after surgery. Pat the incision dry. Don't swim or take a bath for the first 2 weeks, or until your doctor tells you it is okay.

Exercise

Your rehab program will give you a number of exercises to do to help you get back your knee's range of motion and strength. Always do them as your therapist tells you.

Ice and elevation

For pain and swelling, put ice or a cold pack on the area for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.

Other instructions

Continue to wear your support stockings as your doctor says. These help to prevent blood clots. The length of time that you will have to wear them depends on your activity level and the amount of swelling.
You have metal pieces in your knee. These may set off some airport metal detectors. Carry a medical alert card that says you have an artificial joint, just in case.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

You passed out (lost consciousness).
You have severe trouble breathing.
You have sudden chest pain and shortness of breath, or you cough up blood.

Call your doctor or nurse call line now or seek immediate medical care if:

You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the incision.
- Pus draining from the incision.
- A fever.
You have signs of a blood clot, such as:
- Pain in your calf, back of the knee, thigh, or groin.
- Redness and swelling in your leg or groin.
Your incision comes open and begins to bleed, or the bleeding increases.
You have pain that does not get better after you take pain medicine.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

You do not have a bowel movement after taking a laxative.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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