Post-Operation Care for Total Knee Replacement is created to give you an overview of the process as a patient at Flagstaff Medical Center’s Total Joint Program. You will receive a package that goes into more detail for each step.
Expectations Immediately After Surgery
After the surgery is performed, you will be taken to a recovery room where pain control will be established, vital signs will be monitored and an X-ray will be taken of your new joint. After 1-2 hours in the recovery room, you will be taken to the Joint Surgery Center where a specially trained nurse will care for you; one to two close family members should also visit you on this day. At the surgery center, you will receive pain medication through a PCA unit which allows you to self administer small doses of narcotics at the push of a button. The first day will be spent mostly in bed and your nurse will encourage you do perform ankle pumps to help prevent blood clots.
1-2 Days After Surgery
On the first day after the surgery you will be bathed and helped into a nearby recliner. The PCA pain medication will stop on this day and pain medication will be taken orally. Your physical therapist will then meet with you and get you walking with crutches or a walker. You will then participate in a group therapy session in the afternoon.
The second day will start with a morning walk with your physical therapist. Group therapy will then start in the morning. On this day you will begin walking on stairs.
Expectations at Home
Usually, you will be discharged on the third day after surgery. When you get home, it is not necessary to have a full-time nurse or caretaker, but it is important to have someone around to check on you and help you with everyday chores.
Even though it is important to walk, it is also important to follow the precautions described later in this document. The physical therapist will also give you home exercises that should be followed accordingly along with the outpatient physical therapy that may be prescribed. Take your pain medication at least 30 minutes before the exercises to reduce the pain. Applying ice to your hip will help decrease your discomfort but do not apply ice for more than 20 minutes every hour. Information and a journal will be provided to assist you with all the exercises.
Long-Term Care of New Knee
Annual office visits are important to monitor your joint and get feed back from your physician.
To ensure your new knee’s longevity, it is important to avoid impact sports including: basketball, football, soccer, singles tennis, running, and baseball. Also, never lift or carry more than forty pounds.
Along with avoiding impact sports, you will need to monitor your weight and not gain excess pounds. Any extra weight unnecessarily adds stress to your new knee.
In the years after your surgery any type of infection in your body should be treated immediately, as infections can travel to your new knee and cause problems. Viral infections such as the cold or sore throats are not a problem. Always notify your dentist that you have had joint surgery as he/she may prescribe antibiotics for certain procedures.
If you are to have cystoscopy, bronchoscopy, or colonoscopy you should also be covered by an antibiotic. Doctors vary on their recommendations as to which antibiotics should be used and for how long.
The following are Dr. Randall’s recommendations:
Dental, Upper Respiratory, Gastrointestinal and Genitourinary Procedures:
Not Allergic to Amoxicillin: Amoxicillin 500 mg. Four capsules one hour before the procedure.
Allergic to Amoxicillin: Keflex or Duricef 500 mg. Five tablets one hour before the procedure.
OR: Clindamycin 600 mg, Zithromax 500 mg, or Biaxin 500 mg 1 hour before the procedure.
Allowable Activities
It is important to have common sense with your new knee. To protect your knee, you need to minimize stress put on the knee. You are limited as to what activities are possible but you will be able to participate in activities that were impossible before the surgery. Walking and swimming are the best activities. Other activities such as golf, ballroom dancing, horseback riding, and bicycling on a level surface are all allowable.
Problems That May Occur Home
Swelling in the leg and Foot. If this occurs, elevate your leg whenever you are not walking. Swelling could be a sign of a blood clot, so if the swelling does not go away by elevating the leg or there is pain associated with the swelling contact Dr. Randall’s office.
Chest pain, a cough or shortness of breath. This could be signs of an embolism, call Dr. Randall’s office right away.
Drainage from the wound. This could be a sign of an infection; Dr. Randall should be notified and may need to see the wound.
High fever. This could also be a sign of an infection. If your temperature is over 100 degrees call Dr. Randall.
Increasing knee pain. Each day after the surgery the pain should be getting less and less but if the pain seems to be increasing each day, Dr. Randall needs to be notified.
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