At Home After a Knee Replacement
Understanding Your Knee Replacement and Caring for Yourself at Home
After a knee replacement, it's important to closely follow your recovery plan, including exercises and physical therapy, to regain strength and motion.
The recovery process typically takes several months, with most people able to return to most activities within 3 months, and full strength and endurance may take 6 months to a year, according to the University of Maryland Medical System.
Returning to your daily activities after a knee replacement takes time, but engaging in your care can help speed the process.
What is a knee replacement?
Knee replacement surgery, also called total knee arthroplasty, is a procedure that replaces the damaged surfaces of the knee joint with artificial parts made of metal and plastic to relieve pain and restore movement. It's often a solution for severe knee pain and limited mobility caused by conditions like osteoarthritis.
There are two general types of knee replacement:
Total knee replacement: This procedure replaces all parts of the knee joint.
Partial knee replacement: This surgery replaces only the damaged portion of the knee joint, often preserving healthy bones and ligaments.
The recovery process is generally the same whether you had a total or partial knee replacement. Follow your doctor’s instructions carefully, and reach out to your care team if you have any questions or concerns. Engaging in your recovery plan will help ensure the best recovery outcome and reduce your risk of hospital readmission.
What to expect after knee replacement
After a knee replacement surgery, you may be discharged the same day or spend several days in the hospital. Once discharged, you will need a friend or family member to help you at home for at least several days, and up to several weeks.
Generally, you will be able to leave the hospital 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
If you have difficulty meeting these goals, or do not have help at home, you may need to recover in a rehabilitation or skilled nursing facility. When deciding which recovery options are best for you, your surgeon will consider your overall health and whether you have help at home.
Managing knee replacement pain
After a knee replacement, it’s normal to feel some pain. The goal of pain control after surgery is not to take away your pain entirely, but to make it tolerable.
Managing your pain supports your healing by lowering your stress response, decreasing swelling and inflammation, and helping you move sooner.
Opioid medication. Opioid pain medications are most often used for short-term relief when non-opioid options do not give enough relief. Be careful and don’t take more than prescribed. Let your surgeon know if the prescribed dose doesn’t help your pain; it may be a sign of a complication.
Non-Opioid medication. Over-the-counter pain medications such as aspirin, ibuprofen, and acetaminophen can reduce swelling and control mild to moderate pain.
Other pain control. Medication is not the only strategy to manage discomfort. You can also:
• Try different positions for comfort. Pay attention to any movement restrictions your surgeon has given you.
• Use ice for up to 20 minutes at a time 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
Always follow your surgeon’s instructions when taking care of your surgical incision. In general, to prevent infection in your healing wound:
Keep it clean. Keep your incision clean and dry. Ask your surgeon when you can remove the dressing.
Keep it dry. Your dressing may be waterproof and safe to shower with. Ask your surgeon when you can safely shower or bathe.
Keep an eye on it. Watch for signs of infection, like swelling, discharge, and changes in your skin color.
Infection: Warning Signs
Though it’s rare, it is possible to get an infection after hip surgery that can become life-threatening if left untreated. Get immediate medical attention if you experience:
• A fever over 100 degrees
• Chills
• Redness, swelling, and heat
• Increased pain at your surgical incision
• Drainage from your incision
Activities
Avoid activities that put stress on your knee, like jogging, jumping, and strenuous sports.:
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, two to three times a day.
As needed, use an assistive device such as a cane, crutches, or walker.
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, two to three 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, two to three 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
Resources:
Preventing Blood Clots After Surgery. American Academy of Orthopaedic Surgeons.
Activities After Total Knee Replacement . American Academy of Orthopaedic Surgeons.
Total Knee Replacement Exercise Guide. American Academy of Orthopaedic Surgeons.
Managing Pain With Medications After Orthopaedic Surgery. American Academy of Orthopaedic Surgeons.
Key Elements of Enhanced Recovery after Total Joint Arthroplasty: A Reanalysis of the Enhanced Recovery after Surgery Guidelines. Orthopaedic Surgery.
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