The day of knee replacement surgery is mostly a day to recover from your procedure. But it is not just about rest. Depending on the time of day of your surgery, you may be asked to sit in a chair or on the side of the bed.
Patients will begin simple activities including ankle pumps, leg lifts, and heel slides. It is important for patients to take sufficient pain medication to allow them to participate in their rehabilitation exercises. Some doctors will place you into a motion machine, called a CPM. The benefit of a CPM has not been clearly proven, and some surgeons choose not to use the device.
Hospitalization
During your hospitalization, you will meet with physical and occupational therapists. The physical therapist will work on mobility, strengthening, and walking. The occupational therapist will work with you on preparing for tasks such as washing, dressing, and other daily activities.
Therapy progresses at a different pace for each patient. Factors that will affect the rate of your progression include your strength before surgery, body weight, and ability to manage painful symptoms. The type and extent of surgery can also affect your ability to participate in physical therapy.
Discharge/Rehabilitation
Patients are usually discharged 3 to 5 days after knee replacement surgery. It is important that discharged patients be able to safely get in their homes and perform regular activities, such as getting to the bathroom and preparing food.
If patients are not progressing to the point that they can safely return to their home environment, in-patient rehabilitation may be recommended. This allows for further work with the therapists and 24-hour support services. Patients who return home will have home services arranged as necessary. This may include a visiting therapist and/or nurse.
Walking
Most patients take their first steps after surgery with the aid of a walker. Patients with good balance and a strong upper body may opt to use crutches. Transitioning to a cane depends on two factors. First, restrictions from your surgeon -- not all surgeons allow full weight to be placed on the leg in the early weeks after surgery. Second, your ability to regain strength. Usual time to return: 2 to 4 weeks with a cane; 4 to 6 weeks unassisted
Stairs
Many patients have to navigate stairs in order to enter or get through their homes. Therefore, your therapist will work with you to get up and down steps using crutches or a walker. Usual time to return: 1 week with crutch/walker; 4 to 6 weeks unassisted
Driving
Return to driving depends on a number of factors, including the side of your operation and the type of vehicle you have (standard or automatic). Patients need to be able to safely and quickly operate the gas and brake pedals. Under no circumstances should patients drive when taking narcotic pain medications. Usual time to return: 4 to 6 weeks
Work
Return to work depends on the activity that you have to do at your job. Patients who work in a seated position, with limited walking, can plan on returning about 4-6 weeks from the time of surgery.
Patients who are more active at work may need more time until they can return to full duties. Laborers should consider their work obligations before undergoing knee replacement. For example, patients may not be able to return to activities such as heavy lifting after knee replacement. Usual time to return: 4 to 10 weeks, depending on work obligations
Hip Replacement Recovery Guidelines
In the surgical ward, you may be given a switch to enable you to self-administer painkillers at a safe rate, and you may be given oxygen through a mask or tubes. If necessary, you'll be given a blood transfusion.
You'll have a large dressing on your knee to protect your wound and various drains to siphon off blood from the operation site to prevent it collecting inside the wound. Back in the ward, the team will continue to monitor you carefully. You may be allowed to have a drink about an hour after returning to the ward and, depending on your condition, you'll also be allowed to have food. You'll need help moving position and using a bed pan.
You will need to have your wound dressing changed regularly until it has healed over.
How soon will I be up and about ?
As quickly as possible the staff will help you to get up and walk about. If you have had minimally invasive surgery you may even be able to walk on the same day as your operation.
Walking with a frame or crutches is encouraged. Most people will be walking independently with sticks after about a week.
During your stay in hospital a physiotherapist will teach you exercises to help strengthen your knee. You can usually begin these the day after your operation. It's very important that you follow their advice to avoid complications or dislocation of your new joint.
It's normal to experience some initial discomfort while walking and exercising, and your legs and feet may be swollen. You may be put on a passive motion machine to restore movement in your knee and leg. This support will slowly move your knee while you are in bed. It helps to decrease swelling by keeping your leg raised, and helps improve your circulation.
When can I go home ?
You'll usually be in hospital for six to 10 days, depending on what progress you make and what type of knee replacement you've had. Patients who've had a half-knee replacement tend to have a shorter hospital stay. If you're generally fit and well the surgeon may suggest an accelerated rehabilitation programme where you start walking on the day of the operation and are discharged within one to three days.
How will I feel when I get home ?
Don't be surprised if you feel very tired at first. You've had a major operation and muscles and tissues surrounding your new knee will take time to heal. Follow the advice of the surgical team and don't be afraid to call your GP if you have any particular worries or queries.
You may be eligible for a home help and there may be other aids that can help you. You may also want to make your own arrangements to have someone to help you out for a week or so.The exercises that your physiotherapist gives you are an important part of your recovery, so it's vital that you continue with them once you are at home.
Your rehabilitation will be monitored by a physiotherapist when you attend your appointments at the outpatient physiotherapy department
You may be given some specific exercises to carry out, as well as advice on taking short walks and carrying out normal household activities, such as walking up and down stairs. These exercises will help restore your movement and strengthen your new knee.
How long will it be before I feel normal ?
You should be able to get rid of your crutches or walking frame three to six weeks after surgery and resume normal leisure activities. However, it may take up to three months for your pain and swelling to settle down.Your new knee will continue to recover up to two years after your operation. During this time the scar tissue heals and the muscles are restored by exercise, so it's important to take care and look out for problems such as stiffness, pain or infection.
Even after you've recovered, it's best to avoid extreme movements or sports where there is a risk of falling, such as skiing or riding a bicycle. Your doctor or a physiotherapist can advise.
When can I drive again ?
As soon as you can bend your knee enough to allow you to get in and out of a car and control the car properly, you can resume driving. This is usually around four to six weeks after your surgery, but you should check that you are safe to drive with your physiotherapist or doctor.
When can I go back to work ?
It depends on your job, but usually between six and 12 weeks after your operation.
When can I do housework ?
For the first three months, you should be able to manage light chores, like dusting and washing up, but you should avoid heavy household tasks such as vacuuming and changing the beds. Avoid standing for long periods as this may cause ankle swelling, and avoid stretching up or bending down for the first six weeks.
How will it affect my sex life ?
You may find that having the operation gives your sex life a boost. Your surgeon can advise when it's Ok to have sex again but as a rule of thumb, so long as you are careful, it should be fine after six to eight weeks. You should avoid vigorous sex and kneeling positions.
Will I have to go back to the hospital ?
You'll need an outpatient appointment with your GP to check on your progress usually between six and 12 weeks after your knee replacement. The doctor will want to see you a year later to check everything is Ok, and five yearly after that to X-ray your knee and make sure it's not beginning to loosen.
Will I need another new knee ?
The knee can be replaced as often as necessary, although results tend to be slightly less effective each time. Recovery may take longer, but once you have recovered the results are usually good.
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