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After Knee Replacement: Rehabilitation Begins in the Hospital

Your doctor will work with you to determine how soon you will be able to bend and move your knee. Typically, this will be the same day as your surgery. Hospital staff will help you get in and out of bed until you feel safe enough to do it on your own. During your hospital stay, you’ll begin rehabilitation (rehab) therapy. Rehabilitation starts within a few hours after surgery and continues for three months or longer. During this time, you will learn how to safely use your new knee joint and return to your normal activities. The goals of rehab are to:

    • Improve your muscle strength
    • Increase the movement in your knee joint
    • Protect your new knee joint, and
    • Return to most of your normal activities

Your surgeon, nurses and therapists will teach you how to use your new knee joint as you sit, stand, walk and carry out your daily activities. The timeline is tailored to fit your needs. Here are general guidelines to help you understand what to expect after surgery.

Day One

You will learn exercises to help strengthen the muscles in your leg and increase movement in your knee. Your health care team may suggest that you use a machine that gently bends and straightens your knee automatically. This machine is called a continuous passive motion machine, or CPM. Daily activities may include:

    • Sitting on the side of the bed
    • Walking a few steps with a cane, crutches or walker
    • Sitting in a chair
    • Transferring yourself to a bedside commode

Day Two

You will gradually increase your exercises and activities from day one. Daily activities may include: 

    • Walking across the room with a cane, crutches or walker
    • Getting on and off the toilet
    • Climbing up and down two to three steps

Day Three to Discharge

Each day you will increase your exercises and activities. At discharge you may be able to:

    • Bend the knee to a 90 degree angle, or show improvement in bending the knee
    • Straighten the knee
    • Walk with little effort with a cane, crutches or walker
    • Move to a chair or toilet without help
    • Bathe and dress yourself
    • Climb several steps

It is normal to have a low-grade fever for a few days after surgery. The fevers will usually go away before or just after you leave the hospital. Most patients will leave the hospital after a three-to-four day stay.

Leaving the Hospital Following Knee Replacement

Your doctor will help you decide the best place for you to continue recovering after you leave the hospital. This may be at home or in a rehab center. A rehab center is similar to a hospital -- you stay there day and night and are cared for by doctors, nurses and therapists until you become well enough to go home. If your doctor wants you to go home, therapy will continue there as well.

Possible Complications After Knee Replacement

One of the potential complications following knee replacement surgery is infection. If you experience any of the following symptoms, you should contact your surgeon immediately:

    • Drainage and/or foul odor from the incision
    • Fever (temperature of about 101 degrees Fahrenheit or 38 degrees Celsius) for two days
    • Increased swelling, tenderness, redness and/or pain

To help reduce future risk of infection, people with knee replacements are often told to take antibiotics when undergoing medical or dental procedures, including simple teeth cleanings. These routine precautions will be required for up to several years after the surgery to reduce the risk of infection.

Another potential complication, Deep Venous Thrombosis (DVT), occurs when blood in the large veins of the leg forms blood clots within the veins. This may cause the leg to swell and become warm to the touch and painful. These blood clots could potentially travel to the lungs, where they get lodged in the capillaries of the lung and cut off the blood supply to a portion of the lung. This is called a pulmonary embolism. There are many ways to reduce the risk of DVT, but probably the most effective is getting you moving as soon as possible after surgery. Your surgeon will most likely prescribe preventative measures including pressure stockings to keep the blood in your legs moving and taking medications that thin the blood and prevent blood clots from forming.

Important Safety Information

The way a knee replacement will perform depends on your age, weight, activity level and other factors. There are potential risks and recovery takes time. If you have conditions that limit rehabilitation you should not have this surgery. Only an orthopaedic surgeon can tell you if knee replacement is right for you.

Last Updated: 03/28/2007


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