Congratulations, you have made it through your knee replacement surgery and are now beginning your recovery. This video is to review what to expect post-operatively, up until the 6 week mark when I will see you back in the office for your first post-operative visit. Please take a moment to look back at the pre-op email sent to you by my office, as this is where you will find the date and time of your 6 week post-operative appointment. Please call the office if you need to change the date or time of the appointment.

 

When you left the hospital, you were provided with a postoperative discharge paperwork packet. In this packet you will find information regarding what things to look out for, medications, anesthesia information and potential side effects, and the information for home health. In the very back of the packet you will see specific instructions from my office regarding your recovery. I will review the key points in this video.

 

The following are signs to look out for after surgery: Drainage from surgical incision. It is common to have a dime size or quarter size amount of drainage on your bandage after surgery. If you notice a significantly larger amount of drainage, please call my office. The other sign is acute severe pain and swelling in the calf or thigh. This could be an early sign of a blood clot which should be reported to my team for further evaluation. Finally, if you are unable to bear any weight on the operative leg, please call my office. If you experience chest pain, shortness of breath, or life threatening symptoms in the postoperative period, please call 9-1-1.

 

We recommend that you limit your walking in the first 2 weeks after surgery to less than 1000 steps per day. It is best to get up every hour and take a few steps. After two weeks, you can progress your walking as tolerated. You can progress from a walker to cane to no assistive device as you feel comfortable. You can sleep in any position that you find comfortable. You do not have to sleep on your back. Bending and straightening the knee are important parts of the recovery. In the first 2 weeks, we recommend focusing on achieving full extension of the knee. We also recommend gentle bending, but we do not recommend aggressive exercise or aggressive bending in the first 2 weeks. Rest, icing the knee, and keeping the swelling down are your goals in the first 2 weeks after surgery.

 

If you go home the same day of surgery, you will have an ace wrap and cotton material wrapped around your leg. You can remove this the day following surgery. You will have a silver dressing over the incision where the knee was replaced. This silver dressing can be removed at 7 days after surgery. After removing this dressing, you will then notice a small white strip of surgical tape on the incision which should be removed on post-op day 14. You may shower at any time after surgery. The bandage applied is water resistant. Do not swim or otherwise immerse the wound in a pool or bath until seeing me for your 6 week visit. 

 

It is critically important to ice the knee in the early recovery period to help with inflammation and swelling. We recommend icing for at least 20 minutes at a time, at least 5 times per day in the first few days after surgery. You can use whichever setting is comfortable for you on the ice machine. We recommend starting at a middle setting. We recommend using compression if it is comfortable, but it is not required.

 

It is expected for there to be swelling and bruising to the entire leg and foot, which can last up to 6 to 8 weeks but should slowly improve over time. Please note, many patients run a slight fever in the first several days after surgery and also note that the operative joint feels warm. This is typically normal and not a cause for immediate concern. The number one most common issue that patients experience after knee replacement is trouble sleeping at night. This will eventually improve over time. Our recommendation to help with this is to keep your pain controlled with tylenol and anti-inflammatories as needed before bedtime, and be sure to ice the knee before bed. Sleeping disturbances gradually improve throughout the postoperative period but can take 2 to 3 months to resolve. Numbness and nerve-like pains felt on the sides of the knee are very common during recovery after knee replacement surgery. We recommend massaging the sides of the knee as increased touch will improve those discomforts. If you are having difficulty managing these pains, please call the office during our regular business hours to discuss management strategies. A clicking feeling in your knee as well as a sensation of a band across the knee are also common and typically fade over the first year of recovery.

 

Please take all medications as directed in your discharge paperwork. If you need a refill of your medications, please call the office promptly during regular business hours. You must continue taking your blood thinner provided, which for most patients is either aspirin, Eliquis, or Xarelto, for 6 weeks post-operatively. I am going to emphasize now the importance of pain management after knee replacement surgery. It is very important to stay ahead of the pain especially as the anesthesia blocks wear off which is typically around 24 to 36 hours after your surgery. Please take pain medication as indicated and stay on top of the pain, as it is difficult to catch up if you get behind on pain control. Please take all medication as directed. 

 

Our nurse practitioner Ashley will now go through some further frequently asked questions and instructions for your knee replacement surgery.

 

You will have a home physical therapist set up by the Hospital case management that will come to your home twice per week for the first 2 weeks after surgery. You should be hearing from the home PT agencies within a couple days from coming home from the hospital. If you do not hear from them, we advise you to reach out to the Case management office. Their information is provided on your discharge paperwork. After the second week of home PT, you will transition to outpatient PT. Once you pick an outpatient physical therapist, please obtain their fax number and call our office to make us aware so we can fax the prescription to the location promptly.

 

We ask for you to refrain from having any dental work for 3 months after the surgery, unless you have a dental emergency. After your joint replacement you will take antibiotics 1 hour prior to every dental appointment for the first 2 years after surgery.

 

You are cleared to drive when you are fully off narcotic medications and you feel comfortable with your reaction speed for driving. This is typically around the 4 week mark.

 

Most patients return to a desk job within 3 to 5 weeks. For jobs that are more labor intensive, please discuss with us. Please send any disability paperwork to our office and please allow a 7 to 10 day return for all disability paperwork.

 

You are cleared to fly on an airplane at 6 weeks after surgery. If you need to fly sooner, please call the office to discuss. Many patients ask if their new joint will set off the metal detector at the airport. In many cases with only 1 joint replacement, it does not set it off but we recommend that you tell the TSA officer that you have a joint replacement during the screening process. No special documentation is needed for airport security.

 

We recommend that you avoid getting routine vaccines in the first 6 weeks after surgery.

 

Please expect a 2 week phone call from my team to check in. If you are having any issues before then or have any questions, feel free to reach out to the office sooner. Please make sure to take time to allow your body to heal from surgery and do not rush the recovery. If you are wondering when you are able to get back into higher impact sports activities, please wait until seeing us at your 6 week visit to review this with us. Thank you for your attention and we wish you an excellent recovery from your knee replacement surgery.