Guideline for Aftercare of Total Knee Replacement

GUIDELINE FOR AFTERCARE OF TOTAL KNEE REPLACEMENT *Also applies to partial replacements*

o Physical therapy will begin the day following your surgery while still in the hospital. You will be visited by physical therapists as well as a nursing case manager who will work with you regarding home health nurses, insurance coverage, equipment needed, etc. You will receive home physical therapy for the duration of your hospital stay. After your first office visit, you will begin outpatient physical therapy.

o Home Health nurses will change your dressing/bandage at home daily or as needed.

o Your pain will be controlled in the hospital with a PCA pump (patient controlled analgesia). This device allows you, as the patient, to push a button (like a remote control) when you are in pain and medicine will be delivered through your IV. The machine will not let you overdose as it is specifically modified for your weight so push the button as needed.

o You will be given IV antibiotics while in hospital to prevent infection.

o You will also be asked to breathe/cough into a machine to help expand your lungs following anesthesia.

o You will have a Foley catheter in place when you wake up from surgery which will save the inconvenience of trying to walk to the bathroom. This will be removed one or two days after your operation.

o A general estimate you can expect for your hospital stay will be 2-3 nights.

o Dr. Loeffler and/or Tara, the Physician Assistant will check on you each day while in the hospital. Your primary care physician will also be notified of your admission and he/she will visit you as well.

o Equipment such as a walker, bedside commode, etc. can be ordered while still in the hospital to take with you at home.

o Unless instructed otherwise (check discharge instructions), you may bear full weight on your knee as tolerated.

o The CPM (continuous passive motion) or “bending” machine that moves your knee will also go home with you for about 2 weeks until your first office visit. General recommendations for the CPM include using the machine 2-3 hours a day and increasing the bend by 5-10o per day as tolerated. Your goal is to get to 90o of flexion or “bend” by your first office visit but go slow and advance only when you feel ready! o Keep your compression stockings on both legs until your first office visit! They are there to prevent blood clots following surgery. o Keep incision clean and dry. Do not get staples wet. o Keep ice on knee as much as tolerated. You may alternate times such as 20 minutes with ice and 20 minutes without ice throughout the day. o Your injections given at home are for the purpose of thinning the blood to prevent blood clots after surgery. After your injections are finished and there are no more left in your kit, begin taking a regular dose aspirin of 325mg daily until first office visit.