Instructions for after your Knee Surgery
The goal after your surgery is to limit swelling so that you can obtain early range of motion. This is achieved through regular use of adequate pain relief, ice, early movement etc. As your body heals it will generate scar tissue which causes stiffness. Unless you get the movement going early you may find that the knee can stiffen over time.
Mobility
It is important to keep mobile and active. You can gradually increase the frequency and distance of your walking as comfort allows. You should try and avoid uneven or unstable ground. You can wean yourself off crutches as soon as the confidence returns. The earlier you come off the crutches the better the muscle control that you will have and this will expedite and speed up your recovery.
Rest
It is important to have rest periods during the day while you are recuperating from your surgery. Pace your activity and rest periods. You may notice that if you do too much the knee becomes more swollen, tight and you have limited movement. This will compromise the quality of your rehabilitation. It is important that you then get swelling back under control to push your movement to avoid stiffness.
Exercises
Your physiotherapist will give you some exercises on the ward that you will be able to continue after you leave the hospital. These exercises are orientated around making sure that you can fully straighten the knee as well as working on your bend. It is common for people to lose a little bit of straightening in the leg, particularly if there is a pillow under the knee or if patients rest with their knee in a bent position for long periods. Stretching the knee straight is important and this will be demonstrated to you whilst you are in the hospital. Progressively working on knee flexion exercises is extremely important. This will involve gradually stretching the knee into a more flexed position and your goal should be to get the knee to 120 degrees by the four week follow-up. If you feel that you are not achieving this then more input from the physiotherapist would be appropriate.
An exercycle is the most useful device for helping with your knee conditioning. It is important that you have no resistance on the exercycle, that the seat is raised up adequately to allow you to get the knee around on the exercycle. Gradually increase your time and duration on the exercycle. Once you find that the knee has warmed up you may choose to gradually lower the seat height to try and improve the flexion that you are achieving within the knee. Your goal is to build up to 20 to 30 minutes in a single session.
Pain Relief
You are encouraged to take your pain relief regularly to provide good pain management to allow you to do your exercise programme. As pain lessens you can gradually decrease your medication.
Wound
Your wound is sutured beneath the skin with self-dissolving stitches. These do not need to be removed. At the time of your discharge the wound will be covered with a water proof dressing called an op site. This can be removed after one week. The small sticky steri-strips sitting on the skin can then be removed at 10 to 14 days after surgery. Feel free to peel these off yourself. No stitches need to be removed. If you have any concerns feel free to contact Mr Peterson’s rooms on (03) 539 0988 or your GP if you have any concern about wound redness, pain or discharge.
Limb Swelling
It is not uncommon to experience some swelling, often of the entire leg, which may persist for several weeks. During the first weeks following your surgery avoid sitting for long periods - regular short walks are very important. If swelling occurs, sometime lying down during the day with the legs elevated is helpful. Bruising is also common. Don’t be concerned if you see bruising further down your leg.
Bowels
Constipation can be a common problem, due to a combination of reduced mobility and medication. Prevention is better than cure so remember to drink plenty of fluids and eat a healthy, nutritious diet with adequate fibre. Sometimes medication may be needed to help with this.
Bladder
If you had a urinary catheter during your stay in hospital you may notice an increase in urinary frequency after this is removed. This should settle down within a few weeks, if it persists you should contact your GP.
Sexual Activity
May be resumed when you feel comfortable.
Driving
You can return to driving as soon as your confidence returns within the knee. Remember you have to have a rapid response time and be able to stand on a brake at full strength.
Work
Return to work is very dependent on the type of work that you perform. Each person’s work situation will be different. Feel free to liaise with Mr Peterson about this. Generally however sedentary work you can return at four to six weeks, light work at six to eight weeks and heavy work at ten to twelve weeks.
Infection Alert
Because of the risk of potential infection moving to your new artificial knee joint it is important to see your doctor if you have any skin, chest, urine or other infection, as antibiotic treatment may be needed.
Dental Surgery
If you require dental surgery you should inform your dentist that you have had a knee replacement as you may need covering antibiotic treatment beforehand.
Reasons to seek medical help
You should contact your GP as soon as possible if you have:
High temperature
Drainage from your wound
Calf pain, leg swelling, shortness of breath, or chest pain
If the chest pain or shortness of breath is of sudden onset, call 111
Follow-up Appointment
You should leave the hospital with your follow-up appointment arranged at four weeks after surgery. Generally we will arrange for an x-ray just prior to this appointment on the same day.
If you have any concerns or need to alter your appointment please contact Mr Peterson’s rooms on (03) 539 0988. Your follow-up will be at the Collingwood Centre, level 1, 105 Collingwood St, Nelson