TOTAL KNEE REPLACEMENT

First few weeks at home

  1. Discharge medication: You will receive a supply of medication to take home upon discharge from the hospital. This will include pain medication, an anti-inflammatory and blood thinning medication. In addition, we can also prescribe a sleeping tablet for a few days should you so wish. You also get a pain patch to replace the existing one on your shoulder (unless otherwise advised).
  2. Practical considerations: It is important to plan your homecoming. Remember that you will be using two crutches and will have to climb stairs carefully in the early stages of recovery. You can shower, but will not be able to bath for the first 6 weeks. You will be independent on discharge from the hospital, but if you stay alone it is preferable to have someone at home to provide some practical and emotional support during the first two weeks.  You can sleep in any position you find comfortable. It is very important that for the first two weeks you behave as if you were a patient in the hospital. Most of your waking hours should be spent lying down with you lower leg elevated on a soft cushion. Sit and stand only for very short periods at a time.
  3. Step-down care: In select circumstances it may be necessary to consider step-down care. Most medical aids will cover the cost of a one week stay. You will usually be required to arrange your own transport to the facility. The daily physiotherapy session is also usually covered by your medical aid.
  4. Dressings: The adhesive dressing should be kept in place. Remove it only after 10 days following the surgery. The stitches do not need to be removed. They are placed beneath the skin and will dissolve on their own after 4 weeks. There is often a slight red discoloration around the wound at this time.
  5. Walking: For the first 4 weeks you should walk using two crutches. Make a point of going for a short walk every day. For the first week stay indoors or in your garden. During the second week you can start to walk outside, preferably on a level surface. By the end of the second week you should be able to walk around a residential block (about 500m). By the end of the third week aim to be walking 1km and by the end of the fourth week you can increase that up to 2km at a time.
  6. Ice pack:Your knee will be fitted with an ice pack and you will be shown how to use it at home. Ice therapy is very beneficial to the healing process and helps with pain control and swelling. While in hospital we use a more advanced ice therapy pad.
  7. Compression stockings are not routinely used. There will always be a degree of swelling of the lower leg in the early period after the operation. If the swelling is excessive, we may decide to fit you with compression stockings. These are then to be worn at all times during the day up until your first post-operative visit.
  8. Driving your car: You can start driving your car as soon as you feel you can do so safely, but wait at least 2 weeks before you try to do so.
  9. Swimming: You can start swimming as soon as the wounds are fully healed, usually after 2 weeks. Take care getting in and out of the pool.
  10. Return to work: Depending on your type of work you will not be able to work for 4 to 6 weeks following the surgery.
  11. Bruising:  It is normal to have some bruising around the knee and thigh as a tourniquet is used during surgery.  This bruising is due to blood in the tissue beneath the skin. As you will be spending most of your time lying down or with the leg elevated, the blood will descend to the back of your knee and calf. From the bit of walking you do the blood will also descend to your ankles and can cause a blue discoloration there. Do not be alarmed as this will resolve over a period of a few weeks.