Surgery: What Happens in the OR
When you go in for knee replacement surgery, you'll likely get either general or regional anesthesia that blocks pain below your waist. The operation usually lasts one to two hours. The surgeon will make a cut over your kneecap, remove damaged parts of the joint, and attach the new joint, usually with cement. You’ll spend a few hours in recovery before being moved to your hospital room.
Post-op: Waking Up After Surgery
You may have a drainage tube for blood that collects around your knee. You'll have an IV tube, usually in your arm, to replace fluids and give you pain medication. And you may have a catheter in your bladder. You'll probably wear compression stockings to keep blood flowing smoothly. You may get antibiotics to prevent infection and blood thinners to prevent clots.
Day 1: Recovery Begins
Get moving to get your strength back and prevent problems. The drain may be taken out, and you may be fitted with a CPM (continuous passive motion) machine that automatically bends and straightens your knee slowly. A physical therapist will get you on your feet and teach you to pump your ankles to encourage blood flow. You may try walking. Breathing exercises will keep your lungs clear and prevent pneumonia
Day 2: Your Hospital Stay
By day two, you can probably switch to oral pain medication and eat a regular diet. You should be able to get to the bathroom with a little help. You'll continue to work with a physical therapist. You'll be taught how to watch for signs of possible problems like infection, clots, or chest congestion.
Day 3: Personal Hygiene
By now, the wound may be healed enough for you to shower. If your doctor says it's OK, remove the dressing, shower, gently pat the wound dry, and put on new dressing. Don’t rub your wound with any lotions or creams other than what the doctor prescribes. Wait until it's well healed and stitches or staples have been removed -- usually after two weeks -- before taking a bath or getting in a pool.
Days 3-4: Ready to Go Home
You'll probably stay in the hospital about three or four days. Before leaving, you may be able to get in and out of a bed or chair without help, and be able to use the bathroom. You may also be able to walk using crutches or a walker. Some patients recover best with a short stay in a rehabilitation facility, where trained help is always around.
Week 1: First Days at Home
At the hospital, you'll learn how to keep your wound clean and change your dressing. The bandage, and any staples or stitches, can usually be removed after about two weeks. Some swelling is normal, but watch for redness, fever, or other signs of infection. A bag of ice or frozen vegetables wrapped in a towel can help with pain. A physical therapist may visit you at home. Try to walk every couple of hours when you're awake.
Week 2: Take It Easy
Hopefully, in the weeks before surgery, you organized your home so it's easy to move around and arranged for a caregiver to help with daily activities and transportation. Take short walks often, but keep using a cane, crutches, or a walker until you are stable.
Weeks 3-6: Resuming Activities
In three to six weeks, you should be able to get back to most of your normal activities. Swimming and riding a stationary bike are easy on your knee. You can have sex again whenever you feel comfortable. If you're a gardener, you can kneel after a couple of months, though it may be uncomfortable at first. Activities like golf or dancing are fine, but high-impact sports like jogging or basketball should be avoided.
Week 4: Giving Up Pain Meds
Most people no longer need narcotic pain medicine by one month after surgery. They may switch to an over-the-counter painkiller like ibuprofen (Advil, Motrin) or acetaminophen (Panadol, Tylenol). However, if you are on blood thinners, ask your doctor before taking such anti-inflammatory medicines.
Week 6: Driving Again
Don’t rush to get back behind the wheel. Obviously, you need to have enough range of motion and be free enough of pain so that you can work the pedals without hesitation. Waiting six to eight weeks may be necessary.
Weeks to Months: Going Back to Work
When you can return to work depends on the type of work you do. If you spend a lot of time sitting, you may be able to return as early as after a couple of weeks. If your job is more physically demanding, it might be several months.
Year 1: Follow-up Care
Ask your surgeon, but a typical schedule might be doctor visits at three weeks, six weeks, three months, six months, one year, and annually after that. Follow your doctor’s recommendations to protect your new joint. More than 90% of modern replacements are still working 15 years after surgery.