Surgery: What Happens in the OR
You'll get anesthesia, either "general," which puts you to sleep, or "spinal" or "epidural," which blocks pain below your waist. The operation usually lasts 1 to 2 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 infections and blood thinner meds to prevent clots.
Day 1: Recovery Begins
Get moving to get your strength back and avoid prevent problems. 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
You can probably switch to pain meds that you take by mouth instead of IV, and eat a regular diet. You should be able to get to the bathroom with a little help. You'll still work with a physical therapist. You'll be taught how to watch for signs of possible problems like an infection, clots, or chest congestion.
Day 3: Time to Wash Up
By now, your surgical 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 the area 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 2 weeks -- before you take a bath or get in a pool.
Days 3-4: Ready to Go Home
It's time to say goodbye to the hospital. Before you leave, you may be able to get in and out of a bed or chair without help, and use the bathroom. You may also get around using crutches or a walker. Some people recover best with a short stay in a rehab center, where trained help is always around.
Week 1: First Days at Home
You'll use some tips you learned at the hospital about how to keep your wound clean and change your dressing. Some swelling is normal, but watch for redness, a fever, or other signs of an 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 your surgery, you organized your home so it's easy to move around, and you arranged for a caregiver to help with daily activities and car rides. Take short walks often, but use a cane, crutches, or a walker until you are stable. Your bandage, and any staples or stitches, can usually be removed after about 2 weeks.
Weeks 3-6: Back in Action
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. Golf or dancing are fine, but avoid high-impact sports like jogging or basketball.
Week 4: Cut Back on Painkillers
Most people no longer need narcotic pain medicine. They may switch to an over-the-counter drug like ibuprofen or acetaminophen. But ask your doctor whether it's OK to take them if you also use blood thinners.
Week 6: Driving Again
Don't rush to get back behind the wheel. You need to have enough range of motion and be free enough of pain so that you can work the pedals without hesitation. You might have to wait 6-8 weeks before you can do that.
Weeks to Months: Going Back to Work
When you can return to your job depends on what you do for a living. If you spend a lot of time sitting, you may be able to go back as early as a few weeks after your surgery. If you do something that's more physical, it might be several months.
Year 1: Follow-up Care
Ask your surgeon, but a typical schedule might be doctor visits at 3 weeks, 6 weeks, 3 months, 6 months, 1 year, and then once a year 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.