Total knee replacement generally requires between one and one- half to three hours of operative time. After surgery, patients are taken to a recovery room, where vital organs are frequently monitored. When stabilized, patients are returned to their hospital room.
Passage of urine can be difficult in the immediate postoperative period, and this condition can be aggravated by pain medications. A catheter inserted into the urethra (a Foley catheter) allows free passage of urine until the patient becomes more mobile.
Physical therapy is an extremely important part of rehabilitation and requires full participation by the patient for optimal outcome. Patients can begin physical therapy forty-eight hours after surgery. Some degree of pain, discomfort, and stiffness can be expected during the early days of physical therapy. Knee immobilizers are used in order to stabilize the knee while undergoing physical therapy, walking, and sleeping. They may be removed under the guidance of the therapist for various portions of physical therapy.
A unique device that can help speed recovery is the continuous passive motion (CPM) machine. The CPM machine is first attached to the operated leg. The machine then constantly moves the knee through various degrees of range of motion for hours while the patient relaxes.
Patients will start walking using a walker and crutches. Eventually, patients will learn to walk up and down stairs and grades. A number of home exercises are given to strengthen thigh and calf muscles.
How does the patient continue to improve as an outpatient after discharge from the hospital?
It is important for patients to continue in an outpatient physical therapy program along with home exercises for optimal outcome of total knee replacement surgery. Patients will be asked to continue exercising the muscles around the replaced joint to prevent scarring (contracture) and maintain to muscle strength for the purposes of joint stability.
The wound will be monitored by the attending physicians and their staff for healing. Patients also should watch for warning signs of infection including abnormal redness, increasing warmth, swelling, or unusual pain. It is important to report any injury to the joint to the doctor immediately.
Future activities are generally limited to those that do not risk injuring the replaced joint. Sports that involve running or contact are avoided, in favor of leisure sports, such as golf, and swimming. Swimming is the ideal form of exercise, since the sport improves muscle strength and endurance without exerting any pressure or stress on the replaced joint.
Patients with joint replacements should alert their doctors and dentists that they have an artificial joint. These joints are at risk for infection by bacteria introduced by any invasive procedures such as surgery, dental or gum work, urological and endoscopic procedures, as well as from infections elsewhere in the body.
Patients are recommended to take antibiotics before, during, and immediately after any elective procedures in order to prevent infection of the replaced joint.
Though infrequent, patients with total knee replacements can require a second operation years later. The second operation can be necessary because of loosening, fracture or other complications of the replaced joint. Re-operations are generally not as successful as the original operation and carry higher risks of complications. Future replacement devices and techniques will improve patient outcomes and lead to fewer complications.
©1996-2007 MedicineNet, Inc. All rights reserved. MedicineNet does not provide medical advice, diagnosis or treatment