Total Knee Replacement Patients in New York, NY and New Jersey
You will experience swelling in the joint. The swelling will be reabsorbed by your body over time, especially as you develop adequate muscle strength. You may have bruising in the operated leg as well. This may travel down the leg with gravity.
Dressing: The ace wrap is removed 5 days after surgery. The beige adhesive (Aquacel) dressing is removed 7 days after surgery. If the wound is draining, simply tape a dry gauze pad daily until it stops. If no drainage, the incision can be exposed to air.
Incision: Sylke bandage (white bandage directly over incision, under the Aquacel) should be removed 2-3 weeks from surgery, either by the visiting nurse or in our office at your first post-op visit. Keep your incision dry until the Sylke bandage is removed. There are no staples, and all sutures used to close the incision are dissolvable.
Bathing: Once the ACE bandage has been removed, you may shower while keeping the surgical area as dry as possible. We recommend covering the area with plastic wrap to help prevent the wound and dressing from getting wet. If a small amount of water gets on the wound that is okay. After showering, gently pat the area dry with a clean towel. Do not rub the incision.
Medications: Aspirin 81mg will be taken twice a day with food for 28 days. Pain meds should be taken with food. Resume all home meds after surgery unless otherwise instructed. If you are given narcotic pain medicine, take a stool softener.
Ice Machine: If you are interested in an ice machine, please contact the office. If you do not use an ice machine, use ice packs to control the pain and swelling. Do not put the ice directly on the skin. Use ice for 20 minutes at a time, 3-5 times a day.
Physical Therapy: Home PT will be arranged prior to the procedure. If you are unhappy with your home PT visits, do not hesitate to contact the office to begin outpatient physical therapy immediately.
Exercises: Never place a pillow under the operated knee. Please place a towel roll under the ankle and work on achieving full extension during the first week after surgery. Other exercises that may be performed are shown below. Our goal is for you to achieve 90 degrees of flexion and full extension by your first post-op visit (about 4 weeks from surgery date).
CPM: Continuous passive motion (CPM) machines are recommended. Our office will try to get one approved by your insurance provider and have it delivered to your home after surgery. Please contact our office and ask to speak to Troy if you have any questions regarding coverage or how to use the machine. Note: Please check to see if your insurance will cover the CPM before purchasing.
Driving: You will discuss when you can drive with your surgeon. Generally, driving begins 4 wks after surgery. You should be completely off your pain meds to drive.
Follow-up: Your follow-up visit will be ~3 weeks after surgery.
Knee-straightening exercises: Place a small, rolled up towel under your leg just above your heel so that your heel is not touching the bed. Tighten your thigh. Try to fully straighten your knee and to touch the back of your knee to the bed. Hold fully straightened for 5 to 10 seconds. Repeat until your thigh feels fatigued.
Sitting supported knee bends: Sit on a bed or chair with your thighs supported. Alternately straighten and bend your knee, using the foot of your unoperated leg to push your operated leg up (left-hand illustration) and back (right) as far you can. Hold your knee in the full bent/straightened position for 5 to 10 seconds. Repeat several times until your leg feels fatigued or until you can completely bend and straighten your knee.
Sitting unsupported knee bends: Sit on a bed or chair with your thighs supported. Bend your knee as far as you can until your foot rests on the floor. With your foot lightly resting on the floor, slide your upper body forward in the chair to increase
Your knee bend. Hold for 5 to 10 seconds. Straighten your knee fully. Repeat several times until your leg feels fatigued or until you can completely bend your knee.
Bed-supported knee bends: Bend your knee as much as possible while sliding your foot on the bed. Hold your knee in a maximally bent position for 5 to 10 seconds and then straighten. Repeat several times until your leg feels fatigued or until you an cCompletely bend your knee.
Advanced exercises and activities
A full recovery will take time. The pain from your problem knee before your surgery and the pain and swelling after surgery have weakened your knee muscles. The following exercises and activities will help your knee muscles recover fully.
Standing knee bends: Standing erect with the aid of a walker or crutches, lift your thigh and bend your knee as much as you can. Hold for 5 to 10 seconds. Then straighten your knee, touching the floor with your heel first. Repeat several times until fatigued.
Assisted knee bends: Lying on your back, place a folded towel over your operated knee and drop the towel to your foot. Bend your knee and apply gentle pressure through the towel to increase the bend. Hold for 5 to 10 seconds. Repeat several times until fatigued.
Knee exercises with resistance: You can perform any of the early or advanced exercises with light weights around your ankle. (Inexpensive wraparound ankle weights with Velcro straps can be purchased at most sporting goods stores.) These resistance exercises usually can begin four to six weeks after your surgery. Use one- to two-pound weights at first; gradually increase the weight as your strength returns.
Stationary bicycle exercise: Exercising on a stationary bicycle is an excellent activity to help you regain muscle strength and knee mobility. Adjust the seat height so that the bottom of your foot just touches the pedal with your knee almost straight. Pedal backwards at first. Pedal forward only after a comfortable backwards cycling motion is possible. As you become stronger (at about 4 to 6 weeks) slowly increase the tension on the pedals. Pedal forward 10 to 15 minutes twice a day, gradually building up to 20 to 30 minutes 3 to 4 times a week.