You and your doctor, after careful evaluation of your knee, have decided that you need to have a total knee replacement. The following information will provide you with an overview of what to expect before and after your surgery. If you have additional questions, please contact your doctor.
 
 

Prior to the Day of Surgery On The Day of Surgery First Day After Surgery

Day Two After Surgery Day Three After Surgery Call Your Doctor

Prior to the Day of Surgery

• Medical Doctor – You need to schedule an appointment with your medical doctor to be sure that you are cleared for surgery.

 
• Physical Therapy – Before your surgery you will need to have an evaluation done by a physical therapist. The physical therapist will show you various exercises that you will need to do following your surgery, as well as evaluate the need for any medical equipment necessary in your home after the surgery.

 
• Home Health – A representative from Home Health will discuss any medical services and equipment you may need in your home following surgery. This may include having blood drawn while you are at home.

 
• Anesthesia – You need to schedule a pre-hospital visit with the anesthesiologist who will be administering the anesthetics during your surgery.

 

On The Day of Surgery

• Admission to the Hospital – You will be asked to arrive at the hospital 1 to 2 hours before your surgery is scheduled to begin. Please call your doctor’s scheduling nurse after 2:00 p.m. the day before your surgery for an exact arrival time.

 
• REMEMBER: YOU MUST NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT THE EVENING BEFORE YOUR SURGERY.

 
• Initially, you will be in the outpatient surgical area and from there you will be taken to the operating room where your surgery will be performed. After surgery, you will be admitted to the orthopedic floor of the hospital.

 
• Upon arriving on the orthopedic floor, you will be given a patient controlled analgesia (PCA) machine which will provide you with pain medicine. By pushing a button, pain medication is delivered through the IV as you need it.

There are some things you will need to do following surgery. It is important that you:

• Cough and take deep breaths at least once every 30 minutes to an hour to help prevent any pulmonary problems.

• It is also important that you move your ankles up and down and wiggle your toes at least every 30 minutes to an hour to help prevent blood clots.

First Day After Surgery
 

• Physical therapy usually begins on the first day after surgery, with your therapist assisting you in walking. This may be somewhat slow and painful at first, but it should improve each day.

• A continuous passive motion machine (CPM machine) will be used to help gain the flexion in your knee.

• You will be need get out of bed and into a chair twice a day. This is very important to help prevent blood clots. 

Day Two After Surgery

• Physical therapy will continue today as well as use of the CPM machine. 

• The PCA machine will be stopped today; however, there will be pain shots and pills ordered for discomfort you may experience. It is important that you ask for these medications when the pain first begins. Do not wait until the pain is severe to ask for pain medication. It may take some time for the nurse to get your pain medicines to you and it may also take the medicine a little while to work.

 
• If a drain was placed in your knee, it will also be removed. 

• If you have not had a bowel movement by this time, consider asking for a laxative.

• The dressing on your knee may be changed.

Day Three After Surgery

• Many patients go home on the third day after surgery. However, some patients must remain in the hospital and continue physical therapy with range of motion and strengthening exercises. You may also be transferred to the rehabilitation area of the hospital.

• When you are ready to be discharged, your doctor will review your care instructions with you, including information on continuing range of motion and strengthening exercises.

• Arrangements will be made so that you have the appropriate equipment at your home as well as the appropriate home health personnel coming by to continue assisting in your recovery.

• Continued movement of the foot and ankle and knee is crucial to help prevent blood clots. If you are taking blood-thinning medication, you will need to have your blood monitored while you are on this medicine. You may still need to use pain medication after you are discharged. 

If you experience any of the following, it is important to call your doctor immediately:

• Fever above 101.5 or chills

• Drainage from the knee

• Increased swelling and tenderness in your calf or thigh.