Total Knee replacement is one of the most common and successful surgeries in the field of orthopedics. It’s done for patients with advanced osteoarthritis of the knees. The procedure helps in relieving pain and restoring function thus rehabilitating millions of people across the world. In this procedure, the damaged bone and cartilage are removed and replaced with an artificial joint made of cobalt-chromium alloy, titanium, and highly cross-linked polyethylene.
One of the main apprehensions of patients surrounding knee replacement surgery is post-operative care and physiotherapy. They are usually under the impression that the physiotherapy sessions are more painful than the surgery itself. Real-time engagement of the surgeon with timely troubleshooting and supervised guidance from well-qualified physiotherapists can make post-operative care seamless and less traumatic for the patients.
Preoperatively counselling the patients and their families about what to expect post-surgery is a good starting point. If all the instructions are followed it will ensure good pain control, reduced swelling, good range of motion which are essential for optimum recovery.
How to look after the new knees after the surgery?
Once the knee replacement surgery is done, the patient is made to walk the next day with the help of a walker. The first few days in the hospital usually involve pain control, physiotherapy sessions to make them as independent as possible. Once the discharge criteria are met they are sent home in a day or 2 with all the necessary medications and instructions. On average complete recovery is expected in a month’s time.
Taking care of the basics
These are a few basics of post-operative care after knee replacement surgery
Postoperative physiotherapy
- Don’t be fearful of moving around with a walker. It’s recommended that you walk at least once every 3-4 hours.
- Sit up and let the operated leg hang down while having your meals
- Patients can visit the washroom with the help of a walker
- Icing the knee 3-4 times a day is a must to control the swelling
- Ankle pumps and static quadricep exercises are to be done frequently to avoid swelling and clotting of the blood in the legs.
- Involve yourself in the physiotherapy session as much as possible.
- Always engage a physiotherapist recommended by the surgeon. If accessibility is an issue let your therapist talk to the surgeon and take instructions from him
- The pain might increase post exercises. This can be dealt with by icing the knee after the session is done.
Bleeding and discoloration of the skin
- Some amount of bleeding can be visible through the dressing. This is expected as the patients are on blood thinners.
- Similarly, the skin can have discoloration due to the same reason. This spontaneously disappears over time.
- Swelling in the foot after prolonged sitting is expected but any swelling extending to the calf which does not disappear after lying down should be reported immediately to the physiotherapist or the surgeon. It could be a sign of blood clotting in the legs which can be dangerous.
Medications
- Follow all the instructions given in the discharge summary regarding intake of medications
- Any previous medications the patient has been using need to be shown to the surgeon before discharge so that they are incorporated thus avoiding any duplication.
- Sugar control in diabetics is very important and cannot be ignored. Sometimes in the perioperative period changing from tablets to insulin helps control sugars on the advice of the physician.
Diet
- There are a lot of myths surrounding what to eat and what to avoid post-surgery. No correlation exists between the type of food intake and infection post-surgery.
- Only diabetics need to be careful of what they eat in order the keep the sugars below 200gm/dl
- Good nutritious food with high protein content is very important for wound healing.
- A good amount of water intake of about 2 liters is mandatory. This keeps the patient hydrated, avoids urinary tract infections and kidney issues.
Miscellaneous
- The dressing over the surgical wound is not changed frequently unless there is bleeding or has gotten soaked.
- Patients can take a bath post-surgery while covering the surgical site with an impervious plastic wrap that is commercially available.
- Climbing stairs is not prohibited but should be initiated under the supervision of the physiotherapist.
- Once the sutures are removed keep the surgical site clean. Soap and water can be used once the surgeon says it’s ok to do so.
An actively involved patient and family members armed with all the necessary knowledge regarding post-operative care is very crucial in obtaining optimum results post knee replacement surgery.
If you have any further queries regarding post-knee replacement care, please contact Dr. Suhas.
About The Doctor
Dr. A.B. Suhas Masilamani is a Consultant Robotic Joint Replacement Surgeon and Program Director of Sunshine OrthRobotics at Sunshine Hospitals, Hyderabad. He is one of the best orthopedic surgeons trained in New York, USA, and obtained fellowships in adult hip and knee replacement and robotic surgery. He is also one of the few certified trainers in India for Robotic Joint Replacement.
Dr. Suhas practices all the modern techniques in Orthopedics, like robotic joint replacement, minimally invasive techniques for total knee and total hip replacement, Unicondylar knee replacement, and patella-femoral replacement. He is one of the very few surgeons from the city to become a member of the American Academy of Hip and Knee Surgeons (AAHKS). He is also a member of the American Academy of Orthopaedic Surgeons (AAOS) and the International Congress for Joint Replacement (ICJR).