Guidelines for Practice after Hospital Discharge Following Knee Replacement Surgery are essential for patients to pay attention to and must not be neglected. The details are as follows:
Care of the Surgical Wound
Avoid touching the surgical wound directly. The first dressing change will be done by the surgeon, changing it to a waterproof dressing. Generally, the surgeon will stitch the wound with dissolving stitches and cover it with a skin adhesive tape, so there is no need to remove the stitches. The caretaking physician will remove the waterproof dressing and skin tape approximately 14 – 20 days after surgery. After that, you may bathe and touch the wound. However, it is not recommended to soak in a tub until the surgical wound has completely healed, approximately 5 – 6 weeks after surgery. If the dressing comes off before the follow-up appointment, the area around the surgical wound can be cleaned and a new waterproof dressing can be applied in place of the old one, or you can go to the nearest healthcare facility to have it treated.
- Do not remove the dressing yourself under any circumstances.
- If you notice that the wound is leaking more fluid, becoming redder, or causing more pain around the surgical area, please contact the medical team taking care of you.
- If you feel feverish or unwell, please contact the medical team taking care of you.
Swelling and Bruising
Swelling and bruising can normally occur on the operated leg and will gradually improve over time, which may take several weeks to normalize. If activities or exercises increase swelling, lie down and elevate your leg above the level of your heart. Cold compresses can help improve the condition. Apply cold compresses to the surgical area about 3 times a day, each for about 1 hour together with elevating the leg above the heart level can help reduce pain and swelling.
Relieving Pain
Normally, after knee replacement surgery, you can feel pain. Patients will receive pain relief medication, which will be enough until the next follow-up appointment. Pain relief medication takes about 1 and a half hours to start working, so it should be taken before the pain starts. Do not consume alcoholic beverages while on pain relief medication and do not drive. If you need more pain relief before your next follow-up appointment, please contact your doctor.
Controlling Pain
- Take pain relief medication at least 1 hour before starting physical therapy.
- Gradually reduce the use of pain medication until only paracetamol is needed.
- Change your posture every 45 minutes throughout the day.
- Cold compresses on the surgical area can help reduce pain and swelling. You can use cold compresses before and after exercise.
Body Changes
- Patients may have a reduced appetite, which will return to normal soon. It is important to drink water to prevent dehydration.
- Try not to sleep or nap during the day too much, as it may cause difficulty sleeping at night.
- Patients may feel less strength than usual in the first month after surgery.
Bathing
Patients may need to wipe their bodies initially when returning home. The medical team taking care of you will provide guidance on when you can start bathing.
Walking
Walk short distances every 2 hours and gradually increase the distance every day. Please use walking aids every time to prevent overexertion. Do not walk on uneven or rough surfaces such as grass.
Sitting
Sit in a chair with a backrest and armrests. The chair cushion should not be too soft or too hard. Patients may need to use their hands to help push off the armrests when standing up. Do not sit on low chairs or low toilets. If sitting for more than 30 minutes, please exercise by moving your ankles to improve blood circulation.
Picking up Objects
Do not bend over to pick up objects in any case.
Diet and Exercise
Eating appropriately is very important. Clean, hygienic, and suitable food helps the body get the nutrients it needs and aids in recovery. Patients should eat foods high in protein and iron. Patients might not feel like eating in the first 1 – 2 weeks after surgery. If you do not feel like eating, it is recommended to eat small meals 5 – 6 times a day.
Advice: The medical team taking care of you may provide additional advice. Patients should strictly follow the instructions.
Contact the Medical Team if the Following Symptoms Occur
- Fever higher than 38 degrees Celsius
- Increased swelling, redness, and pain in the operated area
- Signs of infection
- Increased wound leakage or bleeding
- Pain, tightness, or tenderness in the calf
- Unable to perform activities or exercises
***If you experience chest tightness, weakness in the limbs, confusion, depression, or difficulty breathing, please go to the hospital immediately***
Guidelines for Patients After Knee Replacement Surgery
The most important thing in the rehabilitation of patients after knee replacement surgery is to increase the degree of bending and straightening of the knee. The physiotherapy team will help and instruct you to exercise every day. The knee should be able to bend about 90 degrees before leaving the hospital (3 – 5 days after surgery) and should be able to straighten fully within the first week after surgery. Generally, standing or lying down positions make it easier to straighten the knee, and sitting positions make it easier to bend the knee as well.
Knee Exercises
- Tightening Thigh Muscles Sit with your legs extended in front of you, straighten your knee, tighten the thigh muscles to press the knee down against the floor and hold for 3 – 5 seconds to straighten the knee as much as possible and increase the strength of the thigh muscles. Do 2 sets, each with 15 repetitions. You may use a rolled towel under your ankle so that your heel does not press against the floor.
- Straight Leg Raises Lie down with your legs flat on the floor, tighten the hip muscles as much as possible, lift your leg about 2 – 3 inches above the floor, then lower it slowly. Repeat for 2 sets, each with 15 repetitions.
What to Do
- Exercise and physical therapy every day as advised in the first 3 months after surgery, especially in the first 1 – 2 weeks.
- Apply cold compresses to the knee after exercising or physical therapy.
- Gradually increase the walking distance.
What to Avoid
- Sitting in low chairs
- Twisting or turning the knee