Preparation of the home environment is essential for ensuring a safe and successful recovery following knee replacement surgery. Physical limitations, such as restricted bending and reduced weight-bearing capacity, increase the risk of falls and make everyday tasks challenging. Equipping the house with specialized devices minimizes strain on the new joint and promotes independence. This allows the patient to focus on physical therapy and healing.
Essential Mobility Aids
Safe ambulation immediately following knee replacement primarily involves using a walker. The choice is typically between a standard walker or a front-wheeled walker. The front-wheeled model, which features two wheels on the front and stationary glides on the back, is often preferred initially. It offers substantial support and easier maneuverability than a standard, non-wheeled model.
While front-wheeled walkers may offer initial advantages, both walker types show similar improvements in speed and endurance by about six weeks post-surgery. A four-wheeled rollator, which has wheels on all four legs, is generally reserved for later stages of recovery. This is because the rollator prioritizes mobility over the stability needed in the early phase.
The physical therapist will guide the transition from the walker to crutches or a single-point cane as strength and balance improve. A single-point cane offers significantly less support than a walker, challenging balance to a greater degree. Pathways within the home should be cleared of tripping hazards, such as loose throw rugs and electrical cords. Chairs with firm backs and armrests in frequently used rooms provide convenient rest points and aid in standing transfers.
Bathroom Safety Modifications
The bathroom is an area of high fall risk due to slippery surfaces and tight spaces. Specialized equipment is needed to adapt the toilet and shower to accommodate temporary restrictions on knee flexion. A raised toilet seat is highly recommended because it adds height to the regular toilet. This minimizes the necessary knee bend when sitting and standing, lessening strain on the new joint.
A shower chair or bench is an important modification, allowing the patient to sit while bathing. Sitting conserves energy and significantly reduces the risk of slipping, which is common when standing for extended periods post-surgery. For tubs, a transfer bench may be used. This bench extends over the tub wall, allowing the patient to sit outside the tub and then pivot their legs inside.
Grab bars should be installed securely near the toilet and inside the shower or tub area for stable support during transfers. These bars should be secured vertically or horizontally, not diagonally, to provide the most effective leverage. The use of non-slip mats inside and outside the shower area is a simple yet effective measure to complement the primary safety equipment.
Tools for Reaching and Dressing
Performing daily activities like dressing and retrieving dropped items requires assistive tools to maintain knee precautions. A reacher or grabber tool is an inexpensive device necessary for picking up objects off the floor without bending or twisting the torso. This tool avoids excessive knee flexion, which can be painful or unsafe in the early recovery period.
Dressing aids are specific devices designed to help with lower-body clothing. A sock aid uses a plastic trough and long cords, allowing the patient to pull on a sock without needing to reach their foot. A long-handled shoehorn allows shoes to be slipped on while sitting, eliminating the need to bend over. These tools are often sold together in a “hip kit,” which facilitates independence in daily activities.
For managing post-operative swelling and pain, cold therapy equipment is used. While simple gel packs are affordable, a cold therapy unit, also known as a cryotherapy machine, provides more consistent cooling by circulating chilled water. Many of these units also provide compression, which helps reduce post-surgical swelling more effectively than cold alone. Pillows or wedges for elevating the leg are routinely used to assist in reducing swelling.