Total knee replacement surgery is a common procedure performed to alleviate pain and restore function by replacing damaged bone and cartilage with artificial components. While it offers significant relief, recovery is a gradual process with specific milestones. Early activities are crucial for healing and long-term success.
Your Initial Steps After Surgery
Within the first 24 to 48 hours, medical teams encourage early movement to promote healing and prevent complications. Patients are assisted out of bed to a chair and begin initial walking with an assistive device like a walker or crutches. Physical therapists guide individuals through gentle exercises focusing on ankle pumps and knee movements to encourage circulation and begin regaining range of motion. This early mobilization is beneficial for reducing the risk of blood clots and accelerating rehabilitation.
Key Milestones for Day Three
By day three, specific mobility goals are in focus. Individuals should be able to sit up independently, transfer safely from bed to a chair, and stand with minimal assistance. Walking short distances, such as to the bathroom or around the hospital room, with a walker or crutches, is a common expectation.
Physical therapy sessions intensify, focusing on regaining knee flexion (bending) and extension (straightening). A reasonable goal for knee flexion by day three is 80 to 90 degrees, while working towards full knee extension (0 degrees). Achieving and maintaining full knee extension is important to prevent a flexion contracture, where the knee cannot fully straighten.
Therapists guide patients through specific exercises to activate muscles around the new joint. These include quadriceps sets, where the patient tightens the thigh muscle to push the knee flat, and heel slides, which involve gently bending the knee by sliding the heel towards the buttocks. These controlled movements are crucial for preventing stiffness, promoting optimal joint function, and initiating muscle re-education.
Early engagement in these exercises helps reduce swelling and minimizes scar tissue, both of which can impede range of motion. Patients are also encouraged to practice getting in and out of bed safely and navigating a few stairs, if applicable to their home environment. Performing these basic activities marks significant progress, setting the foundation for continued rehabilitation and a smoother transition home.
Managing Discomfort and Swelling at Home
Managing discomfort and swelling is important by day three. Adhering to a prescribed pain medication schedule is recommended to control discomfort, allowing for participation in physical therapy and movement. Ice therapy is effective for reducing both pain and swelling around the knee. Applying ice packs for 10 to 20 minutes at a time, several times a day, can alleviate symptoms.
Elevating the leg above the heart, particularly when resting, helps reduce fluid accumulation and swelling. This can be achieved by propping the leg on pillows. Compression stockings, if provided by the medical team, also help manage swelling and assist with circulation, which prevents blood clots. Consistent application of these self-management techniques contributes to a more comfortable recovery and supports healing by minimizing inflammation.
When to Contact Your Medical Team
While discomfort and swelling are expected, certain signs and symptoms warrant immediate contact with your medical team. A sudden increase in pain not relieved by medication, or pain that becomes severe and localized, should be reported. Signs of infection, such as fever, chills, increased redness, warmth, or pus-like drainage at the incision site, require urgent medical attention.
New or worsening numbness or tingling in the foot or ankle could indicate nerve issues. Calf pain, tenderness, or significant swelling in the calf, especially if accompanied by warmth, can be a symptom of a deep vein thrombosis (DVT), a serious blood clot. Persistent nausea, vomiting, or unusual shortness of breath are also reasons to seek prompt medical advice. Recognizing these warning signs and communicating them quickly ensures timely intervention and helps prevent complications.