Knee Replacement Discharge
Total Knee Replacement Guide Home | Preparation for Your Knee Surgery | Pre-Admission Testing | Pre-Op | Post-Op | Discharge | FAQ
You will be discharged with prescriptions for all of your appropriate medications, including pain medications and blood thinning medicines. With pain medication, patients often have problems with constipation. You may use an over-the-counter stool softener, laxative, senna, or enema if necessary. You can help prevent these problems by drinking plenty of fluids, eating high fiber foods, walking and exercising. As far as your blood thinning medicine is concerned, most of you will already have your prescription for Coumadin at home and specific instructions for use will be emphasized.
If injectable blood thinning medicine (a form of low molecular weight heparin) has been prescribed as best for you, specific instructions to its use will also be emphasized. If another blood thinner is used, specific instructions will be provided.
Criteria for going home
- When your physical therapist determines you are moving about safely
- When you can get in and out of bed safely
- You can get up to the bathroom or commode safely
- When you tolerate your diet
- When your incision looks good
- When your vital signs are within normal limits
- When you are comfortable on oral pain medication
- When your laboratory studies are acceptable
Criteria for going to rehabilitation/extended care facility
If you cannot meet these criteria for home discharge in three to four days, then a short rehabilitation stay might be in your best interest. When you schedule your surgery the secretaries will ask you if you are interested in Rehab. A copy of this form will be sent to the Clinical Resource Coordinator (CRC) for Orthopaedics who will call the facility and make a referral for you. This does not automatically mean that you have been accepted. While you are a patient at DHMC, a nurse from the Rehab facility will do an on-site evaluation or your medical chart will be faxed to them. They will decide if you meet the criteria for transfer to their facility. Patients who go to Rehab usually stay less than a week. You will leave the Rehab institution with all of your appropriate medications and instructions as to their use. Patients usually travel by ambulance.
Once at home
During this time at home before your first post-op check, you will continue to use your crutches or walker and continue your exercises. You will be seen by a physical therapist approximately two to three times a week at home or as an outpatient. Approximately one to two months of physical therapy following your surgery is often recommended.
A schedule for monitoring your blood thinning medicines will be continued either at home or at the Rehabilitation facility up until your first post-operative check in the Orthopaedic Clinic. Any unusual calf pain, redness, or swelling should be reported to the Orthopaedic clinic staff immediately.
If you arrive at home with your staples/ sutures still in place, you must cover your incision with plastic wrap or a baggie with tape around it to prevent it from getting wet. Twenty four hours after staple/suture removal, you may get your incision wet in a shower. No swimming, hot tubs, or tub baths are recommended until your incision is completely healed, but it is best to delay this until your first post-operative check with you surgeon or nurse practitioner. Use only antibacterial soap and water on the wound. Pat the incision line dry. No ointments, lotions, oils, or vitamin preparations until the first post-op visit.
Note: IT IS IMPORTANT TO MONITOR YOUR INCISION FOR ANY SIGNS OF INCREASED REDNESS, SWELLING, WARMTH, OR ANY DRAINAGE FROM THE WOUND. YOU SHOULD ALSO WATCH FOR OTHER SIGNS OF INFECTION SUCH AS AN INCREASE IN YOUR TEMPERATURE, FEVER, OR CHILLS. IF ANY OF THESE SYMPTOMS OCCUR, NOTIFY THE ORTHOPAEDIC CLINIC.
Follow-up
A return-to-clinic appointment, scheduled for four to six weeks out, will be sent to you in the mail. This appointment will include X-rays.
