Post-Op Knee Surgery
Total Knee Replacement Guide Home | Preparation for Your Knee Surgery | Pre-Admission Testing | Pre-Op | Post-Op | Discharge | FAQ
You will be transported from the operating room to the Post Anesthesia Care Unit (PACU), where you will recover from the anesthesia. Expect to find a continuous passive motion (CPM) machine on your bed. The PACU nurse will place your affected leg or legs in the device to begin exercising your new knee or knees.
Your new joint will be cooled by a cryo cuff (ice pack). You will have an ace bandage dressing over your knee that will stay there until the doctor changes the dressing in two or three days. Once the dressing is changed, you will wear your TED stocking on that leg. Sequential Compression Devices will massage the legs to aid blood flow.
While you are recovering from your anesthesia in the PACU, your surgeon will have met with your family and friends to inform them of the successful completion of your surgery.
A drain placed during surgery will be attached to a standard collection device or an autotransfusion unit to remove excess blood and body fluids from in and around your knee. The drain will usually be removed the next morning.
Goals & concerns
- First and foremost to be able to straighten your knee out completely
- To bend your knee beyond 90 degrees (a right angle)
- To pump your ankles as much as possible to improve blood flow back to the heart
Pain management
One of the most important factors influencing the outcome of your rehabilitation is pain management. You will not be able to perform required activities effectively, if you can are in too much discomfort. Starting in the PACU and throughout the hospital, nurses, doctors and therapists are going to be asking you what your pain level is on a scale of 0 to 10. It is unrealistic to tell you that we can take away all your pain, but to keep your pain level at a "2" or a "3" is tolerable for most people. It is very important for you to be proactive in your pain control. You need to tell the nurse how the medication is working, in other words, are the pills lasting for four hours or are you having some pain after three hours? We can change your pain medication regimen and make it right for you, but you need to tell us how it is working. The goal is to keep a good blood level of pain medication to assure even control instead of peaks and valleys.
The PACU nurse will give you medication through your IV until you achieve a comfort zone and will start your Patient Controlled Analgesia (PCA) pump. You will be shown how to use the pump, which has a syringe of pain medication chosen by your doctor. You self-administer the medication. However you can't overdose, because there is a lockout interval. The PCA will be used until the next morning, when you will be given pain pills with your breakfast. You may use the PCA until the oral medication is effective.
Nourishment
You will first be given liquids (Jello, broth, ginger ale, and sherbet) until your stomach "wakes up" and you can digest solid food. If you have "good bowel sounds," your diet will be advanced as tolerated. Nausea may occur, but it is usually a temporary condition. Medications can be given to reduce this discomfort.
On the orthopaedic unit
Your urinary catheter will usually be removed on the second post-op day. This may cause a slight burning pain but it resolves quickly and is nothing to worry about.
Your doctors will change your dressing on the second or third post-op day. Your incision may be stapled or sutured. The sutures will be removed in 10 to 14 days by a visiting nurse, therapist, or your doctor. If you go to Rehab, they will remove them there. You may take a shower in the hospital before the staples/sutures are removed. Nursing will apply a waterproof dressing.
A special set of orders has been designed by the doctors, nurses, and therapists caring for you. This pathway is a guide that will allow you to progress safely through post-surgical, nursing, physical and occupational therapy goals, as a preface to your discharge.
