Knee Replacement Surgery Postoperative Procedures

After total knee replacement surgery, patients are monitored for 1–2 hours until the anesthesia wears off. Depending on the specific type of surgery performed and the patient's overall health and recovery, most patients remain in the hospital for several days after the procedure. Prescription pain medication usually is used to relieve postoperative pain.

Several therapies are used soon after knee surgery to encourage circulation in the leg and prevent blood clots. These therapies include the following:

  • Compression boots that wrap around the lower leg and expand and contract to apply gentle pressure
  • Continuous passive motion (CPM) machine that gently moves the leg while the patient rests in bed
  • Movement of the foot and ankle while resting in bed
  • Medication to thin the blood
  • Elevation of the leg for short periods of time

In many cases, a physical therapist consults with the patient the day after knee replacement surgery. Physical therapy involves movements and exercises to help the patient adjust to the new joint and gradually begin to walk again.

Recovery after Knee Replacement Surgery

Before being released from the hospital, patients should make sure they are aware of warning signs that might indicate blood clots or other potentially serious complications. After knee replacement surgery, patients should seek immediate medical attention if any of the following develop:

  • Chest pain
  • Shortness of breath
  • Sudden increased swelling, pain, redness, or tenderness in the lower leg

Much of the success of total knee replacement surgery depends on the patient's willingness to follow his or her surgeon's instructions during the recovery period. Pain is normal for several weeks after the surgery and usually is treated with medication. Postsurgical pain usually subsides after a few weeks of rest and strengthening exercises.

Surgical wounds should be kept clean and dry until area heals. Patients should avoid soaking (e.g., in a bath) for about 6 weeks after total knee replacement surgery. If redness or swelling occurs near the incision, the surgeon should be contacted immediately.

A low-grade fever is normal for the first few days after surgery. However, if fever persists, rises above 101 degrees F, or is accompanied by chills, sweating, pain or drainage at the incision site, the surgeon should be contacted.

Swelling is normal for several months after knee replacement surgery. Elevating the leg for 30–60 minutes every day can help reduce swelling. Patients often experience less swelling in the morning and more in the afternoon and evening. If significant swelling occurs in the morning, the surgeon should be contacted.

After knee surgery, a physical therapist will provide the patient with a clear and specific program of activities and movements to do during the recovery period. Daily movement and exercise can help patients to regain strength and get back to normal activities faster, and can prevent complications such as blood clots. Patients who have difficulty walking or doing the recommended exercises and activities after total knee replacement should consult with their physical therapist.

During the first weeks of recovery, patients are not able to drive. Knee replacement patients can drive when they:

  • are no longer taking any narcotic pain medication,
  • are able to get in and out of the car easily and comfortably, and
  • respond appropriately to reflex and strength testing.

After knee replacement, patients should be sure to eat a healthy diet and should talk with the surgeon about specific dietary instructions. It may take as many as 6 weeks before the patient feels steady on his or her feet, and a walker or crutches should be used until he or she is able to walk unassisted. Once the patient begins using the stairs, he or she should always use the handrail. To reduce stress on the replaced knee, patients should lead with their old knee when going up the stairs and lead with their replaced knee when going down the stairs.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 11 Jan 2010

Last Modified: 28 Sep 2015