Patient education: Knee replacement – Discharge instructions (The Basics)

What are discharge instructions? — Discharge instructions are information about how to take care of yourself after getting medical care for a health problem.

What is knee replacement? — Knee replacement is a surgery in which a doctor replaces part or all of a person's knee joint with artificial or "prosthetic" parts (figure 1). It can reduce knee pain and improve the way the knee works.

How do I care for myself at home? — Ask the doctor or nurse what you should do when you go home. Make sure that you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

For the first 24 hours after surgery:

●Do not drive or operate heavy or dangerous machinery. Your doctor will talk to you about when you can drive again.

●Do not make any important decisions or sign any important papers.

●Do not drink alcohol of any kind.

You should also:

●Follow all instructions for wearing the special boots or stockings that help prevent blood clots, if your doctor gave you these.

●Work with a physical therapist to learn exercises to make the muscles around your knee stronger. They will work with you on bending, walking, and climbing stairs so you can move normally. You will also learn stretching exercises to gradually get flexibility back. All of these exercises are very important to help you recover as quickly as possible and get back to your usual daily activities. Moving your leg regularly also helps lower the risk of blood clots.

●Put a pillow under the foot of the leg you had surgery on when you are in bed. This helps keep your knee straight, which improves flexibility. Do not put a pillow behind your knee.

●Take all of your medicines as instructed, including any medicines to prevent blood clots.

●Take medicines to help with pain.

•If your doctor prescribed opioid pain medicine, you might get constipated. Take a stool softener to prevent this problem.

•Instead of opioids, you can also take non-prescription medicines to relieve pain. Examples include acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), or naproxen (sample brand name: Aleve).

●Take care of your incision – You might have stitches, skin staples, surgical glue, or a special skin tape on your incision.

•Keep your incision dry and covered with a bandage for the first 1 to 2 days after surgery. Your doctor or nurse will tell you exactly how long to keep your incision dry.

•Once you no longer need to keep your incision dry, gently wash it with soap and water whenever you take a shower. Do not soak it in water or swim until your wound has healed. This can slow healing and raise your chance of getting an infection.

•After you wash your incision, pat it dry. Your doctor or nurse will tell you if you need to put an antibiotic ointment on the incision. They will also tell you if you need to cover your incision with a bandage or gauze.

•Always wash your hands before and after you touch your incision or bandage.

●Increase your activity slowly – Most people are able to stand and walk (with help) shortly after surgery.

•Follow all instructions for using a walker, crutches, or a cane. Make sure that you know much weight you can put on the leg with the knee replacement. This can range from no weight-bearing to full weight-bearing.

•Start with short walks around your home, and walk a little more each day.

•Avoid heavy lifting, driving, sports, and swimming for at least 2 weeks. (Your doctor, nurse, or physical therapist will tell you exactly how long to avoid these or other activities.) Over time, slowly increase your level of activity as you get stronger.

What follow-up care do I need? — The doctor will want to see you again after surgery to check on your progress. Go to these appointments.

If you have stitches or staples, you will need to have them taken out. Your doctor will usually want to do this in 1 to 2 weeks. Some stitches absorb on their own and do not need to be removed. If the doctor used skin glue or skin tape, it will fall off on its own. Do not pick at it or try to remove it yourself.

When should I call the doctor? — Call for emergency help right away (in the US and Canada, call 9-1-1) if:

●You feel short of breath or have trouble breathing.

●You have sharp or severe chest pain when you breathe.

●You are coughing up blood.

Call the doctor or nurse for advice if:

●You have a fever of 100.4°F (38°C) or higher, or chills.

●You have skin color changes or swelling around the incision from the surgery.

●You have more pain or swelling in your knee or leg.

●Your leg becomes cool, blue, gray, or numb, or it tingles.

●Your knee feels less stable, or like part of the joint is out of place.

More on this topic

Patient education: Knee replacement (The Basics)
Patient education: Deciding to have a knee replacement (The Basics)
Patient education: Knee pain (The Basics)
Patient education: Osteoarthritis (The Basics)
Patient education: Deep vein thrombosis (blood clot in the leg) (The Basics)
Patient education: How to use crutches (The Basics)

Patient education: Total knee replacement (Beyond the Basics)
Patient education: Knee pain (Beyond the Basics)
Patient education: Joint infection (Beyond the Basics)
Patient education: Deep vein thrombosis (DVT) (Beyond the Basics)