Knee Replacement Recovery: Discharge To 21 Days
After being discharged from the hospital, a patient will go home or to a rehabilitation center with on-site nursing and physical therapy. Whether the patient is home or at a rehabilitation center, the priorities will be the same:
- Do physical therapy
- Keep the incision clean
- Avoid activities that could endanger the patient or the incision
- Watch out for signs of complications, such as deep vein thrombosis
Most patients have a follow-up visit with their surgeon 10 to 21 days after surgery. At that time stitches may be removed and the recovery guidelines may be adjusted.
Should You Elevate Your Legs While Sleeping
Prop up your legs when you are sitting. Use a footrest at work and a footstool or ottoman at home to elevate your feet. Lie down and prop your legs above heart level at the end of the day. Try lying on your back on a bed with your feet propped on the wall or on pillows to improve blood flow back to the heart.
How Long Do You Have Pain After Knee Replacement Surgery
It is usually normal to have some pain after surgery, but this pain generally improves with time. However, doctors can provide some pain relief until this happens.
In rare cases, pain may persist longer. Therefore, people who have ongoing or worsening pain should seek advice from their doctor, as there may be a complication.
The most common complication is that people dont like the way their knee works or they continue to have pain or stiffness.
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Maintaining Good Knee Health
The Dos And Donts Of Leg Elevation
Learning how to elevate the feet in the correct manner can mean the difference between speedy healing, reduced pain and improved blood flow and a slew of negative results, such as increased pain, swelling and risk of infection. Follow these dos and donts to ensure that youre not elevating the legs the wrong way.
- Do: Lie flat on your back. As tempting as it is to elevate while youre sitting upright, its much more beneficial if you start with a flat back. Why? The legs must be elevated to a level above the heartits all about gravity!
- Dont:Sit in a recliner.The key here is to make sure that your upper body, primarily your heart, is positioned at an angle below the legs. Unfortunately, you cant easily accomplish this if youre sitting upright in a recliner or a regular chair.
- Do:Use an elevation aid.As you can see, getting the proper angles and height right is key to proper leg elevation, and using a foot rest pillow can help you achieve these specifications without sacrificing comfort or setting up a new rig every time you need to elevate.
- Dont:Prop your legs up on a table.You wont get the angle right by propping your legs up on a table, or any other surface for that matter, and the hard surface may cause additional pain and discomfort. Always use an elevation pillow for feet to ensure safe, comfortable healing.
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Why Use A Pillow Under The Knee After Knee Replacement
Lets begin with the basics. In previous articles we discussed why elevation is your friend after TKR. Elevation is part of the acronym RICE which stands for Rest, Ice, Compression, and Elevation .
After surgery, your doctor will likely have your leg slightly elevated in your hospital bed. Most people understand that elevating your leg will help reduce inflammation and swelling after TKR.
This will also help reduce the chance of infection and blood clots.
According to research in The Knee Journal, researchers found that elevating the leg at 35 degrees from the hip is a safe and effective way to reduce total blood loss by 25%. This was more effective than the leg laying straight.
Keep in mind this is directly after surgery so there are significant blood loss benefits for leg elevation.
As your knee heals youll experience swelling in the days and months afterward, especially after physical therapy sessions and exercise. Elevation, along with icing after exercise, will help keep swelling down and keep fluid from building up in the leg.
Im a firm believer in ice, compression, and elevation after knee surgery. I also wrote a list of the most important items I used after knee replacement. I believe my routine helped me recover more quickly.
Physical Therapy After Knee Replacement Surgery
Every patient will be given physical therapy exercises to do at home. The patient may also receive in-home physical therapy or go to a physical therapists clinic. Initially, recovery and physical therapy typically prioritize:
- Reducing swelling and pain. The leg must be elevated above the heart. It is important to realize that most reclining chairs do not elevate the knee above the heart. Instead, lie on a bed or couch with the foot propped up on pillows.
- Walking regularly. Walking can be done with a walker, crutches, or other assistive device. Walking encourages the healing process and helps lower the risk of complications.
- Stretching and strengthening exercises. Most stretches and exercises will target the quadriceps, hamstring, and calf muscles. The patient will be given a list of recommended exercises and stretches with descriptions on when and how to do them.
When possible, elevate the foot without support behind the knee. Gravity will force the knee into a straighter position. This position can be uncomfortable but will help prevent scar tissue from forming.
The goal is to eventually bend the knee at least 120°, allowing the person to get in and out of most car seats, low chairs, and sofas.
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Knee Buddy Home Care Procedures And Benefits
The Knee Buddy can be useful following several types of knee surgery. Its unique design has been shown to significantly aid in the successful recovery from total knee arthroscopy, knee replacement, ACL reconstruction, and other knee surgeries.
The purpose of the Knee Buddy is to provide your patients with a multi-functional product that is vital for your recovery by allowing them to elevate their leg, and also allows for full extension of the knee. These two concepts bundled together have the following benefits:
1 Effectively controls edema
2 Increases range of motion postoperatively
3 Speed up recovery time
4 Stabilizing the knee during rehab
5 Can reduce pain medication consumption
How To Reduce Swelling After Knee Surgery
This article was medically reviewed by Erik Kramer, DO, MPH. Dr. Erik Kramer is a Primary Care Physician at the University of Colorado, specializing in internal medicine, diabetes, and weight management. He received his Doctorate in Osteopathic Medicine from the Touro University Nevada College of Osteopathic Medicine in 2012. Dr. Kramer is a Diplomate of the American Board of Obesity Medicine and is board certified.There are 10 references cited in this article, which can be found at the bottom of the page. This article has been viewed 32,352 times.
Swelling may be moderate to severe in the first few days after knee replacement surgery, but it will gradually subside as you recover. Still, you might experience some mild to moderate swelling in the weeks and months following your recovery. Luckily, there are several strategies you can try to reduce swelling, such as following your doctors instructions after surgery and trying out exercises meant to reduce swelling. If you experience an increase in swelling, tell your doctor right away.
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Straight Leg Raising With A Brace On
Before starting to progress your straight leg raising, you should be able to perform the exercise while wearing a brace on your leg. After surgery, your healthcare provider may have you wear a brace to protect your healing knee.
The straight leg raise immediately after surgery can be made safer with the use of your knee brace. Many times after ACL or lateral release surgery, your surgeon will require you to wear a brace on your knee to protect it against excessive bending or straightening. Your brace also helps to protect your knee from sideways forces through your knee joint.
To perform this initial straight leg raise, keep your brace on, lie on the floor, bend your unaffected knee, and keep your surgical knee straight. Try to contract your quadriceps by straightening your knee all the way, and slowly lift your leg up off the floor.
You should lift your leg up about 12 inches, hold it in this position for one or two seconds, and then slowly lower your leg down. Repeat this exercise 10 to 15 times.
To strengthen your hip muscles, you can perform this straight leg raise on your side or on your stomach. Just be sure to keep your brace on to protect your knee, keep your quadriceps muscle contracted, and slowly lift and lower your leg 10 to 15 repetitions.
Pain Medications After Knee Replacement Surgery
If a nerve block was used during knee replacement surgery, it may wear off shortly after being discharged. This means patients may have more pain at home than they did in the hospital. To decrease and avoid pain, patients will need to take oral medications.
The oral pain medications used may include:
- Opioid medications, such as oxycodone
- Non-steroidal anti-inflammatory drugs , such as ibuprofen and COX-2 inhibitors
- Aspirin, a pain reliever as well as a blood thinner
- Gabapentin, a medication developed to treat seizures but sometimes prescribed to treat nerve pain
People should not wait until their pain becomes severe before taking medications. Oral pain medications do not take effect immediately. In addition, pain is easier to stop before it starts.
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What Should I Expect
Its important to note that everyone has different pain level tolerances, and no two cases are the same because our knees are complex joints. Knees are the second-largest joints in the body, after the hip joints. As such, a knee replacement is a complicated surgery that involves balancing ligaments, cutting into the bones of the knee joint, and replacing parts of the knee joint with artificial parts. The manipulation of the knee joint to place the parts leads to the pain after the procedure. Postoperative pain after knee replacement surgery is related to the healing, stretching, bending, and rotating that the knee must do after surgery.
Effectively Control Your Edema
Elevating your leg right away after surgery will greatly decrease swelling following your knee surgery. Being consistent with elevating above your heart is vital to decreasing the edema that is caused by a major surgery. Coupling the consistent elevation with placing your knee in extension for periods at a time in the days following surgery, will promote increased muscle strength in your quad which in turn reduced swelling. The reduction of edema around the surgery site also reduces your chances of a possible infection. When you have edema the integrity of your skin is decreased, which makes it susceptible as a host to unwanted bacteria.
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Knee Buddy Extender Home Care Procedures And Benefits
The Knee Buddy Extender can be useful following several types of knee surgery. Its unique design has been shown to significantly aid in the successful recovery from total knee arthroscopy, knee replacement, ACL reconstruction, and other knee surgeries.
Always consult your medical provider on their recommended use for this product. Our medical advisory board suggests that you elevate as often as possible, and have your leg in extension 3-4 times per day for 30-45 minutes at a time, or as long as you can tolerate.
The purpose of the Knee Buddy Extender is to provide you with a multi-functional product that is vital for your recovery by allowing you to elevate your leg, and also allows for full extension of the knee. These two concepts bundled together have the following benefits:
- Effectively control your edema
- Increase your range of motion postoperatively
- Speed up recovery time
- Stabilizing the knee during rehab
- Can reduce pain medication consumption
Keeping The Legs Completely Straight
You may have seen some other brands of leg elevation pillows that feature a completely straight incline, with no bend for the knee. Theres also a good chance you have elevated your legs without bending the knee if you have ever put your feet up on a wall or the arm of a couch. However, keeping the legs completely straight puts a lot of strain on the muscles and tendons of the knee and can cause significant pain. Gently bending the knees is not only more comfortable, its also less likely to result in further injury.
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Improve Your Sleeping Environment
A dark, cool, clean, and noise-free bedroom with a comfortable mattress is an ideal sleeping environment.
Although an ideal sleeping environment is different for different individuals, a few things are essential to make the space sleep-friendly.
Keep the Room Temperature at 18.3 Degrees Celsius
Experts have recommended a temperature of 18.3 degrees Celsius, or 65 degrees Fahrenheit, as the ideal bedroom temperature .
Your body temperature starts declining at the start of sleep, and this helps with the release of the sleep hormone, melatonin.
If the surrounding air is cool, then the onset of sleep will be faster, while a higher temperature will keep a person alert.
Limit Ambient Light and Light from Electronic Devices
Ambient light should be kept as low as possible for good sleep.
Exposure to light disturbs the circadian rhythm, as well as melatonin release.
A less-discussed source of light is the glow from mobile phones and electronics.
This type of light has the same tendency to disrupt our sleep as regular artificial light.
Moreover, these devices produce noise, and stimulate the brain center, keeping us awake.
I always recommend that my patients minimize the use of electronics in the evenings.
Mobile phones should be put on silent mode and flipped over for the night.
Block Out Noise With Earplugs
Noise is another factor that inhibits our sleep.
A quiet room helps to induce sleep early, while loud noises will cause sleep disruption and fragmentation.
Are There Any Precautions To Be Aware Of
If youre interested in trying leg elevation, there are some pointers to keep in mind.
First, if you have an underlying health condition, talk with your doctor to make sure its safe for you. This is always a good rule of thumb before trying any new therapy.
Your doctor may have specific tips on how best to do leg elevation for your condition. Its also possible that leg elevation may not be recommended for your condition.
Next, ensure that you have the appropriate support for your body. Be sure that youre lying on a surface that provides good support for your back.
Remember that your legs need to rest above the level of your heart. Because of this, it may be helpful to use a pillow to help elevate your legs. In fact, you may want to get a pillow specifically designed for leg elevation.
Lastly, its important to follow your doctors instructions if youre recovering from an injury or surgery. If leg elevation is part of your recovery plan, be sure to adhere to your doctors guidance on how often and how long to do so.
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Is It Ok To Elevate Legs While Sleeping
When youre sleeping, when youre lying on the couch for a night of TV or movie-viewing, and even if you can get horizontal for a little while during the day, arrange some pillows in a comfortable formation to get your legs elevated 6 to 12 inches above your heart. Leg elevation, youll notice, feels good immediately.
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How Often Should I Elevate My Knee Using A Pillow
Literature discussing how often to elevate ones knee after TKR varies. You and your doctor will make the ultimate decision. However, Ive read anywhere from 1-6 times a day after surgery for approximately 20 minutes.
3-4 times per day in the days following TKR is a reasonable amount that will help reduce inflammation. Youll experience pain the first two weeks after surgery but soon youll be feeling much better. Its wise to continue elevating your knee a few times a day, especially in the afternoon if youve been active during the day.
I had a favorite spot on the couch where Id elevate and ice my knee while watching the evening news. Icing and elevating the leg at the same time kills 2 birds with one stone they complement each other but make sure you dont ice too long .
This routine worked well for me as I recovered. It helped prepare me to sleep with less swelling so Id wake up more refreshed the following day.
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