Total knee replacement, or TKR, is not routine, but proper postoperative care can help restore mobility more quickly. Your knee joint is replaced by cutting the surface of the three bones that comprise the knee joint -- the thighbone, shinbone and kneecap. The joint is resurfaced with parts of metal and plastic, which are attached to the bones with cement. Plastic is inserted between the thighbone and shinbone to help the parts move smoothly. According to Georgetown University Hospital, about 200,000 people have TKRs each year. The hospital says it is essential that "you take an active role in your preoperative and postoperative care as well as rehabilitation."
Before Surgery
TKRs primarily are done to relieve pain. Knees can be compromised by arthritis, injuries and other diseases and conditions. Prior to surgery, you might be asked to donate two units of blood, in case it is needed during or after surgery. Therapists discuss the postoperative treatment plan, and your surgeon explains the length of time you are likely to be in the hospital. Home-care plans need to be finalized -- you should have someone stay with you for the first few weeks after surgery. If possible, set up your home so you can stay on the main floor.
After Surgery
After TKR surgery, you're likely to feel tired and weak. You might receive a pain-relief device that you can control. When you are taken to your room, cough regularly, take deep breaths and pump your feet. This will improve your breathing and help the circulation in your legs. Anesthesia and pain meds will limit the amount of food your stomach can tolerate, but you can start drinking small amount of fluids and build up to food over a 24- to 36-hour period. Expect considerable pain around the knee area for the first day or two.
Physical Therapy
You are asked to get on your feet the day after surgery. You might even take some steps using a walker. A continuous passive motion machine, or CPM, is used for about 10 days after surgery. The CPM bends and straightens your leg for you. Expect to use it up to four hours per day. You will receive instructions for getting out of bed and climbing stairs. An occupational therapist will offer information for performing everyday living activities safely, including bathing, dressing and cooking. Expect to wait at least six weeks before driving.
Considerations
Although most patients are discharged to go home, some are advised to spend time in a rehabilitation facility. Get approval for rehab care from your insurance company prior to surgery. When you have recovered from TKR, it is beneficial to walk as much as possible. Low-impact activities such as riding a stationary bike, swimming, golfing and bowling should be fine. High-impact activities like jogging are not advised -- they can loosen the components in your new knee joint.
