Total Knee Replacement: What to Expect at the Hospital

What care can you expect in the hospital?

After knee replacement surgery, you will be taken to the recovery room. In a few hours, you may go to a hospital room. You may see a metal triangle called a trapeze over your bed. You can use this to help move yourself around in bed. You will be very tired and will want to rest. Your nurse may also help turn you as you rest.

You will be getting fluids into your vein through an I.V. tube. You may also have a tube called a drain near the cut (incision) in your knee.

You may not feel hungry. You may feel sick to your stomach or constipated for a couple of days. This is common. Your nurse may give you stool softeners or laxatives to help with constipation.

You may have stockings that put pressure on your legs to prevent blood clots. Your nurse will also give you medicine and exercise instructions to help prevent clots.

Most people get out of bed with help on the day of surgery. Your doctor will let you know if you will stay in the hospital or if you can go home the day of surgery.

This care sheet gives you a general idea about how your recovery will begin in the hospital. Each person has a different experience and recovers at a different pace.

What will happen in the hospital?

Pain and pain medicine

You will receive medicine to help control pain. Some pain medicines are given through an I.V. Others are taken by mouth.
Take it as needed, and remember that it is easier to prevent pain before it starts than to stop it after it has started.
If you are still in pain after you take your medicine, tell your nurse. You may need new medicine or to get the medicine in a different form.

Other medicines

Your doctor will tell you if and when you can restart your medicines. You will also get instructions about taking any new medicines.
If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
Your doctor will probably give you blood thinners to prevent blood clots in your leg. You take this medicine during your hospital stay and when you go home.

Rehabilitation

Your rehabilitation (rehab) will probably begin the day of your surgery. Your physical therapist will get you started. It may be painful to exercise at first, but your nurse will give you pain medicine if you need it.
Your physical therapist will help you walk, go up and down stairs, and get in and out of bed and chairs. The therapist will help improve the movement (range of motion) and strength in your knee. You will learn positions and motions that will help prevent your knee from popping out (dislocating). This is a very important part of your therapy.
How quickly you regain strength and motion and do things on your own depends on how well you follow your physical therapy. Your physical therapist will teach you the exercises, but you must do them yourself.
An occupational therapist will work with you. You will learn how to bathe, dress, and do daily activities. You may need tools to help with everyday activities. Tools include shower stools, shoehorns, and long-handled sponges.

Diet

You will probably get liquids at first, but you can start to eat your normal diet when you feel like it. If your stomach is upset, your nurse will probably bring you bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
Drinking enough fluids, taking a stool softener, and eating foods that are good sources of fiber can help you avoid constipation after surgery.

Incision care

You will have a bandage over your incision. Your nurse will care for this.

Other instructions

Your nurse or respiratory therapist will have you do breathing and coughing exercises to prevent problems such as pneumonia. Breathe in deeply through your nose, and slowly breathe out through your mouth. Do this 3 times, and then cough 2 times.
You may have a device (incentive spirometer) that you suck air through to help keep your lungs healthy. Use this as your nurse or therapist tells you to.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

You have severe trouble breathing.
You have a cough, shortness of breath, or chest pain.
You are sick to your stomach or cannot keep fluids down.
You have signs of a blood clot, such as:
- Pain in your calf, back of the knee, thigh, or groin.
- Redness and swelling in your leg or groin.
You are in pain or your pain does not get better after you take pain medicine.
Bright red blood has soaked through the bandage over your incision.
You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the incision.
- Pus draining from the incision.
- A fever.

Where can you learn more?

Go to http://www.healthwise.net/patientEd

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.

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