In a small percentage of people, as with all major surgical procedures, knee replacement complications can occur.
Postoperative care begins with a team approach of heath professionals within the hospital. Those closely involved with the postoperative total knee patient are:
After surgery, vital signs and sensation in the lower extremities are observed and checked by the nursing staff and documented for the physician. Antibiotics are administered according to the physicians preference to reduce the risk of infection.
The surgical incision is observed closely for:
The respiratory therapist is essential at this stage for:
Instruction on how to use a bedside device to assist in deep breathing exercise called the Incentive Spirometer. This device along with deep breathing exercises are important to minimize the risk of lung complications after surgery by removing any excess secretions that may settle in the lungs while asleep during surgery.
Shortly after surgery the physical therapist addresses:
The occupational therapist is involved in evaluating and addressing how well the patient with the new knee replacement functions with activities of daily living. Issues such as how safely and independently the patient is able to dress, bathe, and care for his or herself following total knee replacement are evaluated.
Exercising the knee and leg muscles following surgery is extremely important to the success of the total knee replacement.
Exercises aim to quickly regain increasing motion in the knee following surgery, prevent muscle loss, which is inevitable after surgery, rebuild the muscle strength and prevent stiffness of the new knee joint.
It is important therefore, to carefully follow the rehabilitation instructions given by the physical therapists and doctors.
Standard exercises that are used for early postoperative knee replacement include:
This is a good beginning exercise as it not only initiates the needed muscle contraction but also is helpful in increasing extension of the knee. It is optimal for both legs as both legs will be in a weakened state postoperatively. Try to do this exercise several times every hour. However, the amount of discomfort will determine how many each individual can perform.
While lying in bed with legs straight and together and arms at the side.
This exercise also helps promote muscle activity and increases knee extension. This exercise is to be repeated 10-20 times.
While lying in bed place a pillow or towel rolled up into a bolster under the operated knee to position the knee joint at approximately 40 degrees from full extension.
This exercise will promote muscle activity of the hamstrings as well as help increase the amount of knee flexion. The physical therapist will record the amount of flexion and extension for a daily report on the patient's progress to be reviewed by the physician.
While lying in bed on the back, keep legs straight and together and arms at the side.
This is another excellent exercise to promote strength to the quadriceps and the flexor muscles important in ambulating. Once the individual can perform 20 repetitions without any difficulty, gradual resistance at the ankle (such as the use of ankle weights) can be utilized to further strengthen the muscles. The amount of weight used should be increased in no more than one pound increments.
This is a good exercise to help strengthen the hip adductors or groin muscles.