Post Op | TKR | Linktree

Exercises

Congratulations on your new knee ! 

We recommend that you walk as much as you feel comfortable (at least 2-3 times a day), trying to walk a little further each time. You can walk inside or outside as you feel comfortable. As stated above, you will need a walker or cane for stability for the first 6 weeks. When you begin to feel that you don’t need the cane anymore, you can begin to wean yourself from the cane; that is, you can stop using it for short distances and walk progressively more without it. Many patients will have to work on bending their knees while walking, so some therapists will recommend exaggerating this motion by "marching".  Equally important is the full extension of the knee with walking, so try to fully straighten the knee when you propel yourself forward. 


Walking

Knee motion is extremely important to work on during your recovery. Scar tissue begins to form immediately after surgery, and if the knee doesn’t regain its motion within a set amount of time, it will continue to be stiff. You must work on both extension (straightening) and flexion (bending) of the knee. Your goal for flexion is to bend beyond 90 degrees within 2 to 3 weeks of surgery 
My best advice to you during your recovery is to listen to your body – that is, if you overdo it one day, you may have more pain in the knee the next day. 


Motion

Some patients may develop blisters around the knee and/or the incision. Although they can be alarming in appearance, they pose no significant risk to your knee replacement. They may leak some clear fluid for a while, but eventually a scab will form, and they will heal. We recommend that you just “ignore” the blisters and allow them to heal on their own. 

The visiting nurse / physical therapist may put an extra dressing over the blister per our protocol and to keep it clean and covered. 

Blisters

 You may develop bruising of the operative leg. It is common and normal to develop bruising of your thigh, calf, ankle and foot. Bleeding normally occurs after a knee replacement and this blood will track along the tissue planes of your leg resulting in bruising of the thigh, calf and foot/ankle. This is normal after a knee replacement, and you should not be alarmed by it. The bruising will gradually go away on its own as the body absorbs the blood.  


Bruising

Immediately after surgery you will have a compressive dressing and/or stockings on your surgical leg.  When you are not actively doing exercises, please keep your surgical leg elevated on two pillows and continue moving your ankles up and down to help reduce the swelling and keep the muscle active.  

Your knee will be swollen for several months following TKR. We advise using your cryotherapy device regularly during recovery. 

It is also common to experience swelling below in the calf. Most times this is a result of gravity (standing on your feet and walking). This type of swelling should go away in the morning if you elevate your leg at night. Wearing a compression stocking that goes above the knee can also help. If the swelling in your calf persists despite elevation, please call my office. 

Swelling

AcitveWrap Ice Therpay Application Instructions

R.I.C.E. is the FOCUS (Rest Ice Compression Elevation)  

First 72 hours after your total knee replacement  

Immediately on arrival home from the surgery it is important that you elevate your leg on two pillows, apply the ice wrap, and continue to do your ankle pump exercises to reduce swelling.  

Follow your pain medication protocol given to you from Dr. Shah’s office 

Do not stay upright for greater than 15 minutes at a stretch before resting and elevating your operative leg  

Do not bend your knee past 45 deg for greater than 15 minutes before resting and elevating your operative leg 

Spend the majority of the first 48-72 hours resting with your leg elevated as instructed.  

Use the Ice wrap at least 5-6 x daily for 30-60 minutes and after any physical therapy sessions 

Keep doing your ankle pump exercises when the leg is elevated and you are resting 

Physical therapist will remove your surgical compressive dressing @ 24 hours during the first post op visit at home


R.I.C.E. 

How To Elevate Your Leg After Total Knee Replacement

Best Recliner After Knee Replacement

Sleeping in Recliner 

How to Elevate on Sofa

Post-Op Dressing 

Immediately on arrival home apply icewrap for minimum of 60 minutes with the leg elevated. 

You do not need to use icewrap when sleeping.

During the first week post surgery, use the icewrap for 45-60 min 5-6x throughout the day, giving 2 hours between treatments. 

After physical therapy sessions, use the icewrap. 

At anytime, you are experiencing pain or swelling, you can use the icewrap with keeping your leg elevated. 

The icewrap is meant to be stable on the knee.. during treatments, if you do need to get up and walk to get something or go to the bathroom, its ok to keep the wrap on. 


Ice Therapy

Post Op Pain Link 

Dr. Shah and his team will have guided you already thru the pain medications profile. You would have also received discharge paperwork that will guide you to exact details of the options provided to you for pain management. If you have questions, please do not hesitate to contact the office. 

Post-Op Pain Medications 

NON PENICILLIN ALLERGIC PATIENTS

1. Intraoperative dose of Ancef 2 g IV

2. On discharge home Keflex 500 mg PO x 1 dose

3. First night home take Keflex 500 mg PO x 1 tablet

4. Next day take Keflex 500 mg PO 1 tablet with breakfast lunch and dinner 




FOR PENICILLIN ALLERGIC PATIENTS

1. Intraoperative dose on Vancomycin 1 gm IV

2. First night home take clindamycin 600 mg PO x 1 tablet at bedtime

3. Next day take clindamycin 600 mg PO x 1 tablet with breakfast and dinner 


Post-Op Antibiotics

First 72hrs | RICE is the FOCUS

After surgery, there will be multiple follow-up visits to ensure that you are recovering properly.

Post-Surgical Appointment Timeline:

7-10 d --- visit at office for dressing change and wound check

12 -14 d --- staple removal, visit with Dr. Shah 

6 –8 weeks --- visit with Physician Assistant and Dr. Shah will stop by to check on you

3- 4 months --- Telemed visit with Dr. Shah 

10- 12 month--- visit with Dr. Shah 


Post-Op Visits

Elevation 

Post Op | TKR

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Post Op | TKR

Enhanced Recovery Guide

First 72hrs | RICE is the FOCUS

Elevation

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