Total Knee

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Total Knee Replacement
What to Expect on Surgery Day
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Life After Knee Replacement

Post-operative Care

In a small percentage of people, as with all major surgical procedures, knee replacement complications can occur. Below is a list of potential knee replacement complications and steps you can take to prevent their occurrence.

Thrombophlebitis

This condition is also known as deep vein thrombosis (DVT), and it occurs when the large veins of the leg form blood clots and, in some instances, become lodged in the capillaries of the lung and cause a pulmonary embolism. The following steps may be taken to avoid knee replacement complications due to blood clots:

Blood-thinning medication (anticoagulants)
Elastic stockings (TED hose)
Foot and ankle exercises to increase blood flow and enhance venous return in the lower leg.

IMPORTANT: If you develop swelling, redness, pain and/or tenderness in the calf muscle, report these symptoms to your orthopaedic surgeon or internist immediately.

Infection
Although great precaution is taken before, during, and after surgery, infections do occur in a small percentage of patients following knee replacement surgery. Steps you can take to minimize this knee replacement complication include the following:

Monitor your incision closely and immediately report any redness, swelling, tenderness, increased drainage, foul odor, persistent fever above 100.4 degrees orally, and increasing pain.
Take your antibiotics as directed and complete the recommended dosage duration.
Strictly follow the incision care guidelines your surgeon recommends.

Pneumonia
Because your lungs tend to become “lazy” as a result of the anesthesia, secretions may pool at the base of your lungs, which may lead to lung congestion or pneumonia. The following steps may be taken to minimize this complication:

Deep breathing exercises: A simple analogy to illustrate proper deep breathing is to, “smell the roses and blow out the candles.” In other words, inhale through your nose, and exhale through your mouth at a slow and controlled rate.
Incentive Spirometer: This simple device gives you visual feedback while you perform your deep breathing exercises. Your nurse or respiratory therapist will demonstrate proper technique.

Knee Stiffness
In some cases, the mobility of your knee following surgery may be significantly restricted and you may develop a contracture in the joint that will cause stiffness during walking or other activities of daily living. The following steps must be taken to maximize your range of motion following surgery:

Strict adherence to the CPM protocol as prescribed by your surgeon
Early physical therapy (Day 1 or 2) to begin range of motion exercises and walking program
Edema control to reduce swelling (ice, compression stocking, and elevation)
Adequate pain control so you can tolerate the rehabilitation regime