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| Total
Knee Replacement |
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Care
after Surgery
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Your
Stay in the Hospital
Your
hospital stay will vary depending on your recovery
and walking. It normally varies from 7 to 14 days after
surgery.
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After
surgery, you will feel some pain in your knee. Pain
medication will be given to make you as comfortable
as possible. To avoid lung congestion after surgery,
you will be asked to breathe deeply and cough frequently.
Frequently, a thin plastic tube (epidural catheter)
is inserted close to your spinal cord while giving
spinal anaesthesia. This catheter is maintained for
a few days after surgery and pain-relieving injections
are given through this tube. Leg exercises are started
as soon as you are comfortable.
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You
will have no plaster on your knee but a bulky dressing
will be applied for after surgery. On second day after
surgery, the dressing is changed, any drain tubes are
removed and a small dressing is applied. Knee bending
is then started.
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As
soon as you have regained your thigh muscle power,
you can commence walking. Most knee replacement patients
begin standing and walking with the help of a walking
support and a physiotherapist, 4 to 5 days after surgery.
The physiotherapist will teach you specific exercises
to strengthen your muscles and restore movement in
your knee for walking and other normal daily activities.
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Possible
Complications After Surgery
The
complication rate following knee replacement surgery
is low. Serious complications, such as joint infection,
occur in less than 2 percent of patients. Major medical
complications, such as heart attack or stroke, occur
even less frequently. However, chronic illnesses may
increase the potential for complications. Although
uncommon, when these complications occur they can prolong
or limit your full recovery.
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Occasionally,
blood clots may form in the leg veins or pelvis. Your
orthopaedic surgeon may prescribe one or more measures
to prevent blood clots from forming in your leg veins,
such as special support hose, inflatable leg coverings,
and blood thinning medications.
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Your
Recovery at Home
The
success of your surgery will depend in large measure
on how well you follow your orthopaedic surgeon's
instructions regarding home care during the first
few weeks after surgery
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Wound
Care You will have stitches or staples running along
your wound. The stitches or staples will be removed
about two weeks after surgery. Avoid getting the
wound wet until it has thoroughly sealed and dried.
A bandage may be placed over the wound to prevent
irritation from clothing or support stockings.
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Diet
Some loss of appetite is common for a few days after
surgery. A balanced diet, often with an iron supplement,
is important to promote proper tissue healing and
restore muscle strength. Be sure to drink plenty
of fluids.
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Activity
: Exercise is a critical component of home care,
particularly during the first few weeks after surgery.
You should be able to resume most normal light activities
of daily living within three to six weeks following
surgery. Some discomfort with activity, and at night,
is common for several weeks.
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Your activity
program should include:
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A graduated walking program initially in
your home and later outside. |
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Walking program to slowly increase your mobility and
endurance. |
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Resuming other normal household activities. |
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Resuming sitting, standing, walking up and down stairs. |
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Specific exercises several times a day to restore movement. |
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Specific exercises several times a day to strengthen
your leg muscles. |
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a physiotherapist to help you at home. |
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Avoiding
Problems After Surgery
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Blood Clot Prevention
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Follow
your orthopaedic surgeon's instructions carefully
to minimize the potential risk of blood clots in
your leg veins, which can occur during first several
weeks of your recovery.
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Warning
signs of possible blood clots include: pain in your
calf and leg unrelated to your incision, tenderness
or redness of your calf, swelling of your thigh,
calf, ankle or foot. Warning signs that a blood clot
has traveled to your lung include shortness of breath,
chest pain, particularly with breathing. Notify your
doctor immediately if you develop any of these signs.
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Preventing
Infection
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The
most common causes of late infection following knee
replacement surgery are from bacteria that enter
the bloodstream during dental procedures, urinary
tract infections, or skin infections. These bacteria
can lodge around your prosthesis.
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Following
your surgery, you should take antibiotics prior
to dental work, including dental cleanings, or
any surgical procedure that could allow bacteria
to enter your bloodstream.
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Warning
signs of a possible knee replacement infection
are:
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Persistent
fever (higher than 100 degrees orally), shaking chills,
increasing redness, tenderness, or swelling of the
knee wound, drainage from the knee wound, increasing
knee pain with both activity and rest. Notify your
doctor immediately if you develop any of these signs.
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Avoiding
Falls
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A fall during the first few weeks
after surgery can damage your new knee and may result
in a need for more surgery. Stairs are a particular
hazard until your knee is strong and mobile. You should
use a cane, crutches, a walker, or handrails, or have
someone help you until you improve your balance, flexibility
and strength.
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Your
surgeon and physiotherapist will help you decide what
assistive aides will be required following surgery,
and when those aides can safely be discontinued.
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