Osteoarthritis of the knee affects many people. At first, a doctor will suggest making lifestyle changes, including exercise and weight loss, if necessary.

In time, however, you may need total knee replacement surgery, in which a surgeon removes damaged tissue in your knee and replaces it with an artificial joint.

Contemplating any surgery can be nerve-wracking, but having an idea of what to expect after surgery can help you prepare and improve the chances of a successful outcome in the long term.

Here, learn what to expect from your hospital stay and beyond.

After total knee replacement (TKR) surgery, you will probably stay in the hospital for several days, depending on how your recovery progresses. The American Association of Hip and Knee Surgeons (AAHKS) suggest 1 to 3 days.

Before leaving the hospital, most people have to reach certain milestones.

These include:

  • standing
  • getting around with the help of a walking device
  • being able to flex and extend your knee sufficiently
  • being able to get to and use the bathroom unaided

You may need to stay longer if you are not yet mobile or if other complications develop.

Medications and dressings

After surgery, you will probably wake up from the anesthesia in the recovery room.

You may have:

  • a large, bulky dressing that will help control swelling
  • a drain to remove fluid buildup around the wound

In most cases, your doctor will remove the drain after 2–4 days.

The surgeon will give you pain relief medication, usually through an intravenous tube and later either through injections or by mouth.

You may also receive blood thinners to prevent clots and antibiotics to reduce the risk of infection.

After surgery, you may experience:

  • nausea and constipation
  • fluid buildup in your lungs
  • blood clots

Nausea and constipation

Nausea and constipation are common after anesthesia and surgery. They usually last 1–2 days.

Your doctor may give you laxatives or stool softeners to ease constipation.

Learn more about managing constipation after surgery.

Breathing exercises

Your doctor or nurse will show you breathing exercises that you need to do after surgery.

This helps you:

  • avoid fluid buildup
  • keep your lungs and bronchial tubes clear

Blood clots

Moving your ankles and doing some exercises while lying in bed after surgery can help maintain circulation and reduce the risk of blood clots.

These may include:

Ankle pumps: Push your foot up and down several times every 5–10 minutes.

Ankle rotations: Move your ankle inward and outward five times, repeating this exercise three to four times each day.

Bed supported knee bends: Lying down, slide your foot back toward your buttock, keeping your heel on the bed. Repeat 10 times, three or four times a day.

Straight leg raises: Tighten your thigh muscle and raise your leg a few inches, keeping it straight. Hold for 5–10 seconds, then gently lower.

If a blood clot develops in your leg, this is deep vein thrombosis (DVT). If a clot breaks off and moves to the lung, a pulmonary embolism can develop. This is potentially a severe complication, but keeping the circulation moving can help reduce the risk.

Compression hose or a special stocking can also help prevent clots.

Find out more here about the complications of TKR and how to reduce the risk.

Your physical therapy regimen will usually begin within 24 hours after surgery.

A physical therapist will visit you several times. They will:

  • help you stand up as soon as possible
  • get you moving and help you adjust to your new knee
  • record your mobility, range of motion, and exercise progress

They will start you on exercises to increase your mobility.

It’s important to get the most from these visits. The sooner you begin your rehabilitation, the better your chances for a successful outcome and speedy recovery.

It’s important to resume normal activities as soon as possible after leaving the hospital.

Early goals you can set yourself include:

  • getting in and out of bed without help
  • working on fully bending and straightening your knee
  • walking as far as you can each day, possibly with crutches or a walker

When not exercising, your doctor may advise you to raise your knee and apply an ice pack or heat to reduce pain and inflammation.

Your doctor will also prescribe medications, such as:

  • antibiotics
  • blood thinners
  • pain relief medication

It is essential to keep taking these for as long as the doctor prescribes, even if you feel better.

If you have adverse effects, you should contact your doctor. Do not stop using medication unless your physician says you should.

Learn more about how to manage postoperative pain.

It is also essential to:

  • attend all appointments with your doctor and physical therapist
  • practice the exercises your physical therapist has prescribed
  • wear compression hose for as long as your doctor advises

Will you be caring for someone after they have a TKR? Click here for some tips.

You should contact your doctor at once if:

  • You notice new or worsening pain, inflammation, and redness around the wound or elsewhere.
  • You have a fever or start to feel generally unwell.
  • You experience chest pain or shortness of breath.
  • You have any other concerns.

Most complications occur within 6 weeks of total knee replacement surgery, so be vigilant in the early weeks.

You can expect to stay in touch with your surgeon for the next year. The frequency of follow-up appointments depends on your surgeon, medical institution, insurance plan, and other individual factors.

Most people will have a surgical follow-up appointment at:

  • 3 weeks
  • 6 weeks
  • 3 months
  • 6 months
  • 1 year

After that, you will probably see your doctor annually to assess how well your implant is doing.

It can take time to get used to a new knee. Learn more here about what to expect.

You should be able to resume most everyday activities within around 3 months, according to the AAHKS. Your doctor will tell you when you can drive again, usually 4–6 weeks after surgery.

It’s important to follow your exercise and rehab program without overexerting yourself.

Most people with sedentary employment can return to work after 4–6 weeks, but if your job involves heavy lifting, you may need to wait 3 months to resume work.

It can take 6–12 months to get back to full activity levels.

Click here to find a timeline for recovery after a TKR.

Learning as much as you can beforehand can help prevent surprises and disappointment after a TKR. It can also help you reduce the risk of complications.

The implant alone will not improve your mobility and pain levels. How you manage the process before and after surgery also plays a role.

Combining surgery with a strategy that involves regular exercise and weight management can increase the chances of long-term satisfaction.

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