Knee (joint replacement) Surgery - at the hospital

Before Knee Surgery
After Knee Surgery
Total Knee Replacement Page
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Morning of Surgery

Upon arrival to the hospital, please check in at the Admission Desk. A Pre-Operative Registered Nurse (RN) will greet you and your family.  A hospital gown and a warm blanket will be provided.  The RN will start an IV. Sequential leggings will be placed on your unaffected leg to help prevent blood clots from forming in your legs.  The RN will wash your affected leg and place sterile towels around it.

Antibiotics will be started through your IV. The surgeon will mark the surgery site. At that time, any unanswered questions can be answered.

An Operating Room Registered Nurse will transport you to an operating suite. The RN will ask questions about your surgery procedure. An Anesthesia provider will be waiting in the suite.  The Anesthesia provider will monitor your vital signs through out your procedure.

What Happens after surgery?

After surgery, your surgical team will escort you to the recovery room where a Post Anesthesia Care Registered Nurse will take care of you.   Your surgical repair knee and leg may be placed in a special device called a Continuous Passive Motion (CPM) machine, which will passively bend your knee. On the following days and after discharge, the CPM machine will be used for four hours each day.  A foley catheter was placed in surgery to monitor your urine output, which is removed the day after surgery.

I.V. fluids will continue for the first day after surgery. Clear liquid will be started first to make sure no nausea will occur.  Once fluids are tolerate without any nausea or vomiting, a regular diet will start.

Diabetic Patients

Diabetic patient’s blood sugar will be monitored thorough out the surgical experience. This will help with the healing process.  

Pain

Pain after surgery is controlled by two different methods.

One method is a spinal injection of a pain medication before surgery begins. Also, a nerve blocked will be place by the Anesthesiologist to help with post-op pain.

A second method is a “PCA” or patient controlled analgesia.  This is a very strong pain medication which is administered through the IV.  A “button” can be pushed if and when pain arises.  Please remember that you are the only person who can push the button. Your family member must not push the button for you.

A decision is made between your surgeon, Anesthesia provider, and yourself to determine which method will work best for you.

Pain medicine by mouth will begin on the second day after surgery.

Questions about your pain level will be asked frequently.  The hospital measures pain on a scale of 1-10, with 10 as the highest level of pain.

Activity

After surgery, it is very important that you take deep breaths and cough every hour while awake. The nurse will instruct the use of an “incentive spirometer”. This device used every hour while awake will help to prevent pneumonia after surgery.

Nursing staff will help you out of bed the night of surgery.  The next day, a physical therapist will begin your exercise program.  Please have a family member present for these therapy sessions.  They will be able to help when you return home.  There is an expectation of walking at least 3-4 times each day in the hallway or in your room.  The goal before discharge is walking 100 Feet during a session.

Going Home

Discharge from the hospital will occur 2-3 days after surgery.  Physical therapy will continue at home with a home health therapist or return for out-patient therapy. Someone will need to be at home with you for the first week.  

Medicine

Prescriptions for pain and medicine to prevent blood clots are giving at discharge.  

Bathing

Showers are allowed after surgery.  Continue to use antibacterial soap. Do not take a tub bath.

The incision can stay uncovered.  If the incision becomes irritated from your clothes rubbing on it, cover the incision with clean dry gauze.  

Diet

It is important to eat a healthy diet including fruits, vegetables, and drink plenty of fluids after surgery.  Constipation is a side effect of pain medicines.  Your nurse will ask about any bowel movements.  It is important to make sure the nurse is aware of decrease or no bowel movements.