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Recovery After Surgery
Keeping track of your recovery
Getting up post-surgery
Getting out of bed early after your knee replacement prevents unnecessary deconditioning and speeds up your return to independence. The physiotherapist will review you after surgery and teach you how to get out of bed, stand up from a chair and walk. Most patients require a walking aid to assist in standing and walking in the initial period of recovery.
• Take your prescribed painkillers
• Continue with your daily recommended exercises
• Practise walking with your therapist and nurses to the toilet and showering
• Aim for discharge
Upon discharge, the doctor and physiotherapist will brief you and/or your caregiver on the follow-up treatment, the use of medication/prescriptions given and the important steps for proper care and rest at home.
Your follow-up appointment and medications will also be given.
Try to walk as normally as possible without limping after you are discharged. It will help to train your knee to get used to the motion.
Swelling management
Excessive swelling can worsen pain and cause stiffness. Manage your swelling by icing it regularly and elevating your operated leg with a stool or pillow placed below the ankle, keeping the knee straight.
Do not put a pillow under the operated knee as it can cause the knee to be bent.
Icing: Apply an ice pack to your operated knee for 15-20mins every 2-3 hours (preferably after doing your prescribed exercises)
Pain management
Pain following TKR surgery is expected. You will be prescribed pain relief medication that should be taken regularly.
Poor pain control can cause you to avoid walking or doing exercises that are necessary for your recovery.
Wound care
Dissolvable sutures are usually used. If staples or non-dissolving sutures are used, they will be removed on the 10th to 14th day after surgery.
Expect to feel some tenderness, tightness, itchiness or numbness around the wound site.
You will be discharged with a waterproof dressing. Keep the dressing and wound site dry and clean.
• Do not attempt to peel off the bandage/dressing or change it yourself
• Do not apply cream or lotion to the wound until fully healed
Visit the polyclinic for your scheduled dressing change or if there are excessive blood stains on the bandage.
Are my symptoms normal?
Upon discharge, it is normal to experience:
• Bruising on your leg
• Warmth around your knee
See a doctor if you notice any of the following:
• Wound is smelly
• Too much drainage from the wound
• Unusual redness, swelling and warmth at the wound site
• Fever > 38 degrees Celsius
• Increasing pain that is not relieved with painkillers
• Calf pain and swelling
Do not over exert yourself, take it slow. Your knee needs rest to heal too.
Post-surgery exercises (Day 0-7) Exercises to improve knee range
Heel slides
Sit upright with your back supported. Place a towel/belt under the sole of your foot or your thigh. With both hands holding onto the ends of the towel/belt, gently pull it to bend your knee as much as possible.
• Hold for 10 secs
• Perform 10 repetitions, 3 sets a day
Seated knee flexion
Sit on a stable chair. Cross your ankles as shown, with the operated leg behind. With the top leg, push the operated leg towards the back. To bend your knee further, you may sit on the edge of the chair or table.
• Hold for 10 secs
• Perform 10 repetitions, 3 sets a day
Seated knee extension
Sit on a stable chair with your thighs supported. Tighten your thigh muscles and straighten your operated knee. Use your unaffected leg to assist slightly as needed.
• Hold for 10 secs
• Perform 10 repetitions, 3 sets a day
Exercises to improve knee strength
Isometric quads
Sit upright with your back supported. Place towel under your ankle. Tighten your thigh muscles and straighten your operated knee.
• Hold for 10 secs
• Perform 10 repetitions, 3 sets a day
Inner range quads
Roll a towel and put it below your operated knee. Lie down. Tighten your thigh muscles and keeping your operated knee firmly on the towel, lift your foot off the bed and straighten your operated knee.
• Hold for 10 secs
• Perform 10 repetitions, 3 sets a day
Straight leg raise Lie down. Bend your unaffected knee for support. Lift your operated leg off the bed, keeping the knee straight. Slowly lower it down.
• Hold for 10 secs
• Perform 10 repetitions, 3 sets a day
Add the following exercises:
Knee extension stretch
Sit on a stable chair with your foot of your operated leg propped up on another chair. Allow gravity to stretch your operated knee to a more straightened position. For an increased stretch, you may place a weight such as a small bag of rice (1kg -2kg) on the knee.
• Hold for up to 5 minutes
Sit to stand
Sit on a stable chair and cross your arms over your chest. Stand up from the chair using as little help from your hands as possible.
• Repeat for 10 reps
• Perform 2 sets a day
Knee extension with band
Sit on a stable chair. Secure an elastic band to a stable support behind your operated leg and tie the other end around your ankle.
Straighten your operated knee against the elastic band.
• Repeat for 10 reps
• Perform 2 -3 sets on alternate days
