The operation to replace your knee takes about 1 – 2 hours. At the end of the surgery, the anaesthetist will take you to the recovery area for a short period of assessment. The drip in your arm should be removed once you are tolerating food and fluids. Your pain control will be established and your vital signs monitored. You will remain there under the care of a specially trained recovery nurse, until it is time for you to go to the orthopaedic ward.
You should expect some discomfort following surgery. You will be given regular painkillers so you are able to do exercises and move your new knee. Please see the section on management of pain following surgery for further information.
Painkillers include paracetamol, ibuprofen-type drugs (non-steroidal anti-inflammatory drugs) and morphine-like drugs (opioids). Initially, you will need strong painkillers to help you to move. We will give you strong painkillers for one or two days after your surgery. Sometimes, these strong painkillers are given to you through a drip into your arm.
Please remember to let the doctors and nurses know if your pain score is 2 (moderate) or above or if the pain stops you doing your exercises. We may need to alter or increase your painkillers.
How is pain assessed?
After your operation your pain will be assessed regularly, pain will be measured by using a pain score. You will be asked to describe your pain on a scale of 0 – 10. Zero being no pain and ten being severe pain.
Some patients experience side effects from painkilling drugs.
These can include:
- Drowsiness (feeling sleepy)
- Nausea or sickness
- Indigestion (heartburn)
If you have any concerns about your pain or the painkillers that you are given, you may discuss this with your nurse or doctor. You can also be referred to the pain specialist nurses if your pain is difficult to manage.
Day One to Three
Day one – after surgery
- You will be assisted to wash and you will get dressed.
- You must not attempt to get out of bed until you have been assessed. You will be helped out of bed and sat in a chair.
- If you are drinking sufficiently your drip will be discontinued.
- The dressing on your wound will be checked daily.
- You will be seen by a member of the medical team.
- Your pain levels will be assessed and pain relief will be given as appropriate.
- You will be given regular pain relief medication by mouth.
- Many of these medications make you constipated and you may need laxatives to counteract this.
- Throughout your stay please let the nurses know if you have not had your bowels open so they can address the problem.
- The Physiotherapist will see you and start your exercise regime. (See video links below for the exercises you must perform)
- On day one or two, bloods tests will be taken and you may need a blood transfusion or to commence iron tablets.
- Your drain and urinary catheter, if you have one, may also be removed.
- You will be assisted to sit in a chair for your breakfast and your wash.
- You will be asked to get dressed.
- From now on you will be expected to sit in a chair for all meals.
- The physiotherapist will continue with your exercises and progress your mobility with a walking aid.
- You will be taught to go up and down stairs if you are ready.
- You will be assisted to walk to the toilet and if possible back again.
- If you have not been seen by the occupational therapist (OT) before your operation an initial assessment will be made today.
- Day three and onwards
- The physiotherapist will continue with your exercises and progress your mobility with a walking aid. They will also check that you are familiar and comfortable with your exercise regime.
- You will be taught to go up and down the stairs if you have not already done so.
- You will be encouraged to walk to the bathroom for your wash. The nurses will assist you as required.
- The Therapy Team will see you to confirm your discharge arrangements.
- They will ensure that you can transfer on and off the bed, chair and toilet unassisted before you go home.
- You will be ready to go home as soon as you have met your discharge goals.
After your knee surgery exercises
These exercises are essential for a complete recovery and satisfactory outcome from your surgery. Some focus on improving your range of movement whilst others are to regain your strength. Your exercises will take you approximately 20 minutes and should be done at least four times a day. If you find any exercises difficult, build up to the suggested number gradually.
- Ankle pumps
- Static quads (knee push-downs)
- Inner range quads
- Straight leg raises
- Heel slides
- Extension stretch
- Knee extension (bend and straighten)
- Seated knee flexion
- Transfer out of bed
- Transfer into bed
- Stair assessment
- Sitting to standing
- Transfer into the car as a passenger