Post-operative care

Post-Operative Care 

As with all major surgical procedures, knee replacement complications can occur. Below is a list of potential knee replacement complications and steps you can take to minimise the likelihood of it occurring, or to minimise the severity of the occurrence.

Thrombophlebitis

This condition is also known as deep vein thrombosis (DVT), and it occurs when the large veins of the leg form blood clots and, in some instances, become lodged in the capillaries (small veins) of the lung and cause a pulmonary embolism (an obstruction in the artery). The following steps may be taken to avoid knee replacement complications due to blood clots: 

  • Blood-thinning medication (anticoagulants)
  • Elastic stockings (TED stocking)
  • Foot and ankle exercises to increase blood flow and enhance venous return in the lower leg. 

IMPORTANT: Ask your doctor for advice on the above, and, if you develop swelling, redness, pain and/or tenderness in the calf muscle, report immediately these symptoms to your orthopaedic surgeon or family doctor.

Infection 

Although great precaution is taken before, during, and after surgery, infections do occur in a small percentage of patients following knee replacement surgery. Steps you can take to minimise this knee replacement complication include the following: 

  • Monitor your incision closely and immediately report to your doctor any redness, swelling, tenderness, increased drainage, foul odour, persistent fever above 38°C orally, and increasing pain.
  • Take your antibiotics as directed and complete the recommended dosage duration.
  • Strictly follow the incision care instructions as provided to you by your surgeon. 

Pneumonia 

Because your lungs tend to become “lazy” as a result of the anaesthetic, secretions may pool at the base of your lungs, which may lead to lung congestion or pneumonia. The following steps may be taken to minimise this complication: 

  • Deep breathing exercises: A simple analogy to illustrate proper deep breathing is to, “smell the roses and blow out the candles.” In other words, inhale through your nose, and exhale through your mouth at a slow and controlled rate. 

Knee Stiffness 

In some cases, the mobility of your knee following surgery may be significantly restricted and you may develop a contracture in the joint that will cause stiffness during walking or other activities of daily living. The following steps must be taken to maximise your range of movement following surgery: 

  • Strict adherence to the post-operative exercises recommended by your surgeon or physical therapist and if you have been given a Continuous Passive Movement (CPM) Machine to use - adhere to the regime recommended by the surgeon 
  • Early physical therapy (Day 1 or 2) to begin a range of movement exercises and walking programme
  • Oedema (excess water/fluid) control to reduce swelling (ice, compression stocking, and elevation)
  • Adequate pain control so you can tolerate the rehabilitation regime