Total Knee Replacement Advice & Tips
In my home care practice too often I see patients who are unprepared when they return home from the hospital after knee replacement. By this I mean they have not prepared the necessary tools to help in their recovery.
Most surgeons are excellent at preparing you for the actual surgery itself including medication management and pre-op testing. Unfortunately the in-home preparation and after surgery management can be left too up in the air.
I’m not going to list the obvious things such as a walker or cane. Those items along with a few others will be coming home with you from the hospital anyway.
There are some things that I would consider must haves in your initial recovery at home after knee replacement. Other things I would label as optional but suggested to make your rehab easier.
Below are 10 Must Haves After Knee Replacement Surgery to maximize your recovery
2 or More Large Gel Ice Packs
I’m still amazed at how often I arrive in a patient’s and find they don’t have the proper ice for their knee. Having frozen vegetable bags or the solid cooler container ice blocks won’t work for your knee replacement.
For you to properly apply ice to a swollen knee, the ice needs to surround the knee completely and keep the cold intact for 25-30 minutes. Not only that, but you will be applying ice 5-7 times per day. For this you must have at least 2 large ice packs frozen before you get home.
I suggest these large gel ice packs on Amazon because they keep the cold for a long time period and they are form fitting to your leg. Some surgeons will provide an ice machine for you to take home which is fine but I would still have a backup ice pack as well.
2+ Weeks of Pain Medications (Both Over the Counter and Prescription)
You will be getting prescription grade pain medications from your surgeon once you return home from the hospital. Likely one of the following will be prescribed to you: Oxycodone, Hydrocodone, Vicodin, Tramadol, Hydromorphone or Codeine.
Patients often forget they will also be taking over the counter pain medications including acetaminophen (Tylenol) or Ibuprofen (Advil) along with the stronger narcotics. Some surgeons will not allow you to take Ibuprofen if you are also taking blood thinners as well.
Check with your surgeon and make sure you have plenty of over the counter pain medications on hand for your pain control
Pillows Pillows and More Pillows
Wait a second! You might be shaking your head ‘no’ and wondering what I’m talking about here. There’s a good chance your surgeon and the nurses told you ‘Do Not Put A Pillow Under Your Knee!’ And yes they are right, with a caveat.
I like my patients to have multiple bed pillows available to them once they get home. In addition to your normal bed pillow, make sure you have at least 4 additional pillows available to you. Why you may ask? There’s a few reasons why you want extra pillows available.
First, you need to elevate your leg above heart level to help decrease knee and leg swelling. This requires you to lay flat with at least 2 pillows propping up your entire leg, not just under your knee. You will want the extra pillows since you may be doing this elevation in your bedroom and another area of the house.
Second, sometimes your leg will tend to turn in or out at rest after your surgery, something you will want to avoid. By using pillows you can position your foot straight and allow it to stay straight without any effort.
PT PRO TIP: You can purchase a wedge pillow designed to help with elevation and reduce swelling after knee replacement. While these pillows are not cheap, they come in handy in positioning your knee properly.
COMFORTABLE Chair WITH ARMRESTS
One thing we all take for granted is the ability to get up from a soft or chair with ease. Once your knee is replaced, doing this task becomes quite difficult.
Your surgery leg will not be able to bend and push off like it normally does when getting up from a sofa. While you are allowed use your sofa for rest and recovery, it might not be worth it if it is too low and makes getting up very difficult.
Best choice is to have a comfortable chair with armrests so that you can sit in it for hours but also get up whenever you need to. Another suggestion would be to have an ottoman or stool in order to place your leg straight out to increase your knee extension.
PT PRO TIP: If you have other joint or arthritis issues and may have difficulty getting up from chairs in the future, purchasing a recliner chair lift is an option. I would suggest a zero gravity recliner in order to elevate your leg to help reduce swelling.
2-3 Pairs of Non-Slip Grip Socks
In the hospital you will likely be given a pair of non-slip grip socks to wear during your stay and bring home from the hospital after surgery. The reason for these socks is to wear for comfort but also prevent falls.
When you come home, good chance your surgery leg will be swollen into your foot and ankle. Because of this, wearing socks with grips should be the choice of footwear since your shoes will likely not fit well early on.
Don’t forget you will also be wearing compression socks so putting grip socks over the compression hose is a good combination for safety. You can find plenty of inexpensive pairs of non-slip grip socks on Amazon.
Supportive Athletic Shoes
I know I just talked about getting grip socks in the point above. But at some point your swelling with decrease and you will be able to return to normal shoe wearing.
Forget about you normally wear around the house, whether you go with flats or slippers or maybe no shoes at all. It would be in your best interest to get a supportive pair of athletic shoes for when you need to go out and leave the home.
When it comes to picking the proper pair of shoes, you need to factor in ease of getting them on and comfort level. Both are equally important to your willingness to wear them early on.
One type of shoe that I do recommend are easy in and out shoes such as those made by Kizik. They provide the cushioning of a normal running shoe with the ease of getting on and off with the heelless design.
Another shoe type on my recommendation list are Kizik brand shoes, known for their ease of getting into and out of as well as being lightweight and supportive. I have been seeing more and more of my patients wearing these and the reviews are extremely positive from them.
Working Cell Phone With Charger
This might sound way too simple but you need to think again. When you come home there will be many times you will be alone either up in your bedroom or even on the main floor.
Having a cell phone with good reception is important for your safety and accessibility early on. This is especially true for those living alone but truly for anyone who has mobility issues.
If you have an older cell phone model or one that you may not use often, make sure to check it works before you return home. This is also important to have to easily communicate with your doctor, home care personnel and family.
Shorts or Loose Fitting Pants
Something you may not be thinking about is the access to your knee for both yourself but also the therapists and nurses in home. When doing your therapy exercises the last thing you want is tight fitting clothing limiting your movement.
In addition, your surgical dressing may be getting removed by the home care staff at some point. Wearing shorts or baggy pants is important to allow easier access to the incision area.
Plus, factor in comfort with jeans or tighter fitting pants rubbing or putting pressure on your incision area. Keep it loose and you will be much happier in the early part of your rehab.
Medication Tracking Chart
It might surprise you how much you will have to handle as far as medications once you get home. You may be adding in as many as 10 new medications including pain meds, anti-inflammatories, blood thinners, stool softeners and more.
One thing my patients struggle with greatly is managing their new medications and tracking when and how much to take. In any case, you will need some way to easily track your medications once home.
One way to do this is find a printable medication tracker online or to use your smartphone and set reminders on when to take your pills. Having control of this will go a long way in making your first few weeks home a lot easier.
In Home Physical Therapy
I know, of course I’m going to say this being a home care physical therapist for 20+ years. But its truly a must have after total knee replacement surgery in my mind.
The fast push to outpatient physical therapy after surgery does not take into account that a TKR is a MAJOR SURGERY. What other MAJOR SURGERY would you be leaving your home 3 days a week immediately after surgery when you can get in home care instead?
Take advantage of the home care services in your area and focus on your recovery. Don’t fall into the trap of outpatient therapy equals quicker recovery because it does not. In fact, often times it can delay it.
Must Haves After Knee Surgery
- 2+ Large Gel Ice Packs
- 2+ Weeks of Pain Medications (Both Prescription and Over the Counter)
- Lots of Pillows
- Comfortable Chair With Armrests
- 2-3 Pairs of Non-Slip Socks
- Supportive Athletic Shoes
- Working Cell Phone With Charger
- Shorts or Loose Fitting Pants
- Medication Tracking Chart
- In Home Physical Therapy