I have run across many orthopedic surgeons who have told their patients that, the knee surgery itself was the easy part, the tough part is the rehabilitation after. The rehabilitation aspect will ultimately fall directly in the hands of the patient. Of course there is a part to play here in regards to the physical therapist, and hopefully the therapist can impress upon the patient through education that keeping the pain and swelling to acceptable levels is vital for a successful rehabilitation outcome.
Our knees after the surgery are very temperamental. In other words, it does not take much in regards to exercise or excessive walking around the house to set off a chain of events that can take hours if not days to get back under control.
Many patients are told after surgery that the rehabilitation and walking are important. Often you will hear “you have too get up and walk” that’s true but like many things, this is done in moderation.
This will mean many things to many people but taking a walk around the house every hour or hour and a half is all that is needed. To much time on your feet will cause excessive swelling and a slow down of the overall strengthening and conditioning of the affected leg.
If you find you must be up on your feet more often due the fact for there is no one in your home to assist you with cooking etc… Its is suggested you look into getting a pair of TED compression stockings to keep the swelling down. They come in several sizes and the pressure gradients vary but a local medical supply should have them in stock. Contact your orthopedic as well if further information is needed. many times your doctor will issue these himself while you are at the hospital before discharge.
Keeping your affected leg elevated is very important. How long to keep your leg elevated will vary between individuals, but in the first two weeks after surgery if you are not walking or exercising, the leg it should be elevated and it should be positioned higher then your heart for proper drainage of the area surrounding your knee.
Keeping ice on the knee is important as well. The ice is used for pain control and to decrease swelling. You really cannot overdue the ice. Many people will have questions on how often the ice should used and how long. Using ice immediately after exercise is the time its most effective along with foot elevation for edema control it will be the best one-two punch you can get to keep pain and swelling manageable.
The amount of time you spend walking around your home or outdoors is extremely important immediately surgery. Getting up is good but this as well has to be in moderation. Body fluid is affected by the law of gravity and will pool in the lower portion of your leg or legs. if you find that you have to spend considerable time up on your feet, take the time that is needed then get back to where you can elevate the leg as soon as possible. I recommend also that if the swelling and pain are consistent and remains a chronic condition, to take an entire day off your feet with the operated foot elevated and you will see and feel a remarkable difference. Taking the day off means also that you hold the exercises as well. I assure you that you will do more good then harm by doing that. The problem would only lie if you decided to take several days off and not get in your walking or exercises that you would fall behind on your rehab.
Remember, ice, elevation, wearing a compression stocking on the operated leg and close monitoring of the time spent on your feet those first two weeks will determine how much pain and swelling you will encounter. If you are someone that retains fluid easily in the first place, your doctor may prescribe a diuretic like lasix to rid the body of the excess fluid, and prescribe the compression stocking before you leave the hospital.
Try this combination for starters and follow the suggestion of your physical therapist for the education needed to make the knee replacement as successful as possible.