Tips for Knee Replacement Surgery

My mom actually just had knee replacement surgery on Wednesday.

It's very painful. She was in the hospital from Wed morning until Friday evening. She was supposed to go home but wasn't recovering quickly enough. Her boyfriend was supposed to sleep over at her house and I was going to be there during the day between kid drop off and pick up.

They made a big deal about removing all loose rugs and things that are crowding walkways and basically decluttering. Also pets are a concern since they run around your legs. They also asked if there are any stairs in the house, how high her bed is off the floor, if the shower is walk in or step in tub and if the toilet is raised or regular height. I'm sure there's other things but I can't remember. lol

They also said someone needed to be with her 24/7 for the first week. Then after that someone should still try to be there for another week or 2 just to make sure she can get in and out of the shower ok and carry her food from the kitchen to the table, things like that.

When she had PT that Friday morning, they said she wasn't stable enough on the walker to go home and they didn't feel like her BF and myself would be able to care for her on our own. So they got a rehab place approved through her insurance.

Just today she was looking better. It's been awful for her. You need to take the pain meds especially before PT because it's very painful. And ice and they also have a machine that moves the knee by itself. They said she needed to use it 6-8 hours every day for a month and they were sending one home with her.

She just texted me tonight and said she was so glad she's not home and is getting good care at the rehab center. I'm glad they did that for her as well as I felt her BF and I were not qualified to take care of her full time. I think she will be there all week or until she is clearly able to move around better on her own since she lives alone. I plan on going over during the day while the kids are in school anyway probably for a month or so, just to make sure I can do the things that need to be done so she isn't putting herself at risk.

Most importantly is to do the physical therapy as instructed and follow all the directions of the doctor. Good luck.

I had 2 knee surgeries last year and was in therapy for 11 months. (I still need a TKR but my doctor had to fix the mechanics of my knee first.) The majority of TKR patients that I spoke during my therapy did extremely well and there only regret was not having the surgery sooner. From my own experience I can say that it is absolutely critical to gain back range of motion. Do exactly what the doctor and therapist say to do and do it quickly. Once scar tissue forms it is so much harder and way more painful to recover. The people that I have known that said their knee replacements were a failure (my uncle and a friend) are the people that didn't gain back full ROM.

Discuss this with the surgeon. Usually they will order visits from the Visiting Nurses, physical therapists, and so on. Sometimes that's done through hospital social workers too. Find out from the office how it's handled and say that you want to get some things in place long before his actual discharge. Sometimes the patient can "graduate" to home health aides who don't do medical care but can remind the patient to take meds, handle showers and dressing, do some simple meal prep, and even reinforce the exercises given by the therapists.

With 3 kids around (not sure of their ages), I'd look into good organization so their shoes, backpacks, toys and general debris are in places where he won't trip or have to go around them. Also look at things like throw rugs, bathmats, and anything that partially obstructs a doorway that he'll be going through on a walker. (And they will probably have him up and walking very quickly.) You may need to rent a shower chair and a shower hand rail too. They may want him in a non-swivel chair with arms so he can be balanced trying to get up and onto a walker.

Some of this depends on whether he will come right home to you, or if he will go from hospital to rehab - often there is a step-down series of places, depending on the patient's age, general strength/condition, and what the set-up is at home. If he's 60 and athletic, that's very different than if he's 80 and frail, you know?

Good luck!

You may have seen tall sitting chairs in the surgeon's office waiting room. That's because it takes a while to be able to sit with the knee at a 90 degree angle. Go to Walmart or Target, somewhere like that, and find a tall "stool" for him to perch on, especially in the kitchen. It will really help. I found one of these for my mom and she loved it. In fact, she still uses it to sit in front of the sink and wash dishes or cut up vegetables. It takes the pressure off of her back.

Buy one of those handheld urinals for him to pee in. It will make it easier for everyone. You may need to find this in a medical equipment store.

Make sure you get the machine that moves his leg FOR him from the hospital. It's great! It helps get range of motion back and prevent blood clots in his legs. It will make his PT go better, too. Go exactly by the directions, and if you have trouble understanding anything, call the rental people the hospital gives you a phone number for. They are wonderful and will talk you through any issues. If the hospital offers for you to rent a machine that has cold water that circulates around his knee, spring for that, too. It's worth it. (Insurance doesn't usually cover it.) However, you need an ice maker in your freezer for that to work because you need plenty of ice at your disposal. A tip for this machine is to have several small commercial ice packs at hand in the freezer as well as ice. You put the ice pack in the water holder. Then you put ice in it, and fill the rest with water. The ice pack will prevent the ice from just melting away in the water. And it will stay colder a lot faster. This will save you a lot of time and running around while you're trying to do everything else. AND it fits very well with being used in tandem with the machine that bends his knee.

You can tell that I've been through this before. My mom had knee replacement surgery and my son had ACL surgery. They didn't have the ice machine back with my mom, and that would have helped so much! I jumped at the chance with my son, and once I got the tip for the ice packs (I kept running out of ice), it was smooth sailing.

Make sure you give him stool softeners - the pain meds will REALLY make him constipated. Don't wait for him to get constipated, either. Prunes in addition are smart, too. You'll be able to gauge it by the consistency of his poops. Sorry if that's TMI...but it's SO miserable to go through major-league constipation after surgery. Prevention goes a long way to helping not have this to contend with, including not having to have an enema done...

Writing down his medication and really managing it is part of the key to him getting through the worst of it after the surgery. Make sure you understand the directions. Make SURE you ask what time he can have his FIRST dose. The stuff they give at the hospital wears off fast. Depending on how long it takes to get him prepared for the trip home, the driving, getting him settled, etc, it will have worn off and he's in misery. And if the pharmacy is CLOSED, you are in for a possible trip to the emergency room. (That happened to a friend of mine. Terrible planning on the part of the hospital personnel, if you ask me.) If you can, send someone else to pick up the medicine while you get him taken care of and prepared for getting home.

DO NOT let him just "soldier it out" with pain. Managing the pain will help him heal. In fact, pain management is so important not only for his knee, but for his brain. Men tend to either be big babies or really stubborn. You need to be the one who calls the shots. Threaten him with Nurse Ratched if he gives you a hard time!

IF the pain meds include acetametaphin, find out (doctor, pharmacist, official website) how many milligrams of it he is allowed everyday. You have to manage the mix of acetametaphin within the medicine. Prescription meds sometimes INCLUDE the acetametaphin along with a controlled substance. What you don't want to do is exceed the acetametaphin limit because it can damage the liver. That means you COUNT the milligrams he's getting every day.

If he gets nauseated taking the medicine, make sure you talk to the doctor quickly. They can give him an anti-nausea medication to take with it.

Write down a daily med/food/liquid diary and keep it current. Make sure he gets plenty of water. (Ask you doctor how many ounces of liquids he should be getting. It's critical that he not become dehydrated.) Set your phone alarm for when he's supposed to get medicine next, and then write down as soon as you give it to him. At first you want to give it as soon as you can (like if the directions are every 4 to 6 hours, give it in 4.) It takes about 20 minutes for the medicine to get into his system to curb the pain. What you DON'T want is for him to run out of medicine in his system and be in agony for 20 minutes because you forgot to give it to him, or waited too long. Make sure you manage his food with the medicine, too. Some meds have to be eaten on a full stomach, but he will have a hard time with a full stomach for a while. Pay close attention. If I were you, I'd research or ask in advance what food you should plan on giving him. Then prepare what you can in advance so that you aren't having to spend too much time in the kitchen. And DEFINITELY shop before you take him to the hospital so that you aren't having to make store runs.

His physical therapy and his willingness to be a compliant participant is very important. It will make all the difference in how his "new knee" will work for him. It is solomnly true that if he doesn't exercise those muscles all around that knee replacement, it can end up breaking. That happened to my father. He wouldn't walk much (yes, he was pretty old) and those muscles were not strong. You don't want this to happen to your dad...

I hope all this helps you. The last thing I want to say is something you might not want to hear. I just lost a dear family member who was in good health, but elderly. It was a real shock. Make sure that he has a will and that you know where it is and that you can get to it. (It shouldn't be in his bank lock-box.) Look at the hospital's paperwork that tells them what to do if something goes very wrong. Really think through this. Ask your father for guidance. He has a right to his opinion and it will make you feel better if you were God forbid, ever have to use it. Make sure that you have him sign a medical power of attorney and a financial power of attorney to whomever should take over for him.

My best of luck to you all. I hope that he bounces back quickly!

my MIL had this done a couple of years ago, and swears she'd never do it again. the reason it wasn't a ringing success is because she refused to do the very, very necessary PT that is required afterwards. yes, she was in a lot of pain, but the whole point of having the surgery is to push through it to a pain-free more mobile life, and it's a pity she didn't hold up her end.
unless your dad is going to be alone for long stretches at a time i doubt he'll need a nurse, since he is going to stay with his awesome daughter for the first and worst weeks. at most you might need to set him up with his meds, snacks and water, and maybe a bottle to pee in if you're not going to be there to help him to the bathroom.
oh, are you asking about when he goes home? if he's basically self-supporting most of the time, i'm guessing he'll be ready in 3 weeks. it'll still be painful and he'll still need a walker, but he shouldn't need a nurse by then. i would only arrange for that if for some reason after he goes home he's still not able to navigate around without help.
make sure he takes his meds.
make sure he does his exercises religiously.
think about getting him a stool softener. the pain meds (which he will need and must take without trying to be a tough guy!) could bind him up.
good luck!
khairete
S.

Years ago, I had helped an older friend with her surgery. I had a friend who was a home-visiting PT come to the friend's house and do a look around to assess what we needed to do in advance to make things safe and accessible. She suggested: having a raised toilet seat installed; making sure there's enough room for a walker to get through the door of the bathroom/areas of the house; getting a shower seat and installing a shower head with a hose which one can use by hand (instead of just a shower head sticking out of the wall) so that some bathing could be done independently. Also, setting up a bed on the ground floor (no steps-- my friend refused this so we installed a second handrail on the stairs. She was very stubborn!)

You've received other good advice below. I hope everything works out and that your father is healing and feeling better in time.

My hubby had both his knees done last year; one in May and the second in October. Make sure your dad does all the rehab including all the exercises at home. He'll probably be using a walker so get rid off all throw rugs for a while. Also see about installing some grab bars in the bathroom or put a shower chair in a shower stall if you have one. A raised toilet seat will make things easier at first. We used travel mugs so he could carry his own coffee without spilling (he wanted to do everything himself).

Right after surgery he'll have to take shots to prevent blood clots so ask the doctor about how to dispose of the used needles safely. After the shots end they'll switch him over to asprin and he'll take that for a while. Ask the doctor what he'll be taking and have it on hand.

My hubby iced his knee a lot. We ended up getting a reusable gel ice pack with velcro that worked great. He'd use it and then throw it back in the freezer for the next time.

When my hubby came home a medical equipment place delivered a cpm machine (continual passive motion). He used that for a month and it really helped a lot with the rehab. The problem is that at first you really can't raise the leg at all so it helps keep everything moving until you get enough physical therapy to really help.

He also had home health care which consisted of a nurse, an occupational therapist, and a physical therapist. We had someone stopping by almost every day for a few weeks. It worked great. They asked that all dogs be removed from the area they are working in so my dog ended up on the back deck a lot. Not everyone is an animal person and everyone claims their dog is friendly but the home heath agencies can't take that chance. Know that up front and don't be upset.

My brother stayed with me after both knee replacement surgeries. He found that sitting in a recliner was the most comfortable.

After the first week, I was able to be gone for long periods of time. I put water and food on the table next to him. He used the urinal when he needed to pee.