Do you recommend any restrictions following this surgery?
Yes. High-impact activities, such as running, singles tennis and basketball are not recommended. Injury-prone sports, such as downhill skiing, are also dangerous for the new joint.
What physical/recreational activities may I participate in after my recovery?
You are encouraged to participate in low impact activities such as walking, dancing, golfing, hiking, swimming, bowling and gardening. Most patients can return to stationary bike riding or elliptical machines in 3-4 weeks. Treadmills may be used on a low speed and with no incline at 4 weeks or later. Weight machines are used with your therapist after the 4th week and continue until you are discharged. Your physical therapist can answer specific questions about special exercises and machines.
Will I notice anything different about my knee?
Yes. You may have a small area of numbness to the outside of the scar that may last a year or more and is not serious. Sometimes, however, this numbness is permanent. Kneeling may be uncomfortable, but will not injure the knee replacement. Some patients notice some clicking when they move their knee. This is the result of the artificial surfaces coming together and is not any cause for concern. In addition, most patients have some swelling and warmth to the knee and leg that may last up to one year. This swelling is usually not associated with any pain.
Can I place a pillow under my knee to keep it bent and make it more comfortable?
No! Definitely not. We understand that after surgery it may seem like a good idea to put a pillow under your knee. However this is something you should not do. Placing a pillow under your knee would allow your knee to stay slightly flexed. This can cause contractures or problems with how far you are able to extend your knee in the future. To prevent this, we ask that you DO NOT place a pillow under your knee. To elevate the leg, you may use a pillow or stool under your ankle.
When can I stop taking Iron and Vitamin C?
The Iron and Vitamin C are important to help build up your blood count and aid in tissue healing after surgery. It is important to begin the Iron and Vitamin C six weeks prior to surgery. Iron can be constipating to some patients. Therefore, monitor you bowel movements, drink plenty of fluids and eat foods high in fiber. If you have any difficulties, consult your pharmacist regarding over-the-counter treatments for constipation. Following surgery, we do not require that you continue the Iron and Vitamin C.
What are the "six week blues?"
Approximately 5-6 weeks after surgery many patients begin to feel both depressed and frustrated. It is normal to have these feelings during this period. During the first 6 weeks you make great strides in the reduction of pain and with your range of motion. However, at the 6 week mark, you often feel as though you have "hit a wall" in your progress. At this point, it is important to realize how far you have come. Don't be discouraged. The key to getting off of this plateau is building strength. Muscle strength takes at least 8 weeks to build. Thus, until you reach 8 weeks after surgery, you are on a plateau. You will get through this! It is important to remember that your exercises will pay off. Continue to build strength by focusing on the strengthening exercises located in the back of this book and from therapy, for at least another 4-6 weeks. As time passes, you will slowly notice that you will feel better. The next phase you will enter is the endurance phase. During this phase, you will feel more tired than usual at the end of the day or even after a few hours of work. This phase lasts anywhere from 3-6 months and even up to a year in some patients. Generally, you will see this get better.
What about some drainage from my incision?
A layer of stitches are placed just below the skin. This is in place of metal staples or outer sutures on your skin. Although this special plastic surgery suture makes your incision look better, it will dissolve and sometimes this causes fluid collections under and above the skin. During the dissolving process, there will be some redness and swelling. In some cases, it may form a small amount of milky-white fluid, which looks like pus. It is only the bi-product of the dissolving suture. If this occurs, wash out the area with antibacterial soap and water and cover with a large band-aide for 24 to 48 hrs. Do not apply any gels or lotions to the area. After 48 hrs, this area normally dries up by itself. However, if this worsens, contact our office.
A few days after I went home from the hospital, I noticed more bruising and swelling. Why?
Swelling and bruising, which occurs about 3-6 days after discharge from the hospital, is normal. This is due to the echymosis (or bruising) produced during the surgery itself. It works its way up to the surface of the skin, where it is visible. This is normal and will subside in about 2 weeks. During this time after surgery, it is very important to elevate and apply mild heat to these areas to reduce the symptoms. We recommend using a heating pad on the low setting, 20 to 30 minutes at a time, 2-4 times daily. You should continue to use ice over the incision itself. If you notice any increasing calf pain, please call our office as soon as possible. Occasionally patients will notice some blisters on their surgical leg at their period of maximum swelling. This is because there is no room available for the swelling and fluid to go within the skin and therefore pockets or blisters form. These should not be popped. If they pop on their own, cleanse them with warm soapy water and leave them open to air. If you have any concerns of infection, contact us immediately