Care After Surgery

Same-Day Discharge

If you are a candidate for kinematic alignment total knee replacement, Dr. Stephen Howell and Dr. Alexander Nedopil have developed a plan to help you return to the comfort of your own home even more quickly. Our team has found that patients who go home the same day of surgery experience less pain and have a lowered risk of exposure to hospital-acquired infections and COVID-19. This same-day discharge creates a safe, effective, more comfortable approach to knee replacement surgery.

We encourage you to ask one family member, friend, or your personal coach to spend several days with you to assist with your needs and ensure safety. You can eat when you feel hungry.

After leaving the recovery room you will return to the area where you prepared for surgery. You will eat and continue to recover from anesthesia. Usually, within an hour, your nurse will call your coach to come in to receive education with you. Your therapist will teach you how to ambulate with a walker, bend and straighten the knee, get in and out of the shower and car, and walk up and down stairs. Your therapist will also review the handouts regarding post-operative care at home with you and your coach. Your coach is encouraged to take notes. Most patients return home or to a local hotel later that same day.

If you need to stay in the hospital overnight, you will be transferred to a comfortable room for your overnight stay. Your coach will be called to come in the following day for post-op education before discharge.

Managing Discomfort

In the first days after surgery, our aim is to enhance your recovery so you can walk and bend and straighten your knee, care for yourself, and breathe deeply. Following surgery, the nurse will ask you to rate your discomfort on a scale of 0-10, with 10 being the worst. The nurse will administer medication until your discomfort is reduced to a tolerable level. Always reposition your leg or ambulate before taking narcotic medications. This often alleviates the discomfort to a tolerable level, often eliminating the need for the narcotic medication. Complete relief of discomfort has drawbacks as it can compromise your breathing and make you nauseated. You will receive medication about taking pain medications at home before discharge.

Managing Swelling

In the first two weeks after surgery, you will be instructed to elevate your leg above your heart, which decreases swelling and discomfort and promotes bending and straightening your new knee. When you are awake frequently pump your ankles up and down to reduce the risk of blood clots. You may also use ice packs as needed for comfort.

Managing Constipation

Pain medication frequently causes constipation. Consider taking a stool softener such as over-the-counter Colace or Metamucil starting the day before the surgery. If you become constipated, there are a variety of over-the-counter remedies you can use at home.

Activities and Exercises That Rehabilitate Your Knee

It is important to begin rehabilitating your total knee replacement within a few hours after surgery. Because the implants are cemented to your bone, you can place all your weight on your new knee. Physical and occupational therapists will teach you to get in and out of bed, straighten and bend your knee, walk down the hall with a walker, go up and down stairs, and take care of yourself while recovering at home. Patients that get in and out of bed by themselves (with a walker), walk 50 feet with a walker, and climb stairs are discharged home. Ninety percent of our patients discharge home the same day. A small number of patients will spend one night in the hospital and return home the day after surgery.