Learning About Your Health

Total Knee Replacement: What to Expect While You Are in the Hospital

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Your Hospital Stay

After total knee surgery, most patients go home after 3 or 4 days. Some patients may need more therapy and more time to recover. These patients may go to a Post Acute Unit before going home.

Nursing
On the day after your surgery, your nurse will help you with these activities. As you become stronger, you may do these on your own:

  • Change Position: Turn every 2 hours from your back to your sides.
  • Cough and Deep Breathe: Every 2 hours.
  • Do Ankle Pump Exercises: Every 2 hours. Remember to bend your ankles up and down. Alternate your feet.
Physical Therapy
A physical therapist will start working with you the day after surgery. The therapist will see you 1 or 2 times a day. The physical therapist will help you to get out of bed, sit in a chair, and walk short distances.

Occupational Therapy
An occupational therapist will evaluate you before you leave the hospital. The occupational therapist will make sure you are safe to perform the following activities: using the toilet, showering or bathing, dressing, and performing simple activities at the sink.

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Managing Your Pain

  • It is important to take action to control your pain as soon as the pain starts. It is more difficult to relieve pain once it has become severe.
  • Managing pain early and adequately is key in effective pain control and essential to your recovery. Take your pain medication before you participate in any activity that may increase your level of discomfort.
  • Each person experiences pain differently. You can help your doctors and nurses "rate" your pain using the pain scale on the next page. A 0 on the scale means no pain, and a 10 on the scale means the worst pain you can imagine.
0-10 Numeric Pain Intensity Scale


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About Your Diet

Right after surgery, you will be given ice chips and clear liquids. When you are able to drink liquids without any problems, you may start your regular diet.

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Your Treatments & Tests

  • You will have a blood test each day for 3 days to check your blood count.
  • You may have a blood transfusion. Your doctor will talk with you about this.
  • Foot compression pumps and/or anti-embolism stockings may be used to prevent blood clots in your legs.
  • You will have an Intravenous (IV) line. This will usually be taken out the 2nd or 3rd day after surgery.
  • If your doctor orders a Continuous Passive Motion (CPM) machine, it will be used after surgery to prevent the operative knee from becoming stiff.
  • You may have a urinary catheter. A urinary catheter is a tube placed in your bladder to drain your urine. Your nurse will usually remove this catheter on the 2nd or 3rd day after surgery.

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Tips for Recovery

  • Watch the patient education video "Total Knee Replacement & Rehabilitation" (#20) on the patient education video channel.
  • Keep your pain under control, so you can move about as much as possible, and work with the therapists fully.
  • Spend time out of bed each day. Get out of bed 2 or 3 times each day and walk for short distances or sit in a chair at the bedside.
  • Change your position, cough, and take deep breaths every 2 hours when you are in bed.
  • Do your ankle pump exercises every 2 hours while you are in bed.
  • Use the foot compression pumps in bed.
  • Use the Continuous Passive Motion (CPM) machine if your doctor has ordered it.

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Meeting Your Therapy Goals Before You Go Home

You and your doctor will discuss when you are able to go home. You must meet the therapy goals listed below. A RN case manager or social worker will meet with you and your family to discuss your individual needs.

Your Therapy Goals

  • You are able to get in and out of bed by yourself.
  • You are able to walk a minimum of 50 feet using a walker on your own.
  • You are able to climb up and down 12 steps, with someone standing by to help, if needed. This goal is only for people who have stairs at home.
  • You are able to get into and out of a car with assistance.
  • You are able to use the toilet or commode without help.
  • You are able to stand for 10 minutes at a counter or sink to do simple tasks without help.
  • You are able to bend your knee to 90 degrees and then straighten it out.
  • You are able to follow your home exercise program independently.

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Getting Ready To Go Home

  • Nurses or physical therapists will help you to start to walk. Ask them questions about the best ways to move.
  • RN Case managers are available to assist you with getting ready to go home.
  • Social workers are available to assist with concerns regarding financial and family issues.
  • Social workers are also available to help in emergencies or in particularly difficult situations. They can also give you information about community resources for assistance over the long term.
  • Financial counselors are available should you have questions or concerns about your health insurance.
  • Chaplains are available at all times. Please let your doctor or nurse know if you would like us to arrange for a visit.

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Continuing Care: Admission to a Post Acute Unit (Licensed Skilled Nursing Facility)

Your doctor may decide that you need more time in a hospital for continuing treatment or rehabilitation. California Pacific’s Post Acute Units are licensed, Skilled Nursing Facilities that provide short-term care for people who do not need to be in the "acute" hospital. Your condition is stable, but you still need more care than can be safely delivered at home. You may be admitted to one of the California Pacific’s Post Acute Units, or a Skilled Nursing Facility in the community.

The patient care focus on a Post Acute Unit is different from the hospital, with more attention given to the rehabilitation needed for your recovery. Your rehabilitation may include: physical therapy, occupational therapy, speech therapy, IV antibiotics, and dressing changes. You will be encouraged to be an active participant in your care.

A team of doctors, nurses, case managers, social workers, pharmacists, dietitians, and therapists will work together to provide your care. Your primary care doctor does not change, however he or she may wish to assign you to the care of one of the doctors at the Post Acute Unit. Or your doctor may follow you in collaboration with the medical team there.

The Post Acute Units at California Pacific are located on the California Campus (3698 California St.) and the Davies Campus (Castro & Duboce Streets).

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More Ways to Learn

  • Watch the Patient Education Video Channel. You can order a videotape for viewing according to category or title. Listen carefully to information given over the telephone. The "Total Knee Replacement & Rehabilitation" is videotape #20.
  • Visit our Community Health Resource Center. The Community Health Resource Center is located at 2100 Webster Street, San Francisco, (415) 923-3155. Services include classes, and written information on a wide variety of health topics.


Developed by the Center for Patient and Community Education in association with the Department of Outcomes Management at California Pacific Medical Center. Last updated: 6/04.

© 2002 - 2008 California Pacific Medical Center.

Funded by: A generous donation from the Mr. and Mrs. Arthur A. Ciocca Foundation.

Note: This information is not meant to replace any information or personal medical advice which you get directly from your doctor(s). If you have any questions about this information, such as the risks or benefits of the treatment listed, please ask your doctor(s).

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