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Going Home

 

Things to Watch

If you experience any of the following symptoms or have any concerns, you should call your surgeon:

• Increased pain in calf or thigh of either leg
• Increased pain in leg or leg appears shorter
• Increased swelling, tenderness or redness in either leg
• Temperature above 38°C taken at least 30 minutes after eating or drinking
• Increased drainage from the incision, redness or opening of incision edges
• Increased difficulty with walking
• Shortness of breath
• Chest pain or tightness
• If you develop sudden shortness of breath or chest pain/tightness, you need to go to the nearest Emergency Department

 

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Your Incision

NO lotions, ointments or cremes should be applied over or around the incision area until you have your follow-up appointment with your surgeon.

Incision with Staples

• DO NOT allow your incision to get wet until two days AFTER the staples have been removed
• Look at the incision every other day and watch for any redness, drainage or opening of the edges
• Change the bandage every other day or when necessary and replace it with a new sterile bandage. Bandages can be purchased at a pharmacy
• DO NOT touch the incision with your hands. Remember: Wash hands before and after incision care
• Have the staples removed by your family doctor two weeks after your surgery

Incision with Sutures

• The incision is closed with dissolvable sutures.  No appointment is necessary with your family doctor at two weeks after surgery
• You may shower when you return home.  NO BATHS
• Rinse the incision clean so there is no soap residue and pat dry.  NO RUBBING
• The steri-strips over the incision are to be left on.  Just let them fall off on their own
• You may have a light dressing over the incision when clothed for comfort

 

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Prevention of Swelling

Edema or swelling occurs as a natural response to surgery and tissue injury. Swelling tends to increase in the operated leg when sitting or standing, but should decrease over time and should be less upon waking in the morning. Increased redness around the incision should not be present.

To minimize swelling, apply ice to your hip or knee before and/or after doing your exercises. It is also a good idea to apply ice to your hip or knee between exercise sessions for the first 1-2 weeks you are home. Elevating your leg slightly when lying down will also help with reducing swelling.

It is not uncommon for patients to have swelling in the leg for several months after surgery. If you have questions about swelling, please consult with your physiotherapist or surgeon.

 

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Physiotherapy

Discharge Home

Physiotherapy after your surgery is very important for you to participate in once you return home. It is your responsibility to ensure that BEFORE surgery, arrangements have been made and transportation organized for you to have physiotherapy, at a clinic of your choice, within two weeks of surgery.

Many patients from London will attend the Orthopaedic Physiotherapy clinic located in the basement at University Hospital. On discharge from the hospital, you will be given a physiotherapy appointment date and time.  There is no cost to patients attending physiotherapy at University Hospital.

If you choose not to attend physiotherapy at University Hospital once you’ve returned home, you:

• Will be given an Outpatient Physiotherapy Referral
• Start physiotherapy at clinic of your choice
• Continue with the exercises outlined by your physiotherapist in the hospital until your first physiotherapy appointment

A list of physiotherapy clinics in the SWLHIN can be found here. Please note that this list is not comprehensive and primarily lists other available hospital or OHIP funded clinics in the SWLHIN.

Once you attend physiotherapy in the community, your therapist will progress you with other exercises that will continue to improve your strength and movement of your leg. The frequency of visits to physiotherapy in the community depends on the progress you are making and your ability to exercise on your own. This is something you should discuss with your physiotherapist on your first visit to the clinic.

Discharge to Short Stay Bed

Many of the facilities that offer Short Stay beds in London and Middlesex County have physiotherapy services that will assist you in your recovery.  If services are not available, a referral to CCAC will be made on your behalf to have a physiotherapist see you at the Short Stay facility. Patients are typically seen 1-2x/week over the duration of their stay in the Short Stay bed.  It is expected that patients continue with prescribed exercises on their own when not being seen by the physiotherapist.

 

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Activity Guidelines

As with any surgery, there are guidelines as to what activities you can participate in at certain times after surgery. For some individuals, some of the activities listed may never be appropriate for them to participate in. Please consult with your surgeon.

First 6 weeks

• Walking with appropriate gait aid in and outdoors
• May begin gentle exercising in the water after staples are removed. Please discuss with your physiotherapist before attempting.

After knee surgery, you may begin:

• Stationary upright or recumbent bicycle
• Treadmill walking

After 6 weeks

• Stationary upright or recumbent bicycle
• Treadmill walking
• Driving a car

After 12 weeks

• Golfing
• Bicycling
• Bowling
• Water aerobics
• Swimming
• Slow dancing
• Gardening with assistive devices and stool

Long Term after Sugery

• Low impact aerobics
• Ballroom, jazz and square dancing

With Previous Experience

• Doubles tennis
• Recreational ice skating or rollerblading
• Recreational or light downhill skiing
• Cross country skiing
• Road cycling
• Weight machines
• Hiking
• Horseback Riding

Activities to Avoid

• Do not lift objects more than 50 pounds repeatedly
• Avoid jogging, basketball or any sports that are high impact and involve twisting and pivoting on the new knee
• Avoid HEAVY weight lifting or training

 

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