Postoperative Self-Care After Knee Replacement Surgery

     Osteoarthritis of the knee is a degenerative condition involving the deterioration of the cartilage surface, extending to the underlying bone structure within the knee joint. As the cartilage wears away, joint stiffness and a sensation of bone friction during movement may occur. If left untreated and the degeneration progresses, the patient may experience pain, crepitus (grating sounds) in the knee, difficulty walking, and an inability to ascend or descend stairs. The knee may no longer fully extend or flex, eventually leading to muscle atrophy and knee deformity, such as bowing of the legs.

Knee Replacement Surgery

     Knee replacement surgery is currently the most effective treatment for relieving pain caused by osteoarthritis of the knee. The procedure involves removing the degenerated portions of bone and replacing them with a prosthetic joint, allowing for more natural movement of the knee.

Postoperative Self-Care

     Although patients receive medical care and physical rehabilitation following surgery, unexpected complications, such as limited knee extension or flexion, muscle weakness, prosthesis loosening, or impaired walking ability, may arise. Therefore, it is crucial to adhere to the doctor’s recommendations, perform physiotherapy to strengthen the muscles, and use supportive devices to protect the knee joint, all of which contribute to a smoother recovery and return to daily activities.

1. Cold Compression

     Patients should rest and take anti-inflammatory medications as prescribed during the initial recovery phase. If there is pain, swelling, redness, or bruising, cold compression should be applied to the knee every two hours to help reduce inflammation.

2. Knee Rehabilitation Exercises

Initial physiotherapy can be performed through four basic exercises, whether in a sitting, lying, or walking position, as follows:

• Lying flat on the back: Place a pillow under the knee and elevate the leg, holding for 6 seconds. Ensure the pillow supports the knee up to the joint crease. Begin with 10 repetitions or as many as tolerated
• Lying with knees bent: Gradually bend the affected leg as much as possible.
• Sitting with legs extended: If there is no back pain, sit with your back against a chair and slowly straighten the knee, holding for 6 seconds. Perform 10 repetitions or as tolerated, gradually increasing as strength improves.
• Walking with a walker: Begin by sitting on the side of the bed, with assistance in positioning and stabilizing using a walker. Once properly positioned and stable, begin walking.

3. Use of Assistive Devices During Activities

     Following physiotherapy, patients should use a wheelchair, knee-supportive devices, or other mobility aids such as a cane or walker. Additionally, it is important to maintain a balanced diet and prevent bloodstream infections, particularly during the first year after surgery.

Medical Advice

• Avoid excessive use of the knee joint, such as running, jumping, climbing many stairs, squatting, sitting cross-legged, kneeling, or sitting on the floor.
• Keep the surgical wound dry and avoid exposing it to water.
• Do not self-medicate with painkillers, as overuse can lead to kidney or gastrointestinal complications.
• Support the knee joint with quadriceps-strengthening exercises to help slow further degeneration.