Orthopaedics

Total Joint Replacement Program

UMMC's Orthopaedics Program ranked as one of the nation's top best by U.S. News & World Report's 2011 "Best Hospitals" survey.

Total Knee Patient Pathway

We specialize in the care of patients undergoing joint replacement surgery. We are dedicated to returning our patients to independent living with an improved quality of life. The Patient Pathway to Healing below lists what you can expect to happen on the first three days following total knee replacement surgery.

Day 1

Activity

You should do ankle pumps while you are in bed.
Physical therapy is twice a day. You will be out of bed and in a chair.
The physical therapist will help you walk with a walker or crutches.
Occupational therapy will assist you in the activities of daily living.

Medications

Your pain will be controlledmedications given through an epidural catheter or an intravenous catheter.
You will receive antibiotics to prevent infection.
You will receive a blood thinner and wear antiembolic stockings to help prevent blood clots.
Your will start on a stool softener to avoid constipation.

Breathing Exercises

Deep breathing and using the incentive spirometer every 2 hours is important to open closed alveoli of the lung and help to prevent fevers and pneumonia.

Diet

You will start with a clear liquid diet and advance to a regular diet.

Self Care

You can feed yourself.
You can bathe your face and upper body. The nurse will assist you with your legs.
Bring loose fitting clothes and sturdy shoes that don't slip (like tennis shoes) to use during physical therapy and when you practice dressing with the occupational therapist.

Planning Your Discharge

You will meet with the case manager to plan your discharge.

Day 2

Activity

Physical therapy is twice a day.
The physical therapist will help you with knee exercises and walking with a walker or crutches.
Occupational therapy will assist you in the activities of daily living.
When you are out of bed your operative leg should be extended.
NO PILLOWS UNDER KNEE.

Medications

Your pain will continue to be managed with medications given through an epidural catheter, an intravenous catheter, or orally.
You will continue to get a blood thinner and wear the antiemboliic stockings to help prevent blood clots.
You will get a stool softener to avoid constipation.

Breathing Exercises

Deep breathing and using the incentive spirometer every 2 hours is important to open closed alveoli of the lung and help to prevent fevers and pneumonia.

Diet

You will be on a regular diet.

Self Care

You will be able to bathe yourself with help for your legs.
You will be out of bed to the bathroom with assistance. A bedside commode will be available if you are unable to walk to the bathroom.
Walking to the bathroom helps build your strength and prepares you for discharge.

Planning Your Discharge

Your discharge plans are finalized and will be discussed with you and your family.
You will work with the PT and the OT therapist, and the nurse to identify equipment you will need at home. The therapist will arrange or the equipment to be delivered to your home.
Plan your transportation and discuss getting in and out of a car with your therapist.
If you have stairs at home the physical therapist will instruct you on how to go up and come down on crutches or with a walker.
If you are going to rehab, the case manager will make the arrangements for you.

Day 3

Activity

You will be able to get out of bed independently.
You will be able to walk with a walker or crutches.
You will receive PT and OT before discharge.
You will be independent with your exercise program at home.
NO PILLOWS UNDER YOUR KNEE.

Medications

Your pain will be managed with oral medication.
A review of the medications you are going to take at home will be included with your discharge instructions.
DO NOT DRINK ALCOHOLIC BEVERAGES WHILE YOU ARE TAKING PAIN MEDICATIONS.

Breathing Exercises

Do your deep breathing exercises every 2 hours while you're awake.

Diet

You will be on a regular diet, but to help prevent constipation eat plenty of fresh fruits and vegetables and drink several glasses of liquid daily.

Self Care

You will walk to the bathroom with one of the staff.
You will be able to dress and bathe yourself with some help for your legs.

Planning Your Discharge

Follow knee precautions with all movements.
You and your family will receive verbal and written discharge instructions.
The nurse will review instructions for your care at home including care of your incision, the signs and symptoms of infection and complications of your knee surgery. The nurse will also review the sign and symptoms of blood clots in your leg.
The nurse will review good nutrition and its importance in wound healing.
Your doctor may request home care services such as visiting nurses and physical therapy.
If you are going to rehab your PT and OT will continue there.

This page was last updated on: January 15, 2013.

For more information about UM Orthopaedics or to make an appointment, call toll-free at 1-877-771-4567 or 410-448-6400, send us an e-mail or complete our secure contact form.