YOU AND YOUR KNEE REPLACEMENT

Transcription

1 YOU AND YOUR KNEE REPLACEMENT PLEASE BRING THIS BOOKLET WITH YOU TO THE HOSPITAL N/19/Surg/Ortho/-/KneeReplacement/Any/10-06/V1/booklet

2 The Niagara Health System (NHS) and the Hamilton Niagara Haldimand Brant Community Care Access (HNHB CCAC) Niagara branch will partner with you in your successful recovery after your knee replacement operation. The development of this booklet was a combined effort between the NHS, HNHB CCAC and the following rehab service providers: Community Rehab, Comcare and St. Elizabeth Health Care. TABLE OF CONTENTS Introduction Household Safety Check List What is a Total Knee Replacement? Exercises After Surgery After Your Knee Operation Mobility Weight Bearing Status Your Daily Activities How to Use the Bathroom Getting In and Out of a Car When You Go Home Questions

3 HOUSEHOLD SAFETY CHECKLIST Plan ahead- prepare easy meals in advance. Put away throw rugs. Create clear pathways for walking. Tuck in corners of bedspread. Remove or tie up long telephone cords and/or electrical cords. Have outside paths and walkways cleared of ice and snow. Arrange to have help with heavy housework (i.e. vacuuming). Place commonly used items within easy reach. Carry objects in apron pockets, bag, or walker basket. Use nightlights, especially between your bedroom and bathroom. Wear footwear with adequate support and non-slip soles. If you are using a cane, crutches or walker, check the rubber tips and replace if worn. 3

4 WHAT IS A TOTAL KNEE REPLACEMENT? The damaged surfaces of the knee joint (bone and cartilage) are removed and replaced by new joint surfaces. The new joint consists of a plastic platform that lines the top of the shin bone (the tibia) and a metal surface that covers the bottom of the thigh bone (the femur). The two surfaces together create the new joint. The back of the knee cap (the patella) may also be replaced with a smooth plastic lining. After surgery, the goals of your treatment program will be to minimize swelling, improve your knee movement, and strengthen your knee muscles. Your physiotherapist will guide you through your exercises designed to restore the function of your knee YOUR ROLE IN RECOVERY Your progress will depend on your active participation in the exercise program and your commitment to following the rules provided for you. Continue to do your prescribed exercises, not only with your Physiotherapist, but also ON YOUR OWN, so you can return to your normal activities as soon as possible. Your family and friends can work with you to help you meet your goals. If you have access to the internet, you may be interested in the detailed information that is available on the website: http// A copy of this information will also be available at the pre-op clinic and at the hospital unit nurse s station. 4

5 EXERCISES AFTER SURGERY 1. ANKLE/FOOT Range of Motion 2. STRAIGHT LEG RAISE Relax your leg. Gently bend and straighten ankle. Move through full range of motion. Do times Do times per day 3. QUAD SETS Push Knee Down Lying on your back, try to lift your operated leg up with your knee locked. Hold for a slow count of four and then slowly lower your leg. Do times Do times per day 4. HAMSTRING SETS Push Heels Down Tighten muscles on top of thigh by pushing knees down into the bed. Hold 5 seconds. Do times Do times per day Push your heel into the bed without letting your knee bend. Hold 5 seconds. Do times Do times per day 5

6 EXERCISES (continued) 5. SLIDE HEEL UP 6. HIP AND KNEE STRENGTHENING Heel Slides: With your affected leg out straight, slowly slide your heel up towards your buttocks, then slowly straighten the knee. Do times Do times a day 7. ASSISTED KNEE BENDING With affected knee bent over roll, straighten knee by tightening muscle on top of thigh. Be sure to keep bottom of knee on the roll. Hold 5 seconds. Lower gently. Do times Do times a day 8. KNEE FLEXION / /EXTENSION Place your good leg over your affected leg and try to gently bend your affected knee back. Keep the knee / foot straight. Do times Do times a day Sitting well back on a chair, making sure that you don t lean forward, slowly straighten your affected knee, hold position for 5 seconds. Lower slowly. Do times Do times a day 6

7 Bend your knee as much as you can. AFTER YOUR KNEE OPERATION Straighten your knee all the way. Pick your foot up as you turn around when walking. REMEMBER! 7

8 MOBILITY Lying to Sitting: While you are in hospital, your therapist will teach you the right way to get on and off the bed. Sitting to Standing: Sit on the edge of your bed with your affected knee bent and slightly out in front Place your hands on the bed. Use your hands and your good leg to push up from sitting to standing and then reach for the walker. DO NOT lean forward or grab the walker when moving from sitting to standing. Move the walker forward, first making sure all four of its legs are flat on the floor. Move your affected leg forward into the walker, remembering the right amount of weight on your affected leg. 1. Walker 2. Sore (operated) leg 3. Good (non-operated) leg This pattern is repeated for walking with the walker in your room or in the hallway. If both knees have been operated on at the same time, use the same rules, using the stronger leg. 8

9 MOBILITY (continued) Standing to Sitting: Feel the back of the chair touching your good leg. Slide your affected leg forward while reaching for the arms of the chair behind you. Lower yourself gently down into the chair. Follow the same steps when sitting on a commode chair or a raised toilet seat. Walking indoors with a walker: Walk halfway into the walker with your affected leg first then step with your good leg. Remember not to twist your affected knee. Keep your foot straight! 9

10 MOBILITY (continued) STEPS / STAIRS If there is a safe handrail on the steps you should use it. The cane will then go in the other hand. Going Up the Stairs 1. Stand close to the bottom step. 2. Hold onto the handrail if there is one. 3. Lift your good leg up first. 4. Lift your cane and the operated leg up to the first step (use the handrail to help lift you up). 5. Climb one step at a time using this pattern. Going Down the Stairs 1. Stand close to the edge of the first step. 2. Hold onto the handrail if there is one. 3. Lower your cane and the operated leg onto the first step. 4. Lower your good leg onto the same step. 5. Go down one step at a time using this pattern.. 10

11 WEIGHT BEARING STATUS After the operation your doctor will advise you on how much weight can be placed on your operated leg. Be sure to follow the instructions. The following terms will help you understand: Partial Weight Bearing: You may place less than half of your body weight through your affected leg. Weight Bearing as Tolerated or Full Weight Bearing: You may place as much of your body weight on the affected leg as you can tolerate, or you can place your full weight on the affected leg. Your weight bearing status recommended by your doctor is: 11

12 Your Daily Activities Washing or Bathing You can stand at the sink to sponge bathe. A long handled sponge may help you to wash your feet more easily. Once your doctor allows bathing or showering: Adjust water flow and temperature before getting in. With walker / crutches, turn your back toward the tub. Sit sideways on the tub chair. Bring your legs into the tub, one at a time, leaning back slightly, keeping legs apart. Dressing Yourself Choose loose fitting or stretchy clothes like a track suit. Choose light weight, well fitting flat shoes with rubber soles and Velcro fasteners. These could be runners or joggers. Please bring these shoes with you to the hospital. Have all your clothes ready when you want to get dressed. Sit on the side of your bed or chair to get dressed. Dress your operated let first. 12

13 HOW TO USE THE BATHROOM Using the Toilet Follow the same pattern as for getting up/down properly from a chair. You may need to use a raised toilet seat. It fits on the rim of the toilet with the toilet seat up. You may find grab bars or toilet arms helpful to help you get up from a sitting position. Helpful Hints: Do not sit on bottom of tub. Your walker should be left outside the tub/shower. Place rubber-backed bath mat under bath chair/bench to prevent slipping. Dry yourself before leaving the tub and be sure the floor is dry before standing up. Aids that might help you: Sturdy bath chair/bench with rubber footing. Safety strips on floor of tub. Long handled bath sponge, unless you have help. Grab bars. 13

14 Getting In: GETTING IN AND OUT OF A CAR 1. Back up to the car with a walker. 2. Lower slowly and sit sideways on the seat. 3. Slide back into the car until knee crease touches seat. 4. Bring one leg in at a time. 5. Keep knees moderately apart. Getting Out: 1. Bring one leg out at a time, keeping knees apart. 2. Slide forward toward the edge of the seat. 3. Stand up on your strong leg. Remember! Roll down your window part way to assist with positioning. Enter the car from street level rather than next to the curb. Front seat should be moved back as far as possible. Car travel and driving check with your doctor. 14

15 WHEN YOU GO HOME ACTIVITY: Walking is encouraged as instructed by your doctor or therapist. Increase your activity gradually. Continue your exercise program until your doctor/therapist tells you differently. POSITION: Change your position every two hours when awake in bed and when sitting. This will help prevent skin problems. Do not rest with a pillow under your knee. Keep your leg straight in bed. Try to bend your knee as much as you can under the direction of your therapist. INCISION: Keep it clean and dry. Only get it wet if your doctor says you can. Watch for any increase in pain, redness, swelling around the wound, or drainage from your incision. If any of these symptoms appear, CALL YOUR DOCTOR. CIRCULATION: If you have been told to wear elastic stockings, continue to wear them as instructed. If you have any chest pain or difficulty breathing CALL YOUR DOCTOR IMMEDIATELY. ICING YOUR KNEE: This will help reduce pain and swelling in your knee. Place a small wash cloth over your incision and then apply your icepack to the top of your knee for ten to fifteen minutes, three or four times a day. If your pain increases or your skin starts to turn blue or white, remove the ice pack immediately. 15

16 Please use this space for any questions you may think of and want to ask If you have questions or concerns about your hospital stay you may contact the Utilization Department at your hospital. The numbers are listed below. Welland County General Site Ext Greater Niagara General Site Ext St. Catharines General Site Ext For questions about your care once you are home you may contact HNHB CCAC at and speak to your case manager or call your physiotherapist directly. 16