You will be checked by one of the team doctors. A blood test will be taken in the morning and repeated on the next two days. This is to check that any loss of blood or body salts is being made up. You will be encouraged to take more liquids and solids by mouth if you are not feeling sick or nauseous. When you can drink sufficient amounts, the intravenous drip will be removed.
The nurses will assist to wash you and the physiotherapist will help you out of bed. At this time you may notice two plastic tubes coming out from the wound dressings which empty into bottles. These are inserted to help remove any excess bleeding after the surgery. You will be encouraged to take a few steps with the aid of a walking frame and take some weight through the operated leg. You will then be helped to sit out of bed in a chair with your operated leg elevated on a foot stool.
The physiotherapist will also supervise you in carrying out a number of exercises for your legs, arms as well as in breathing exercises. The latter are helpful in removing the extra secretions that may have collected in your lungs during the operation. If the secretions are not removed they can increase the risk of getting a chest infection.
The catheter inserted into your bladder will be removed. The support stockings will be removed for about half an hour once every 6 to 8 hours. You will possibly be prescribed a number of medications which include iron (to help build up the level of blood in your body), painkillers and laxatives.
As would be expected, the first 24 hours after surgery are not pleasant, but the staff is available to make this period as comfortable for you as possible.
The plastic tubes draining your wound will be removed by the nurse. This is a simple procedure that may cause a little discomfort, but you will be glad to have one less attachment! It is unlikely that you will require any more pain killing injections though you will still be on tablets. The physiotherapist will help you up and instruct you on transferring safely from bed to chair and back. She will get you walking a little. You may put all your body weight on the operated knee if you are able to tolerate that, but if you cannot, there is no cause to worry as you will be able to do so soon. Your blood tests will be reviewed and some patients may need to have a blood transfusion depending upon the results.
With each passing day the therapist will increase your activity. As your strength and confidence grows, you will graduate from using the frame to using two crutches and then to two sticks. Gradually, you will learn to walk further and eventually also do stairs. Your bulky operation theatre dressings will be changed and you will undergo an X-ray of the new knee to check its position. From this point onwards you will be using a support stocking on the operated leg as well. The physiotherapist will also use a CPM (continous passive motion) machine to assist in recovering the range of motion in your knee. The CPM machine gradually moves your knee for you without you having to do so consciously and the range of movement can be set by the therapist depending upon how you are progressing. Generally it is set to move your knee between 0 and 30 degrees initially and increased by about 10 degrees each day. The use of the machine may however be delayed if your wound healing is slow.
You will be encouraged to dress in your own clothes and work towards increasing your independence. Your wound will be regularly dressed until it heals over. You will be instructed in the use of the 'helping hand' which is a long stick like device with a grasper at the end that you can use to reach for and pick various items.
Most patients are walking independently by the seventh day after surgery and then are given some practice in negotiating stairs. You will be seeing the Occupational therapist who will assess your need for equipment that would be helpful for you in hospital and after your discharge such as a raised toilet seat, a helping hand, long handled shoe horn, a device to help you with your socks etc. Occasionally, some suggestions may be made to make your home environment safer. These include the installation of grab handles in the bathroom or a bannister by the stair case. The nurse is likely to check with you, your discharge arrangements. If you are assessed as likely to require help at home from the social services, they will be contacted. The precise help you receive however, is decided by the social workers themselves after a full assessment. They function on an independent basis and are not part of the hospital staff. About a week to 10 days from your operation you will be able to go home depending upon your progress. You will be asked to continue taking your iron tablets for two weeks after discharge. A district nurse will visit you at home on the 12th day after your surgery to remove the staples used to close your skin wound. You should also take your surgical stockings home with you and wear them until your first follow-up appointment which will be at about six weeks. Until that visit you should be using two sticks to walk.