Discharge Home After Knee Arthroplasty (Replacement)

Pre-op exercises

Your loved one may be given exercises during the pre-op visit to perform before surgery. If they aren't given these instructions, these are excellent pre-op exercises for them to implement anyway.

• Deep Breathing Exercises. Your loved one should exercise their lungs every day before surgery by inhaling deeply through the nose and then slowly exhaling through the mouth. They should repeat this three times before coughing twice. Have them do this every 30-60 minutes while awake. This exercise helps to expand the alveoli of the lungs and remove any excess secretions that may settle in the lungs while under general anesthesia.

• Ankle Pumps. Have your loved one pump their ankles back and forth (like pressing and releasing a gas pedal) 1,000 times every day before surgery. Count 1 every time they lift their toes (back) and count 1 every time they point their toes (forth), and break sessions into 100 pumps every hour (for 10 hours). This is the best defense against blood clots forming the lower legs (deep vein thrombosis, or DVT).

Preparing for knee arthroplasty (replacement)

Pre-op preparation for knee replacement can start weeks before the surgery and may involve altering your loved one's living space and means of performing daily activities.

Before the surgery, or at least before they leave the hospital for a smooth transition home, prepare for discharge. 

• Make sure your loved one has a ride home from the hospital.

• Arrange for transportation to follow-up visits with the surgeon.

• Ensure that your loved one's living space is ready for their arrival, including any new equipment, supplies and medications, clean clothes and linens, plenty of toileting and hygiene products, and a stocked kitchen (see below).

• Line up a caregiver.

  • Don't be hesitant to ask your loved one's spouse, partner, or roommate to help, as well as other family members. 

  • If your loved one lives alone, or if their spouse, partner, or roommate is physically unable to help, or if the family cannot be continuously present to help, ask the provider about home health or consider hiring home care assistance.

• Speak to the health care team about equipment (that may be covered by their insurance) to help with daily activities after surgery, such as:

  • Assistive devices to help them move around (walker, cane, or crutches).

  • Handrails and grab bars in traffic areas of the home.

  • Safety bars in the bathroom.

  • Shower chair or bench to use during bathing (with rubber feet).

  • Slip-resistant rubber mat in the tub, and one outside the tub if the bathroom floor is tile or linoleum.

  • Elevated toilet seat.

  • Grasping device for putting on socks and shoes.

General safety tips to keep in mind.

• Remove clutter from walkways, beds, chairs, and tables.

• Keep stairs free of objects.

• Keep supplies in the same, easily reachable place, and stocked.

• Remove small rugs throughout the house and arrange cords so they are out of traffic areas.

Extra safety measures in traffic areas.

• Ensure that the driveway is unobstructed.

• Clear the paths and sidewalks outside their home.

  • Remove hoses, tools, and tree branches. 

• Warn them about watching out for pets when walking.

  • Consider having pets stay away from the home during recovery and rehab.

• Ensure that small children who visit understand what is needed to help your loved one during recovery and rehab.

• Keep hallways/stairways well-lit.

• Also, purchase night lights for bedrooms and bathrooms (these can be motion sensors).

• Stairs should have securely fastened handrails. Non-skid treads on stairs add to safety. If your loved one has vision problems, add a contrasting color to mark stair edges (bright yellow, orange, pink).

Preparing the home

Set up an area in the home where your loved one will spend most of their time recovering.

• Prepare a sleeping room on the main floor, or make sure that they only have to climb the stairs once a day.

• Keep the television remote control, telephone, cell phone, medicine, tissues, and wastebasket close by. 

• Place other items they use every day at arm’s level so they can easily reach them.

• Encourage them to wear an apron with large pockets for carrying things around the house. This leaves hands and arms free for balance or to use a walking aid, and maintains comfort.

• Encourage them to use a long-handled “reacher” or "grabber" to turn on lights or get things that are beyond arm’s length. 

Accessorize their walker (if applicable). 

• Two invaluable accessories to attach are a basket and a drink holder. The basket is a great place to keep their phone, wallet or purse, tissues, reading glasses, etc.

  • Consider purchasing a rollator walker that comes equipped with wheels, a seat, a basket, and brakes.

• Advise them to never carry anything in their hands while using the walker. 

Streamline the kitchen.

• Prepare meals in advance. Either prepare, package, and refrigerate/freeze home-cooked meals, purchase frozen meals, or arrange to have meals delivered.

• Place a bar stool or chair in the kitchen so they can sit while reheating and preparing meals.

• Make sure any dishes and cleaners they’ll need are in cupboards or on countertops at heights between their waist and shoulder for easy access. 

• Consider using paper plates and plastic silverware during recovery and rehab. 

Streamline the bathroom.

• Make sure all soaps and shampoos are within easy reach so that they don't have to bend down to reach items in the shower. 

• Consider purchasing a sponge on a handle so they may wash easily without bending or twisting.

• Place a robe hook near the bath/tub and encourage them to wrap in a cotton/terry cloth robe when getting out of the shower rather than toweling off.

• Ensure that all personal hygiene and grooming products are in a place together, that is easily reachable, near the sink and mirror.