Circumstances vary, but patients are generally considered for total knee replacement if:
• Pain occurs daily.
• Pain is severe enough to restrict not only work and recreation, but also the ordinary activities of daily living.
• Significant stiffness of the knee results in loss of motion.
• The knee constantly gives way (significant instability).
• The knee is significantly deformed (knock-knees or bowlegs).

The result of most complications is simply that the patient stays in the hospital longer. The most common complications are not directly related to the knee and do not usually affect the result of the operation. These include:
• Blood clots in the leg.
• Urinary tract infections or difficulty urinating.
• Blood clots in the lung.
• Infection in the knee.
• Stiffness.
• Lingering knee pain.

• Maintain good physical health.
• Arrange for physical therapy before and after surgery.
• Arrange for someone to be at home to help you with daily tasks – bathing, dressing, and getting meals.

• Do not eat or drink after midnight the night before your surgery.
• Take a shower and remove nail polish and makeup.
• Practice deep breathing to minimize the risk of lung complications after surgery.
• Dr. Larson will explain the risks and benefits associated with the different anesthesia available.
• Your family is welcome to accompany you to the hospital and will be instructed to wait in your patient room.

Although circumstances vary from patient to patient, you will likely have the following after surgery:
• A large surgical dressing will have been applied to the surgical area to maintain cleanliness and absorb any fluid. This dressing is usually changed two days after the surgery by Dr. Larson or his assistant.
• An IV, started prior to surgery, will continue until you are taking adequate amounts of fluid by mouth. When you are taking fluids well, the IV may be changed to a heparin lock–a small sterile tube that allows for easier movement while keeping the vein accessible for antibiotics. Antibiotics are usually administered intravenously for 24 hours to reduce the risk of infection.
• Difficulty urinating. One common side effect of anesthesia is a difficulty in urination after surgery. For this reason, a sterile tube called a catheter is inserted into your bladder to ensure a passageway for urine. This may remain in place for one day.
• Compression stockings (in addition to the elastic hose [TEDS]) will be applied. You will also be given medications and exercises (such as moving your ankles up and down) to help prevent blood clots.
• Temporary nausea and vomiting due to anesthesia or medications. Anti-nausea medications may be given to minimize any nausea and vomiting.
• Dietary restrictions. You will start with a diet of ice chips and clear liquids as tolerated and be allowed to progress as your condition permits.
• Coughing and deep breathing exercises are important to help prevent complications like congestion or pneumonia. Inhale deeply through your nose, then, slowly exhale through your mouth. Repeat this three times and then cough two times. You will be encouraged to use your incentive spirometer.
• A knee immobilizer may be worn as directed by Dr. Larson.
• A continuous passive motion (CPM) machine. In order to speed your rehabilitation, you may be using a CPM machine- a device that is fit to your leg and is placed in bed with you. It slowly and smoothly bends and straightens your knee. You will use the machine periodically during the day and it will be adjusted to increase the bend in your knee.
• “Up time” time on the first day after surgery. You will be assisted into a chair, provided there are no complications. Physical therapy is started the day of surgery. It is very important for you to have pain medication 30 minutes before going to physical therapy to help you fully participate in the exercises. Please discuss this with your nurse.

• Keep up on the recommend physical therapy program provided by your therapist.
• Use ice and heat to reduce any swelling and pain that may occur.
• Continue to take medications as prescribed by your doctor. (If pain continues to be a problem, call Dr. Larson’s office.)
• Continue to walk with crutches or a walker for 2-3 weeks.
• You should not drive until after your six-week follow-up appointment.
• Keep the incision clean and dry. Typically the sutures or staples are removed in two weeks.
• You can usually return to work within 1-2 months of your procedure.