Thank you for choosing Rutland Regional Medical Center for your upcoming medical procedure. In
this video, we will demonstrate what occurs once your total joint procedure is complete and once
you are fully awake after surgery. Once your surgery is over, you will be introduced to the
physical therapist and trained therapy technician. They will come to your room and evaluate you
either the day of your surgery or the very next morning. Your therapist will ask questions about
your pain level, your level of activity, and any equipment needed before surgery. They are also
available to answer any questions you may have at any time. So, ask them. It is important for
you to let your therapist know the details of your home, such as the number of steps inside and out,
location of handrails, and setup of bathrooms. Our goal is to make sure you are able to safely
move around your home. During the evaluation, the therapist may recommend the removal of
tripping hazards, like throw rugs. Depending on your mobility level and the setup in your home,
your therapist may recommend equipment such as a rolling walker and/or crutches. At this point,
your surgeon has cleared you for some activity; and the physical therapist will get you out of
bed. First, the therapist will inspect your dressing, test for sensation, and assess your
strength. You will practice getting out of bed the same way you would as if you were home. It would
be easiest for you to sit up towards the operative leg, if possible. Continue until both heels are
just off the mattress. At this point, you should be able to sit yourself up with assistance from
the therapist. Once seated at the edge of the bed, you may feel slightly lightheaded or nauseous.
Here the therapist will assess your level of pain. A rolling walker will be placed in front of you.
Prior to standing, the therapist will instruct you where to place your operative leg. At this point,
you are allowed to put as much weight as is comfortable on the operative leg, unless otherwise
instructed by your therapist. Some important cues to remember: use your arms to push off from a
stable support surface, lean your body forward thinking "nose over toes," do not reach for
the assistive device until fully standing. Once standing, the therapist will adjust the rolling
walker to fit you. The handles will line up with a bend in your wrist allowing for the elbows to
maintain a slight bend. Next, your therapist will teach you the safest way to walk. There are three
steps. Step 1, slide the walker forward. Step 2, move the operative leg forward to the center of
the walker. Step 3, using the walker to support yourself, move your non-surgical leg forward to
meet the other leg. Next, your therapist will work with you to walk up and down stairs,
using either a crutch or a cane. First, advance your non-surgical leg onto the first step. Next,
use your arms and your non-surgical leg to bring the operative leg onto the same step. As you do
this, slightly bend the knee of the operative leg to avoid catching your toe. Take your time
as you repeat this pattern, all the way to the top. During this process, your therapist will
be with you. Remember your therapist is ready to answer any questions you may have, so be sure to
ask them. This process is reversed on the way down. Inch close to the edge of the top step,
use the railing to support your weight, and slowly lower the operative leg to the first
step. Be sure to have the foot fully supported on the step and not too far forward. Again,
using the railing for support, slowly lower the non-surgical leg. This pattern is repeated all
the way down to the bottom. Physical therapy will go over the basic therapeutic exercises, as seen
in your surgical manual. These exercises should be completed 3 times a day at home prior to surgery,
unless otherwise instructed by your doctor. After surgery, you will perform your exercise program as
instructed by your physical therapist. For the first set of exercises, you will be laying on
your back in a bed on a flat surface or in a fully reclined chair. These exercises will help improve
circulation and decrease the likelihood of blood clots. First are "ankle pumps." Using your ankles,
bend your feet toward you and then away using a controlled motion. You may feel a slight stretch
behind the leg, but no hold is required. Next is the "quad set." With both legs straight,
tighten the muscle at the front of your thighs as you press the back of your knees down
toward the bed. Hold for 3 to 5 seconds. Then the "gluteal set." With your legs,
straight squeeze your buttocks together tightly. Your hips may rise slightly off the bed. Hold for
3 to 5 seconds. Next is the "active heel slide." Start with both legs stretched out in front of
you. Slide your heels toward your buttocks as far as possible while keeping your heel on the
bed. Hold for 3 to 5 seconds and slide it back. If you experience a cramp in your leg, lessen the
distance. Repeat this exercise with the other leg. These exercises are important for your recovery;
so, if you have any questions, please ask your physical therapist. They are here to help. Your
physical therapist may recommend other exercises depending on your type of surgery. After surgery,
the use of ice is highly recommended. Ice is used to desensitize the surgical area, as well
as decrease pain and inflammation. Always use a barrier between you and ice, such as a pillowcase.
Apply the ice while you are sitting or lying down and keep it in place for 20 minutes each
time. Apply ice frequently throughout the day but especially after physical activity and exercises.
It's good to remember that ice is your friend. Your occupational therapist will help you to be as
independent as possible with activities of daily living, such as dressing, bathing, and toileting.
You may be given adaptive equipment to assist you with any dressing or bathing tasks that were
difficult either before or after your surgery. If you can dress yourself without adaptive equipment,
your occupational therapists will encourage you to do so. If you are having difficulty,
equipment may include a teacher, a dressing stick, a long-handled sponge, a leg lifter,
or a sock aid. Depending on your mobility level and how your home is set up, you may want to
invest in additional equipment, such as a shower chair, a tub transfer bench, grab bars, a commode,
or an elevated toilet seat. It's time to leave the hospital. When you've been cleared to go home,
a hospital Volunteer will come to your room with a wheelchair to bring you to the hospital exit.
Your caregiver should pull the car up to the exit. They should adjust the passenger seat
for you so that it is pulled back away from the dashboard and with the back of the seat slightly
reclined. This will give you space to swing your legs into the car more easily. Using your walker,
move to the passenger side of the car. Slowly turn around using small steps so that your back side
faces the seat and is in contact with the seat. Move your operative leg slightly forward, reach
back for the seat, then lower yourself onto the seat. If you find it hard to move on to your seat,
use a plastic bag to make the surface slippery. While keeping your legs together, carefully and
slowly bring both legs into the car with as little movement as possible. Once you are in the car and
seated comfortably, take the seat back out of reclined position so it is in the normal upright
position and buckle yourself in. Please have someone at home to assist you during the first
two weeks of your recovery after your surgery. During your recovery at home, it is very important
that you always walk using your assistive device to prevent falls. This concludes the
video on post-operative recovery from total knee replacement. By doing the exercises recommended
before and after your surgery and following your doctor's instructions, you will be well on your
way to recovery. thank you for choosing Rutland Regional Medical Center for your medical procedure
and for taking the time to view this video. All of us wish you a full and successful recovery.