These notes are a result of having both of my knees replaced, one in January and the other in September 2025. I am not a medical professional, I can’t even spell arthrop… orthop…. total knee replacement. While I am trying to be humorous, there is some valuable information here.
Most likely you will have been given a spinal block, and probably had some injections directly in your knee to deaden nerve pain, prior to the surgery. These blocks will last for a while after surgery. Some effect will still be in place up to 24 hours later. This means you’ll be feeling little or no pain. Do not be lulled into thinking you can wait to take your prescription narcotics. Once you fall behind the pain it is very hard to catch up.
This is not the time to be frugal or skimpy. Inexpensive walkers are cumbersome and, I felt, actually impeded my walking. For about $130 you can get a good, folding, walker with wheels that turn, and a handy pouch to carry things with. Worth every penny. I recommend the Stander Wonder Walker Plus
Get a cane that is adjustable and has a four legged foot. It will stand by itself, and provides a better grip on the floor. Using a cane takes some getting used to, maybe practice a little ahead of time. I recommend the BeneCane
Really. Pick a schedule that works for you and stick to it. Use sticky notes as reminders. Get family members to help remind you. What worked for me was a 6 - 12 - 6 - 12 schedule. Pain medication at 6 am, noon, 6 pm, and midnight. That was for the primary narcotic (hydrocodone in my case). I had a secondary pain mediation, tramadal, that I took in between the hydrocodone doses. Roughly 9 am, 3 pm, and 9 pm. If I was up in the night (bathroom) around 3 or 4 am, I’d take a tramadal then too.
You will not be stable, or able to stand comfortably on your surgery leg for a few days. Get a shower seat, preferably one with handles/arm rests. You will not want to climb into and out of a tub. A walk-in shower is best. Ideally you’ll have a care giver who is willing to help you bathe.
Take them. Gradually ease back on the amount and frequency. Don’t be surprised if you have a set back or bad day that leaves you hurting more. When that happens, take more pain medication.
It will be a while before lowering yourself to the normal height of a toilet seat will be easy. Even with a raised seat that adds 3 inches to the height you’ll struggle at first to sit and to get up again. And, once you are used to the higher seat, you’ll likely keep it after your recovery is over.
They’re good drugs. The slightly fuzzy, floating feeling will honestly help you fall asleep.
As a prevention against blood clots, you’ll get to wear TED hose, or Thrombo-Embolic Deterrent stockings, for four weeks following your surgery. Getting one onto your non-surgery leg will be a nice workout. Getting one onto your surgery leg will require more effort. It is possible to have someone help, but pulling the sock up your leg and over your knee will be better controlled by you.
When the prescription says 1-2 every 4-6 hours, believe them.
Your leg is going to be one large bruise from mid-thigh down to your foot. At first there won’t be much, but within a day or two of getting home you’ll be astonished at the amount and size of your bruising. Any bruised spot that is warm to the touch needs to be iced.
Narcotic pain meds can’t be renewed without an okay from the doctor. If you are running low and will need more before the weekend is over, call your doctor by Thursday to ask for more. Insurance is sticky about paying for more than a 7 day supply.
Get some good reusable cold packs to put on your leg and knee. An old fashioned ice bag works well too. Fill it partially with crushed ice and a little water. It’ll mold to your knee or leg nicely that way. These Rester’s Choice flexible ice packs are superb.
Use pillows to elevate your leg as much as possible. Getting the knee above your heart several times a day for 45 minutes is the goal. Every minute will help.
Narcotics can make you nauseous which is miserable on top of being in pain. Doesn’t need to be a whole meal, but something in your stomach will help.
Take pain meds before PT. Plan on being tired afterwards. The goal is regaining flexibility and strength. Some of the quads are cut during the surgery and those muscles need to be strengthened. Your hamstring will be sore and tight. At first you won’t be able to get your leg 100% straight and it’ll only bend about 80-85°. The goal is 0° - I.e., completely straight, and about 120° bent.
Eventually you’ll be able to get by without the prescription pain medication, and can manage with over-the-counter meds. Be prepared to take a prescription one if you have a bad day.
My first knee surgery was nine months ago and I can still feel a slight pull in the quads going downstairs. I was told it can take a year to completely recover from knee replacement surgery.
Lean on your medical team. They want you to succeed, they want your quality of life to be improved following the surgery. They have answers for your questions.