The First 14 Days After Knee Replacement: Complete Home Protocol

Executive Summary

The first two weeks following a Total Knee Arthroplasty (TKA) dictate your long-term range of motion and functional recovery. Strict adherence to this clinical protocol prevents surgical complications such as Deep Vein Thrombosis (DVT) and flexion contracture.

Phase 1: Days 1 to 5 (Acute Inflammatory Phase)

• Cryotherapy (Ice Compression): 20 minutes every 2 hours while awake. Never apply ice directly to bare skin.
• Elevation: Elevate the leg with pillows placed under the calf/heel, never directly under the knee joint, to avoid joint flexion stiffness.
• Bed Exercises:
  • Ankle pumps: 20 repetitions every hour to promote venous return.
  • Quad sets: Tighten thigh muscles, pushing the back of the knee down into the mattress for 5 seconds. Repeat 15 times, 3x daily.
  • Heel slides: Gently slide heel toward buttocks within comfort limits (target 70° flexion by Day 5).

Phase 2: Days 6 to 14 (Active Mobilization & Wound Healing)

• Walker to Cane Transition: Walk only under supervision of your Swarn Home Physiotherapist.
• Wound Inspection: Keep surgical incision dry until staples/sutures are removed. Monitor daily for erythema, warmth, or exudate.
• Medication Timing: Take prescribed analgesics 30-45 minutes before your home physiotherapy session for optimal tolerance.

Red Flag Symptoms (Call Emergency 1066 / Tele-Doctor Immediately):

1. Sudden swelling or tenderness in the calf (unilateral).
2. Spiking fever (>101°F / 38.3°C) or persistent chills.
3. Increasing purulent discharge or foul odor from incision.
4. Acute shortness of breath or pleuritic chest pain.