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Total Knee Replacement Postoperative Instructions

Wound Care

  • Keep ACE wrap on and keep knee dry for three days. 

  • After 3 days, you may remove the ACE wrap.

  • Once the ACE wrap is removed, you will see either an Aquacel or Dermabond Prineo dressing.  Leave these in place.

  • You may shower with either of these dressings 3 days after surgery.  You may sit in a shower chair or stand. Use crutches or a walker to get in and out of the shower

  • No bath tubs

  • The Aquacel Dressing should be left in place for 10-14 days.  If we have not removed it for you by then, you may remove it on your own. 

  • The Dermabond Prineo is left in place for 1-2 months and will "fall off" on its own

Ice Therapy

  • Cryotherapy (cold therapy) is a very important part of pain control after surgery.

  • The cold temperature will help control swelling and reduce pain.

  • Use an ice pack or cold therapy unit for 20 minutes, 4-6 times a day until the swelling is down and pain is improved.

  • Most patient use ice therapy for an average of 7-14 days following surgery.

Aquacel Dressing

(Can not see incision through dressing)

Dermabond Prineo dressing

(Can see incision through dressing)

Deep Vein Thrombosis (DVT) Prophylaxis

  • If you are at low risk for blood clots, you will take Aspirin 81 mg twice a day for 4 weeks following surgery.  If you were already on aspirin prior to surgery for another condition, restart the dose prescribed by the other provider.  For high risk patients, Lovenox is administered for 4 weeks.

Pain Medications

  • Pain is a natural reaction to the work that was done in your knee.  Pain is your body's way of kicking off the healing process.  It is normal and expected for every patient.

  • Many modalities are used to control pain:  ice, narcotic and anti-inflammatory medications, physical therapy, elevation, and time. 

  • Your pain will improve gradually and predictably.

  • You will be given a prescription for a narcotic (opioid) medication to help with pain relief (refer to our practice's Opioid Policy).

  • As your pain improves, decrease the amount of pain medication either by taking fewer tablets and/or increasing the time between doses).

  • Hold your pain medication if you experience oversedation (sleeping too much), slurred speech, slow breathing, or hallucinations.

  • Pain medication often causes constipation. It is important to drink adequate liquid daily and take a stool softener.

  • Do not drive or operate heavy machinery while taking your pain medication.

  • Combining pain medication with alcohol, benzodiazepines, and other medications may cause respiratory depression and increased altered mental status.


  • Absolutely no driving while taking any narcotic pain medications (Vicodin, Percocet, Oxycodone, etc.).  These medications impair your ability to safely drive a vehicle.

  • In general, you should not drive until it is safe for you to do so, and different patients recover at different rates.

  • We will direct you in this regard during your post-operative visits


  • Please call the office to make or confirm your postoperative appointment.

  • The first appointment is usually 10-21 days after the surgery and may vary depending on the nature of the procedure.

  • Subsequent appointments are usually at 6 weeks, 3 months, 6 months, and 1 year after surgery.

  • Please bring your black Ortho.Boston folder with you to all of your post-operative appointments.

Please Notify Our Office Immediately if any of the Following Occur:

  • Any drainage or bleeding from the incision more than three days from surgery

  • If your pain is increasing and not decreasing over the course of three consecutive days

  • Poor pain control with your medications.

  • Fever > 101.5° after postoperative day #3.  It is common to have an elevated temperature the first couple of days after surgery.

  • Increased redness along incision or concern for infection.

  • Calf pain or leg swelling.

  • Shortness of breath.

  • Chest Pain.

  • Any other concerns or questions.  If you feel it is an emergency and can not get a hold of our office, either call 911 or go to your nearest emergency room.

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