Some discomfort is normal after surgery. You will receive regular background pain killers, but can take additional strong pain killers if really needed (they often have side effects such as nausea, constipation). Aim for 4 out of 10, so it is manageable; aiming for zero pain is unrealistic initially. If you need increasing doses of pain killers (typically a few days after going home from the hospital) then you are doing too much activity too soon - reduce your activity levels but keep the gentle stretches going as described.

Marked soft tissue swelling is a normal response to knee replacement surgery. Maximal swelling is usually on day 3 or 4, then it settles slowly over about 6 months (up to 12 months in many patients). Frequent REST, ICE and ELEVATION (foot must be above hip level or else it won’t help) are the keys to reducing the early peak of swelling and allowing the knee to move more easily as it is not so ‘tight’.

Bruising often affects the sides/back of the knee, and often tracks down the calf into the ankle or foot due to the bruise travelling downstream with gravity. The bruising resolves over the first few weeks (of course, rest, ice and elevation help it settle).

Most patients use a frame initially in hospital, then start using a stick when ready (physio helps with this advice). Cease using a stick when you can walk safely and correctly without a limp. Some patients obviously need to use a walking aid for longer than others if they have had very severe or longstanding joint disease or poor balance. Limps are often present before surgery and usually take months to correct after surgery.

The Australian joint replacement society recommends not driving for a minimum of 4 weeks. You can drive when you feel ready after this, as long as you can use the pedals appropriately.

These are hard to put on yourself - if it’s too hard, then cease using them. For swelling control, it is even better to do frequent rest, ice and elevation (above heart height.)

Keep gently moving regularly as described, particularly the ‘ankle pumps’ to keep the calf muscles moving. Don’t spend all day in bed or prolonged periods in one position without moving. Take your blood thinners as prescribed.

You will see a physiotherapist every day while in hospital to check you are doing your gentle stretches correctly and using a walking aid correctly. After leaving the hospital you should see your regular physio around every week or two to make sure you are on track. Sometimes patients are very sore after a physio session of repetitive exercises, this should not be the case, as you should know from reading this. All physical therapists should ensure you are reaching your primary goals of gentle knee motion (0-100 degrees) and improving your mobility/walking style. Gentle muscle activation exercises to make sure your muscles are ‘waking up’ after surgery are fine. Do not try repetitive strengthening exercises which make the swelling, tightness and pain worse. Typically, gentle strengthening exercises can be introduced from 6 weeks post surgery, but the ‘too much too soon’ phenomenon of increased pain occurs for months after surgery if you overdo it.

Yes, as long as your waterproof clear dressing on your knee is intact. If the dressing is peeling off or water is getting onto your incision this is bad for infection risk - phone the Ascent nurse to have a new dressing placed. Delay soaking in a bath, pool or spa until 6 weeks after surgery.

Yes, with a pillow between your knees. Difficulty sleeping is common in the first 4-6 weeks and corrects with time. Practice good sleep habits if possible, take pain tablets at night if needed, use meditation, relaxing music or breathing exercises. Sleeping tablets tend not to work well.