Tips and exercises at home
In the first six to eight weeks following the operation your new joint is still relatively unprotected, as the muscles around the knee tend to weaken and become smaller through lack of use. It is therefore necessary to build up again and strengthen the surrounding muscles so as to restore your freedom of movement as quickly as possible hence your active cooperation is indispensable.
Please consult your surgeon or your physiotherapist if you are uncertain about the following exercises or if you do not fully understand them.
Use the crutches correctly
To stand, place the two crutches in a bit in front and to the side of your feet.
Keep your hips as straight as possible. A slightly bent elbow will permit you to do so.
Support yourself firmly on the handles of the crutches when walking.
Important: carry your weight on your hands – and not on your forearms.
Always load the operated knee as you were shown at the clinic, but walk as normally as possible. This means that each step should be of the same length, as in normal walking. Load the operated leg with no more than the permitted load.
If you are permitted to use one single crutch, use in on the healthy side.
Going up and down stairs
Important: do not attempt your first trials on the stairs alone!
Going upstairs
Set the healthy leg on the first step of the staircase.
Push your weight with the healthy leg and with your hands, so that you are able to lift the operated leg to the same step.
Repeat this until you have reached the halfway mark or landing.
Proceed exactly the same way even if the stairs have banisters.
Going downstairs
Place both crutches on the first step.
Put the operated leg on the same step.
Take care to put as much weight as possible on the crutches.
Place the healthy leg on the same step.
If your healthy leg is strong enough, you can try to put the crutches and the operated leg on the next step at the same time and to make the healthy leg follow.
Sitting correctly
Abstain from sitting in deep armchairs, especially during the early days.
Ideal are high stable chairs with arm rests. If necessary, you can increase the height of your seat with a pillow.
To sit down: move backwards to the chair until you feel its edge.
Move both crutches to the side of the healthy leg.
Support yourself on the arm rests to sit down – stretch the operated leg slightly forward.
Angle your legs slightly and sit upright.
Slip forward to get up. Use the arm rests to stand on your healthy leg. Continue to stretch out the operated leg slightly.
Take the crutches in both hands to stand on the operated leg.
Going to the bathroom
Move both crutches to the healthy side. Grip either an arm rest on the toilet (if available) or a handhold next to the toilet.
Sit down slowly and stretch out the operated leg slightly.
Get up as from a chair: support yourself on the arm rests or on the handhold. Put the operated leg slightly forward.
Having a shower
To keep your balance, use an anti-skid mat and a handhold on the wall.
Mix the water to the right temperature before taking a shower.
Start by putting the healthy leg into the shower. The crutches remain outside the shower, but close by.
A sponge with a long handle keeps you from having to bend forward.
Leave the shower with the operated leg first.
Taking a bath
Immersing the operated leg in water is not permitted in the first 2-3 weeks after the operation. If you do not have a shower, it is preferable to have a strip wash rather than a bath unless you are sufficiently agile and able to support most of your body weight on your arms. If you do attempt to have a bath, then use the following method:
Go to the broad side of the bathtub on your crutches.
Mix the water to the right temperature before entering the tub. Keep the water level quite shallow.
To get into the tub, sit down on the edge or on a chair which is slightly higher than the bathtub and positioned directly next to it.
Lift the operated leg first, if possible, and then the healthy one over the edge. Try to sit down opposite the water tap when you are on the edge of the tub. It may help to place your hands under the thigh of the operated leg to lift it into the tub.
Don’t forget that you can put the foot of your operated leg in the water but you must not immerse the knee joint as otherwise water can penetrate into the wound causing infection.
Lift your legs carefully over the edge to leave the bathtub.
Going to bed
Sit down backwards on the bed in the vicinity of the head end.
Move your bottom slightly backwards and put the healthy leg onto the bed.
The operated leg is next: if you do not yet have enough strength to lift it yourself, support it with the healthy leg or place your hands under the femur for support. Now you can lie on your back.
Important: move your pelvis and legs evenly. Keep your legs slightly spread.
Rising
Make sure your crutches can be reached. Put the operated leg out of bed first. If necessary using the normal leg or your hands to assist you. Sit for a moment. If possible position yourself where you have something you can hold to steady yourself or use the crutches to assist you. Stretch the operated leg slightly forward. Now stand putting most of your weight on your normal leg and on the crutches or other support.
Sleeping
The best thing is to sleep on your back.
If you prefer to sleep on your side, place a pillow between your legs to prevent them from crossing in your sleep and your hip from turning on one side.
Getting dressed
Select comfortable clothing.
You will need help from others at first, or a dressing aid. If you choose a dressing aid, use the hook to grasp the waistband of your clothing and pull it first over the operated leg and up over the knee.
Use a crutch to stand on the healthy leg and then finish putting on the item of clothing.
Undressing
Remove the clothing from the healthy leg first.
Shoes
Flat, firm shoes that are easily slipped on and do not have shoelaces are best, as you do not have to bend over to put them on.
Pay attention to good soles. Leather soles are unsuitable as they are very hard and do not absorb shocks.
Use a dressing aid or a shoehorn with an extra long handle.
In the kitchen
An apron with several pockets can be of help.
Transport hot fluids in containers with a lid.
Slide things on the counter or working surface instead of carrying them.
Take small steps instead of turning your body; do this when walking as well.
Use gripping pliers to pick up objects.
Do not bend when reaching for something in a lower drawer or in the oven – keep the operated leg extended.
You may also sit on a chair. Position it so that the operated leg is turning toward the drawer or the oven.
Use a trolley to transport tableware. It will also help you avoid unnecessary extra trips
In the car
Do not drive a car until your doctor permits it.
Get into the car on the side with the most leg room (normally the passenger side).
Sit down backwards on the car seat.
Lift your legs carefully and slowly into the car. Support your legs with your hands under the femur or with the healthy leg.
Important: move your pelvis and legs as uniformly as possible and keep your body as straight as possible.
Taking a walk
Begin taking regular walks on well constructed paths soon after the operation. Start with a short walk of five to ten minutes.
Gradually increase your walking distance.
Important: avoid uneven and slippery roads. Always wear sturdy shoes.
Recommended exercises
Move your knee joint as much as possible. Sit down on a chair and place a towel on the smooth floor. “Mop” the floor by moving the towel back and forth.
If you have a home exercise cycle and achieve sufficient flexion of the knee joint, then use it daily for about ten minutes on low resistance. Keep the seat up high.
