Week 1

Pain is expected. Progress is possible.

1 Day After Surgery

🎯 Today’s Focus

Your job right now is to rest, manage pain, prevent clots, and start to move. Swelling is starting, and you may feel groggy from anesthesia. Your caregiver, whether a professional nurse or a friend or family member, will help with your care overnight. Follow the icing schedule, stay hydrated, and take medications as directed.

Your Actions

Take pain medication on schedule — don’t wait until pain peaks
Ankle pumps every 1–2 hours while awake — your most important blood clot prevention tool
Ice the knee 20 minutes on / 40 minutes off throughout the day
Walk to the bathroom and back — supervised — at least 3 times
Eat small meals even if appetite is low; anesthesia affects the stomach

PAIN MEDICATION — EVERY 4–6 HOURS

Take with food; many patients use a combination of an opioid and acetaminophen
Do not exceed acetaminophen limits if taking both
Stay ahead of pain — set a phone alarm if needed

BLOOD THINNER — STARTS TODAY

Most patients are prescribed aspirin, Xarelto, or Eliquis starting today
Take exactly as directed — do not skip doses

Deep Dive

Ankle Pumps

DVT (deep vein thrombosis) is a serious risk after knee replacement. The calf muscles pump venous blood return — when you’re not walking, that pump is idle.

To perform ankle pumps: flex your foot up toward your shin, hold 3 seconds, then point it down. Repeat 10–20 times per hour. This is non-negotiable.

Icing Correctly

Apply 20 minutes on, 40 minutes off. Never apply ice directly to skin, and never sleep with ice on. If your surgeon provided a cryo-compression device (such as a Game Ready), follow the manufacturer’s settings.

Walking Today

Your goal is not distance — it’s controlled, safe weight-bearing. With your walker or crutches, walk to the bathroom and back 2–3 times. Keep the knee slightly bent (not locked) when standing.

Your physical therapist will begin formal PT starting tomorrow or the day after, and will set your weight-bearing progression.

What’s Normal vs. Call the Office

Normal:

Discomfort more than sharp pain
Significant swelling
Grogginess from anesthesia

Call Dr. Davis‘s office immediately ( ) if you experience:

Calf pain, redness, or warmth — possible blood clot
Sudden shortness of breath or chest pain — call 911
Fever above 101.5°F
Wound drainage that is green, foul-smelling, or soaking through dressings

Quick Reference

⏰ When Can I…

Start PT

Day 2 – 3

Shower

Day 3 – 4

Drive

When you’re off narcotics and in control (4 – 6 weeks)

Stop blood thinners

When advised by surgeon

🔍 What to Expect

You will be swollen. This is normal and expected.

Significant swelling is expected for the first 1–3 weeks. The knee may look larger than you anticipated — this is a normal inflammatory response.

Pain is commonly highest on days 1–3. Many patients find days 3–4 emotionally difficult because progress feels slow. This plateau is normal and temporary.

📚 Why This Matters

Patients who begin controlled movement within 24 hours of knee replacement generally have better range-of-motion outcomes, lower DVT risk, and shorter hospital stays. Early movement does not damage the implant — it’s designed for it. The risk of too little movement far outweighs the risk of too much, within your surgeon’s guidelines.