How to Be a Caregiver for Someone Having Knee Replacement Surgery

Now what?

Many hospitals offer classes, information booklets, and presurgical visits or phone calls to help patients and their loved ones prepare. Take advantage of those opportunities, says Nicci George, an orthopedic nurse at Henry Ford West Bloomfield Hospital, near Detroit.

George teaches a pre-surgery class for patients and says she always welcomes caregivers to join or watch a recorded session. Likewise, Catherine Wysin, a physical therapist at the Hospital for Special Surgery, meets with patients before surgery and encourages caregivers to come: “There’s a lot of information,” she says.

Here are some of the things George and Wysin say you can do to help someone get ready for surgery:

• Make the home safer. Clear away throw rugs, clutter, and other tripping hazards. “The patient’s balance is going to be off,” Wysin says. Pets also can be falling hazards and hard for the patient to care for right after surgery, George says. “Some people choose to board their dogs, especially if they’re big dogs,” she says. At the very least, figure out who’s going to walk and feed a dog, she says.
• Get any equipment they’ll need.The one must-have is a walker with front wheels only, George says. “Four wheels is too fast, and with no wheels, you have to lift it up and walk, and that’s not safe.” Some people get bathroom aids, like raised toilet seats, she says. Claudette James, 62, of New Boston, Michigan, says it was a “big help” when her husband Jeff, 61, got her a hand-held shower head and shower chair before her first knee replacement in 2020. She says she felt safer not standing in the shower at first. She used them again after her second surgery, in October.
• Stock up on easy meals. This is especially important if you or another caregiver won’t be there at every meal for the first couple of weeks. Someone with a new knee won’t be in shape to cook and clean up right away. Think microwavable, George says.
• Think about stairs and chairs. If your loved one will need to climb stairs to get into their home or to their bed, physical therapists will make sure they know how to do it safely before they leave the surgical center, George and Wysin say. But some people set up a temporary sleeping and resting spot on a ground floor, they say. Get their spot ready — ideally with a bed, a sofa, or chair/ottoman combo that will let your loved one rest with a straight leg, Wysin says. Recliners, she notes, may not be ideal, since they can bend the knee.
• Follow the doctor’s pre-surgery instructions. For example, your loved one might be asked to shower with a special antibacterial soap a day or two before surgery, to reduce infection risks. And, as with any surgery, they might need to limit what they eat or drink the night before.

Claudette James says her husband, Jeff, kept her well supplied with ice packs and hot tea.

Courtesy of Claudette and Jeff James

On the day of surgery

Besides making sure your loved one gets to the surgical center on time, you won’t have much to do — until they leave the recovery area. Here’s what to expect:

• Be prepared to go home quickly. While some people may spend a night in the hospital or be discharged to a rehab facility, it’s common for people to go home a few hours after surgery, George says. At her hospital, people can leave once a physical therapist confirms they can walk a short distance, with a walker, and safely navigate a few stairs, if needed, she says. A few people, she says, need a night in the recovery unit before they reach those milestones.
• Make sure you get medications and instructions. Your loved one will go home with discharge instructions and with some supplies, like ice packs and knee wraps, George says. But you’ll probably need to pick up some prescription medications, which could include painkillers, a muscle relaxer, and a blood thinner to prevent blood clots. Your loved one will also need stool softeners to ease post-surgical constipation (a common problem, caused in part by pain medications), she says.
• Assist, as needed.You’ll need to make sure your loved one makes it safely home, and then to bed or a comfortable chair. They may be able to do more than you’d expect, with their walker and with you close by, George says. “Most people sleep in their own beds. Most people (can) navigate 14 steps on the day of surgery, as long as they pass the stairs here at the hospital… if you can do four steps you could do 14.” But, at first, they should go up and down stairs no more than once or twice a day, George and Wysin say.
• Stay near. On the night after surgery, make sure you or another caregiver stays with your loved one, George says.  

After surgery

George says patients often feel better than they expect right after surgery: “They’re walking around the recovery room (saying), ‘Oh, I’m so glad I did this. I wish I’d done this 10 years ago.’ And then I call them in a few days and they’re like, ‘Why did I do this?’”

It’s normal for swelling and pain around the knee to get worse after a few days, before they get better, she explains. “Between days three and six are the roughest days,” when your loved one may need the most help and encouragement, she says.

Here’s what you can do in those tough days and the days and weeks afterward:

• Help manage medications. Keeping track of multiple medications, including some painkillers that need to be taken on a steady schedule and some that should be taken as needed, can get tricky, George says. Some people make spreadsheets to avoid mistakes, she says.
• Pamper them … but not too much. James says her husband, a delivery truck driver, made sure she had plenty of cold packs for her knee, along with water, Vernors ginger ale, and her favorite hot black tea during her toughest recovery days. “He learned how to make my tea really good,” she says. But George urges caregivers not to hover or do so much that the patient never gets out of their chair or bed. After all, she says, getting a new knee is about regaining independence. “You don’t need someone coming around acting like a babysitter,” she says. “You need someone to come around and ask if you need anything from the grocery store.”
• Help them get active ... but not too active. Typically, physical therapists will come to the home during the first couple of weeks to teach exercises focused on bending and straightening the knee, strengthening the thigh muscles, and maintaining blood flow, Wysin says. While it’s important to do the assigned exercises between PT sessions and get up to walk around the house regularly, it’s also important to rest, and to elevate and ice the knee, she says. The balance can be tricky. Krigger says that after his first knee surgery, in 2020, “I overdid it,” and paid with more pain.
• Expect to drive them for a while. After the first couple of weeks, most people will need to go out for several more weeks of physical therapy and other appointments. But they may not be cleared to drive for four to six weeks, according to the surgeon’s group. If one caregiver can’t do all that driving, you’ll need to find back-ups.

The whole process can be demanding, but worth it, Carrara says. Before his latest surgery, Krigger had been limping “for a very long time,” she says, and now he’s not. “Just to see him walking straight is very rewarding.”