Jordan Ellis
Total knee replacement (TKR) surgery is a common procedure, but what equipment and supplies does the hospital provide for recovery? Patients often require a wheelchair, walker, cane, and ice therapy machine. Compression stockings are also sometimes provided to prevent blood clots such as deep vein thrombosis (DVT) and pulmonary embolism (PE), but recent studies suggest that anti-clotting medication may be more effective.
| Characteristics | Values |
|---|---|
| Equipment supplied by hospital after TKR | Walker, cane, wheelchair, ice therapy machine, compression stockings |
| Alternatives to compression stockings | Anti-clotting medication (e.g. heparin), hydration and mobilization |
| Effectiveness of alternatives | Anti-clotting medication alone found to be as effective as medication + compression stockings |
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What You'll Learn
Compression stockings are not necessary for patients on anti-clotting medication
Compression stockings are tight-fitting socks that gently squeeze the legs to improve blood flow and reduce pain and swelling. They are also known as thrombo-embolic deterrent (TED) hose or anti-embolism stockings and are often used after surgery to prevent the formation of blood clots.
While compression stockings are an effective way to prevent blood clots, they are not a standalone treatment for existing clots. Anticoagulant medications are an alternative treatment for existing clots and to prevent new clots from forming. A large-scale study called GAPS found that anti-clotting medication alone is just as effective as using it in combination with compression stockings. The study found that heparin alone was as effective at preventing blood clots as the combination of medication and compression stockings.
Compression stockings can also cause discomfort, pressure sores, blistering, and other skin problems. They may also worsen conditions like severe peripheral artery disease. Given the risks and costs associated with compression stockings, researchers are questioning whether they should be standard care for most patients having planned surgery and taking anti-clotting medication.
Therefore, compression stockings are not necessary for patients on anti-clotting medication. Anti-clotting medication alone is effective in preventing blood clots, and the addition of compression stockings may not provide significant additional benefits. However, it is important to note that every individual's health condition is unique, and treatment plans should be tailored accordingly.
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Alternatives to compression stockings include hydration and mobilisation
Compression stockings are a common post-operative measure to prevent blood clots and reduce swelling. They are often recommended after surgery, especially for those who need to stay in bed. However, alternatives to compression stockings include hydration and mobilisation.
Staying hydrated is essential for maintaining good blood flow and preventing blood clots. Fluids help to thin the blood, making it less likely to clot. Drinking plenty of water or other fluids can help prevent blood clots and improve circulation. In addition, staying hydrated can aid in reducing swelling in the body, including the legs and ankles.
Mobilisation, or early ambulation, is another effective alternative to compression stockings. Getting up and moving around as soon as possible after surgery improves blood flow in the legs and can help prevent blood clots and swelling. Walking and light physical activity can aid in circulation and reduce the risk of deep vein thrombosis (DVT). It is important to note that mobilisation should be gradual and supervised by a healthcare professional.
In some cases, a combination of hydration, mobilisation, and compression stockings may be recommended for optimal recovery and to prevent complications. It is always advisable to consult with a healthcare provider to determine the best course of treatment for an individual's specific needs.
Additionally, there are other alternatives to compression stockings that can aid in improving blood flow and reducing the risk of blood clots. These include:
- Thrombo-embolic deterrent (TED) hose or anti-embolism stockings: These are designed to maintain blood circulation and reduce the chances of severe swelling.
- Gradient stockings: These provide a gradient compression that can improve blood flow and reduce swelling.
- Support hosiery: This type offers even compression throughout, providing relief for tired and achy legs.
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Walker, wheelchair, and cane for mobility
After a total knee replacement (TKR), a walking aid is a must. Depending on your needs, you may use a walker, a wheelchair, or a cane to help you move around. Some people may only require a walking aid for a short time, while others may need to use one for several weeks or even months after surgery.
Walker
A walker is a stable option for those who need more support after TKR. It is recommended to use a walker with wheels, such as the Drive Medical Four-Wheeled Walker, as it provides better mobility and can be used on various surfaces. A walker with hand brakes, a basket, and a seat can also be helpful. It is important to ensure that the walker is adjusted to the correct height to maintain balance and avoid falls.
Wheelchair
A wheelchair is not typically necessary after TKR unless the patient has other conditions that require one. However, some people may find it helpful to have a wheelchair for the first few days or weeks after surgery, especially if they are unable to bear weight on the operated leg.
Cane
Canes are a simple and lightweight option for those who need less support after TKR. The Hurry Cane, for example, has a flexible bottom and a 3-leg base that prevents it from falling over. Canes can also be made from lightweight aluminium or even wood. They are easy to travel with and can be broken down to fit in a bag.
Other Options
In addition to walkers, wheelchairs, and canes, there are other options for mobility after TKR. These include hiking poles, walking sticks, or trekking poles, which can provide balance and shock absorption during walks or hikes.
It is important to keep your walking aid close by, especially in the first few weeks after surgery. This means keeping it near your bed or couch to help you stand up and when getting up from the toilet or bathing. As your recovery progresses, you may only need the walking aid for longer walks or outdoor activities.
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Toilet rails and grab bars for the shower
Toilet rails and grab bars are essential safety measures to prevent falls and injuries in the bathroom, especially for those recovering from a total knee replacement (TKR). Falls are the leading cause of injury among older adults, and the bathroom, with its slippery surfaces and high-stepping requirements, can be a hazardous place.
Toilet rails are a great aid for those with limited upper-body strength, as they provide support when sitting down and standing up. If the toilet is not near a wall, a toilet frame with arms on both sides can be installed. Alternatively, a raised toilet seat or a bedside commode placed over the toilet bowl can provide similar benefits. Grab bars, on the other hand, are designed to support a person's full weight and should be firmly attached to the wall, ideally screwed into wall studs.
In the shower, grab bars should be placed near wet and slippery surfaces, such as the bathtub, shower floor, or tile walls, to assist users in maintaining their balance. The ideal height for grab bars is between 33 and 36 inches above the shower floor, with the bar positioned about 1.5 inches from the wall. If there is a shower seat, a vertical grab bar should also be placed on the sidewall to help users maneuver into a standing position.
When installing grab bars, it is important to consult local building codes and ensure that the hardware used is resistant to corrosion. The bars should have a slip-resistant surface and be able to support a minimum weight of 250 pounds. While straight grab bars are the most common, curved grab bars can add a stylish element to the bathroom while serving the same function.
These safety measures can provide peace of mind and help individuals maintain their independence as they navigate the challenges of recovery and ageing in place.
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Ice therapy machine for pain and swelling
After a total knee replacement (TKR), patients are usually given painkillers and medicines to help with the pain. They are also provided with crutches or a walking frame to aid them in moving around.
Ice therapy machines are a widely accepted form of pain management that can be used after a TKR. They work by applying cold to the knee, which reduces its internal temperature, slowing down the speed at which pain signals travel along the nerves. This, in turn, reduces the number of pain signals that are sent to the brain.
Ice therapy machines offer precise temperature control, continuous cold application, and compression benefits. However, they can be costly and may be less portable. Some people may also find ice cubes or ice packs to be a more convenient and equally effective alternative, as they are easily accessible and free.
There are several ice therapy machines available on the market, such as the BelugaPro Cold Therapy Machine and the Cold Therapy Machine by Polar Sport, which offer large adjustable cold pads for pain in the knee, shoulder, ankle, and neck, as well as a pump for water circulation.
It is important to follow the advice of medical professionals when deciding on a pain management approach after a TKR.
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Frequently asked questions
TKR stands for total knee replacement.
TED stockings, or compression stockings, are often recommended as part of post-surgical care. However, recent studies have shown that compression stockings may be unnecessary for patients who are already receiving anti-clotting medication.
Alternatives to TED stockings include anti-clotting medication, hydration, and mobilization. Anti-clotting medication, such as heparin, can be just as effective at preventing blood clots. Staying adequately hydrated and moving around as much as possible post-surgery can also help prevent post-surgical complications.
