Reducing Risk of Hospital Return after Total Knee Replacement

Themistocles Gluck, believed to be the first to implant artificial joints, inserted an ivory knee joint into a 17-year-old girl in May of 1890.

Since 1991, there has been a substantial increase in the number of senior adults receiving total knee replacements. In Canada alone, approximately 60,000 are performed annually. The increase in this elective surgery can be attributed to its success rates and the overall increase in quality of life senior patients can enjoy after the procedure. Total knee replacement can reduce or alleviate pain and increase mobility, allowing seniors to participate in activities from which they may have been precluded due to knee problems.

However, while the rates of this surgery have increased, the length of time the senior remains in the hospital after total knee replacement has decreased by half. Unfortunately, because complications can arise during recovery, there is substantial risk that older adults who have undergone total knee replacement will end up back in the hospital. The good news is that there are actions these individuals can take to reduce this risk.

Older individuals who have undergone total knee replacement can potentially experience complications deriving from medical conditions or other factors such as deep vein thrombosis (DVT) and infection. The best defense against these complications is for the senior to be well informed about the procedure, recovery, and self care during recovery. Seniors should ask their doctors to explain any part of the procedure or recovery of which they are unsure. They should ensure that their doctor’s are also fully aware of any medical conditions that could cause potential complications.

DVT, the leading cause of complications that result in re-admittance to the hospital, results when a blood clot forms within a deep vein. This can be deadly if it breaks free and enters the lungs. Some medical conditions, such as varicose veins, and other factors, such as smoking or medications, may make a person more susceptible to the formation of this type of clot. Medical professionals who are aware of these factors before the senior goes into surgery can take precautions to minimize the potential for this risk and can monitor the senior for this complication more closely during the weeks that follow.

Older adults who elect to have total knee replacement should also be vigilant about following their physician’s recommendations for rehabilitation and recovery. While it may seem contrary to recovery, movement is a strong deterrent to DVT. Doctors usually prescribe rehabilitation the first day after surgery. Seniors can help their own recovery by performing activities and exercises exactly as prescribed.

To reduce the risk of other complications, such as infections, older adults who have undergone total knee replacement should follow the recommended schedule of follow-up visits with their primary care physicians. Their physicians can monitor their recovery and identify any signs of complications that may need to be addressed.

During the recovery period, the senior individual may need help with daily activities. When family and friends are not available, the senior may benefit from in-home care. In-home caregivers can help the senior with bathing and grooming, can remind the senior to take his or her medications, and can take the senior to follow-up doctor’s and rehabilitation appointments to help the senior recover successfully. For more information on how in-home care can help during recovery after surgery, contact your local Comfort Keepers® office today.


  • American Academy of Orthopedic Surgeons.(January 2009). Deep vein thrombosis. Retrieved from
  • Brand, R.A., Mont, M.A., Manring, M.M. (June 2011). Biographical Sketch: Themistocles Gluck (1853–1942). Clin Orthop Relat Res., 469(6), 1525–1527. Retrieved from
  • Cram, P. (February 19, 2013). Total knee arthroplasty among Medicare beneficiaries. Physicians Weekly. Retrieved from
  • Jordan, C.J., Goldstein, R.Y., Michels, R.F., Hutzler, L., Slover, J.D. and Bosco, J.A. (Novemebr 2012). Comprehensive program reduces hospital readmission rates after total joint arthroplasty. Am J Orthop., 41(11), E147-151.

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