TKR question

Putting a pillow directly under the knee can make the new knee "go bad"

Mainly, what Catjo posted. It's fine to put a pillow or preferably a rolled up towel under the operative leg's ankle though.

NJ: It's important to get that knee bending as soon as possible. It's a proven fact that the patient will recover faster to their pre-op level of functioning. I don't think approximation is a big deal if the skin is stapled together. (So far) I've never seen or heard of an incision splitting open due to ROM exercises in the immediate postoperative period. We usually start at 65 degrees flexion on the day of surgery and often get the patient up to 90 degrees flexion by day 2 or 3. If it is a young patient they can usually get to 90 even faster.

Jared: I'm usually cool with letting the patient take their CPM off if it is really bugging them (I work the night shift). It's really a matter of pain tolerance. Some patients say they really like the CPM. Some of them can't tolerate it at all, even if I practically snow them with narcotics. Like I said, if I have a patient complaining of pain I'll give them a break from it for a while (sometimes almost my entire shift). It is usually females in the 50+ age range that have problems with the CPM for some reason. I just document the situation and move on. Not really that big of a deal. Most of the surgeons are pretty understanding if a patient has a low pain tolerance (it's usually pretty apparent when they round). But the surgeons will get ****** if we don't at least make an effort to get a patient to use it.