Introduction Rehabilitation requires coordinated effort from orthopaedic surgeon physical therapist occupational therapist case manager nursing staff patient and patient's family Care can be broken down into different phases including Inpatient management post-operative anemia Inpatient Management Pain management preoperative NSAIDS and opioids given immediately before procedure reduce postoperative pain intraoperative regional anesthesia (spinal and/or epidural) preferred over general anesthesia peripheral nerve blocks useful adjuvant to decrease postoperative pain periarticular multimodal drug injection decrease postoperative pain with minimal risks postoperative multimodal oral drug therapy gold standard and includes NSAIDs: Inhibit COX-1 and COX-2 ? inhibition of inflammatory mediators ( PGs, TXA, AA) opioids Mu agonist leading to neuron hyperpolarization and reduced excitability NSAIDs inhibit COX-1 and COX-2 inhibition of inflammatory mediators (PGs, TXA, AA) selective COX-2 inhibitors inhibits transformation of AA to PG precursors minimizes GI effects may inhibit bone healing gabapentin/pregabalin reduce hyper-excitability of voltage dependent Ca2+ channels in activated neurons. pregabalin= better oral bioavailability. SNRIs inhibition of serotonin and noradrenergic reuptake in the CNS Physical therapy therapy should start on the day of surgery reduces length of hospital stay reduced pain and improves function Range of motion requirements swing phase of gait 65° of flexion activities of daily living 90° of flexion stairs 95° of flexion rise from a chair 105° of flexion Continuous passive motion (CPM) machine improve early knee flexion has not been shown to have a long-term benefit Drain Placement has not demonstrated any difference in complications or outcomes Discharge home criteria medically stable 80-90° AROM knee flexion ambulate 75-100 feet ascend or descend stairs Post-Operative Anemia Intra-operative less intraoperative blood loss with the use of tourniquet Earlier discharge to rehab from hospital associated with improved outcomes Discharge criteria to home similar to those in hospital