Specialized garments, often called anti-embolism stockings or TED hose, are a standard component of recovery following knee surgery. These stockings provide mechanical pressure to the lower legs, maintaining healthy blood flow and circulation in the veins. They apply a gradient of pressure, strongest at the ankle and gradually lessening up the leg, encouraging blood return toward the heart. The exact duration of use is individualized, depending on the procedure, health history, and risk factors for complications. Therefore, all guidelines regarding the duration of use must be followed precisely as directed by the operating surgeon and care team.
The Primary Goal: Preventing Blood Clots
Knee surgery significantly elevates the risk of forming blood clots, a condition known as venous thromboembolism (VTE). Surgery itself causes trauma and activates the body’s clotting mechanisms, while the subsequent reduced mobility slows blood flow in the veins of the lower limbs. This combination creates a high-risk environment for deep vein thrombosis (DVT), which occurs when a clot forms in a deep vein, commonly in the calf or thigh.
The danger of DVT is that a piece of the clot can break off and travel through the bloodstream, lodging in the lungs to cause a life-threatening pulmonary embolism (PE). Compression socks work by actively counteracting the pooling of blood, or venous stasis, that results from immobility.
The graduated pressure exerted by the socks physically squeezes the veins and surrounding tissues, narrowing the diameter of the vessels. This narrowing increases the velocity of blood flow back up to the heart, preventing the stagnation that allows clots to form. The continuous, gentle pressure essentially substitutes for the muscle action that is temporarily lost due to the surgery and limited movement. By promoting more consistent blood flow, these stockings help ensure the circulatory system functions more efficiently during the earliest phase of recovery.
Determining the Duration of Use
The duration for wearing compression stockings is phased, directly correlating with a patient’s recovery milestones and the diminishing risk of VTE. In the immediate post-operative period, while the patient is still hospitalized, the socks are typically worn continuously, both day and night. This continuous use maximizes protection during the time of lowest mobility and highest inflammatory response following the procedure.
Once the patient is discharged, the guidelines may shift, depending on the type of knee surgery performed. For major procedures like total knee replacement, the critical period for wearing the socks often lasts several weeks. Patients are commonly advised to wear the compression garments during all waking hours, especially if swelling continues to be present.
Recommendations frequently suggest wearing the socks for an initial period of two to four weeks post-surgery. However, patients with pre-existing risk factors, such as a history of previous clots or other vascular concerns, may be instructed to continue use for up to six weeks or even longer. As a patient achieves sustained, unassisted mobility, the surgeon may give clearance to reduce the wearing time.
The stopping point is always determined by a medical professional, who evaluates the patient’s individual risk profile and physical progress. For many, the socks are discontinued once the high-risk period for DVT—which generally lasts about six weeks after major joint surgery—has passed, and the patient is moving around normally.
Essential Guidelines for Wearing Compression Socks
Proper application and monitoring are required to ensure the compression socks are effective and safe. The socks must be correctly sized to provide the graduated pressure gradient, meaning they should be snug but never painful or constricting. A correctly fitted sock will be smooth against the skin, without any wrinkles or bunching, which could create areas of uneven, excessive pressure that impede circulation.
Patients should conduct daily skin checks to look for any signs of irritation, redness, or pressure sores, especially at the heel, ankle, and behind the knee. Any new numbness, tingling, or color changes in the toes or feet should be reported to a healthcare provider immediately. Socks should be removed once daily for bathing and for skin hygiene, allowing the skin to breathe and be inspected thoroughly.
Anti-embolism stockings, often white and provided in the hospital, are designed for non-mobile patients to prevent VTE. Graduated compression socks, which may be prescribed for home use, are designed for patients who are beginning to ambulate and are more active. Clean garments maintain their elasticity and therapeutic pressure more effectively.