Ways To Manage Pain After Hip Or Knee Replacement Surgery
1. Take Your Pain Medication Like Clockwork
A lot of people are afraid of prescription pain medication . Everyone has heard horror stories about addiction and the opioid epidemic. However, when used responsibly for a short period of time, pain medication can be of great assistance in your recovery. After all, pain medications are created toyou guessed ittreat physical pain!
When taking your prescribed narcotics, make sure that you know exactly what youre taking and when you should be taking them. Be sure that your physician knows of any other medications that youre on that could interfere with the prescribed narcotics. Do not take more than prescribed dose. In a similar vein, do not take a lower dose than your doctor has recommended before speaking with your care team.
Its important to take your pain medication like clockwork in the days and first week that follow surgery. If you lower your dose without your physician signing-off, you may notice spikes of pain at night, have trouble sleeping, and actually roadblock your own ability to complete the necessary steps in your recovery. If youre experiencing too much pain, you wont sleep well, you wont perform the required exercises, and you will take-away from your own recovery.
2. Ice and Elevate
3. Keep-Up with Exercises and Physical Therapy
4. Get Tissue Massages
5. Try Pain Management Alternatives
Alternatives To Total Knee Replacement Surgery
There are several different conservative or less invasive options that may be attempted prior to having a total knee replacement.
Injections are often used in an attempt to decrease inflammation, friction, and pain in the joint. Surgical options to consider aim to preserve or restructure remaining tissue and to prevent or put off a total knee replacement.
Physical Therapists provide non-invasive treatment options to improve strength, flexibility, and body mechanics for functional activities to reduce knee pain. PTs can also educate patients on an exercise program for improving body composition.
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What Causes A Stiff Knee After Tka And How Can It Be Prevented
Dr. Jesse Otero answers ICJRs questions about the most common causes of knee stiffness after total knee arthroplasty, what to do if a patient presents with stiffness, and when to consider a revision procedure.
ICJR: What is the definition of a stiff knee after total knee arthroplasty ?
Jesse E. Otero, MD, PhD: The goals of TKA are to relieve pain and restore function in patients with moderate to advanced osteoarthritis who have exhausted conservative treatments but still have knee pain that interferes with their activities of daily living. In most patients minds, the ideal result of TKA would be a knee that moves and feels the way it did in a more youthful time.
Before discussing stiffness after TKA, it is essential to first review normal native knee motion in relation to the activities patients routinely perform. Laubenthal et al presented a quantitative analysis of knee motion required to achieve normal activities of daily living. In this classic article, the authors used an electro-goniometer to show that on average:
- 83° of flexion is required for climbing stairs
- 93° of flexion is required for sitting
- 106° of flexion is required for tying a shoe
- 117° of flexion is required for squatting to lift an object
The widely accepted target after TKA, based on this study, is 120° of knee flexion. In objective terms, therefore, knees that fail to achieve 120° of flexion after surgery are commonly considered to be stiff.
ICJR: What are the most common causes of knee stiffness?
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What Causes An Acute Patellar Injury In The Knee
Acute patellar injuries can occur as a result of trauma, sports activities, or anatomical problems within the knee joint. The location of the patella at the front of the knee makes it vulnerable to fracture, dislocation, or tendon tears during falls, blows to the knee, or sharp impacts such as with the dashboard in a car accident.
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Q: I Had Knee Replacement Surgery Four Months Ago Why Do I Still Have Pain
A: Recovery from surgery can take several months, so its not unusual to still have soreness in the knee that was replaced. As the intensity of rehabilitation exercises increases, more strain is put on the muscles and joints that have not been used in a period of time. Stick with the routine of exercises that were prescribed by a physical therapist. Though bending and stretching the knee may hurt at first, re-training the body to move normally will help with recovery in the long run.
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In addition, postoperative swelling is often a major source of pain for patients. Pain in the knee following the operation can last from six months to as long as one year, but dont get discouraged. Once fully healed, knee replacement surgery will help provide pain relief and improved function long-term.
This article is adapted from Cleveland Clinic Arthritis Advisor.
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Dos And Donts After Knee Surgery
After knee surgery, youll likely encounter challenges and pain on your path to recovery. While it may seem difficult, remember that what happens after your surgery is just as important as the surgery itself.
Here are some dos and donts to help you recover:
If you experience problems during recovery, call your doctor immediately for proper healing and to prevent further health issues.
How Long Does Pain And Stiffness Last After Knee Replacement
Early treatment of the stiff TKA includes physical therapy and manipulation under anesthesia . MUA performed within 3 months may have the greatest increase in ROM but notable improvement can occur up to 6 months after TKA. After six months, arthroscopic or open surgery is recommended for persistent stiffness.
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What Should I Expect
Its important to note that everyone has different pain level tolerances, and no two cases are the same because our knees are complex joints. Knees are the second-largest joints in the body, after the hip joints. As such, a knee replacement is a complicated surgery that involves balancing ligaments, cutting into the bones of the knee joint, and replacing parts of the knee joint with artificial parts. The manipulation of the knee joint to place the parts leads to the pain after the procedure. Postoperative pain after knee replacement surgery is related to the healing, stretching, bending, and rotating that the knee must do after surgery.
When Should I Call My Doctor If I Am Not Able To Sleep After Knee Replacement Surgery
Approximately half of all people experience insomnia after surgery. If you are having difficulty sleeping after your surgery, here is what you should do so that it does not interfere with your healing process.
- First, it is important to be proactive and start sleeping on the side of the injured knee so that it does not swell excessively during sleep.
- Second, try to refrain from taking any medications that might interfere with sleep.
- Third, you should take naps during the day if necessary to make up for lost sleep at night.
- Lastly, if you are having trouble sleeping at night, there are behavioral interventions like cognitive behavioral therapy or relaxation exercises that can help improve your sleep quality.
Note: Make sure to have a conversation with the doctor, too, considering the sleeping posture you need to adapt. It also depends on the surgery site too, and doctors will suggest you accordingly.
Following are the things a person can keep in mind after knee replacement surgery. If you are someone planning to go for surgery, make sure to approach the best orthopedic doctor in the town. For Rajasthan residents, Jaipur is the best city to approach for it.
Here you can approach Dr. Arun Partani at Partani Clinic in Jaipur. He is among the best knee replacement surgeons in the town and is a part of over 1000+ surgeries in his career till yet.
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Severity Of Pain Vs Patient Age Vs Life Span Of Knee Replacement
If you are like me, I was concerned that if I had the surgery too soon that I might wear out the new joint and need another replacement later on. I had been told that the life of a knee replacement would be 15-20 years.
I preferred to wait and tolerate the pain so that the knee joint would outlive me. I did not want to have the surgery in my late 40s or early 50s hoping that new medical improvements might eliminate the need for surgery or that a better, longer lasting knee replacement might be developed.
These are all thoughts that went through my mind while I was considering TKR.
If the pain was sudden and had come on without notice I may have thought different. But, when the pain slowly increases over a period of 40 years you learn to live with it.
What Should You Expect After Knee Revision Surgery
Most patients who undergo revision procedures can expect to have good to excellent results. Although expected outcomes include pain relief with increased stability and function, complete pain relief and restoration of function is not always possible.
Up to 20% of patients may still experience some pain following revision knee surgery. This can persist for several years after the procedure. Additionally recovery after revision total knee surgery is heavily dependent on the state and function of the knee prior to the revision surgery.
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Research: Doctors Are Looking For The Causes Of Pain After Knee Replacement And It Is Hard To Find
The confusion as to what may be the cause of chronic knee pain after knee replacement is a cause of great concern not only among doctors but obviously among patients. We often find patients to be confused between what is normal and what is not normal after knee replacement.
- Is some pain normal?
- Are the clunking sounds normal?
- Is the instability normal?
How To Sleep After Knee Replacement Surgery
Knee replacement surgery is major surgery, and a person needs to be sure about a lot of things after it. Along with aftercare and medication, the sleeping position creates a big difference. An individual needs to be sure about how to sleep after the knee replacement surgery so that the artificial joint will not have any effect. Here we are discussing the tips to sleep after the knee replacement surgery so that there will be no problem lately!
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Knee Replacement Recovery Timeline
Knee replacement recovery begins before your surgery. You will have a rehab programme to work on which you can actually start before your operation to get your muscles in the best shape possible which will really help. The people who make the best total knee replacement recovery are the ones who start the rehab process before their operation.
Here, we will look at total knee replacement recovery time, what is involved and how long it usually takes to get back to things. If are having or have had only one side of your knee replaced, visit the partial knee replacement recovery time section instead to found out how it will be for you.
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Prepare Your Home Before Surgery
Its a good idea to prepare your home for your recovery before you go to the hospital for your surgery. That way, when you return with a walker or cane, you can easily move around your living space. Also, youll want to be sure to have a comfortable chair and ottoman where you can rest and elevate your knee, so you dont have to stay in bed.
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What To Expect After Discharge
Within 10 days following your discharge, you should be able to:
- Bend your knee 90 degrees and extend your leg fully
- Stand independently or with little help
- Rely less on assistive devices
- Bathe, dress and use the toilet on your own
- Climb up or down a flight of stairs
At the two to three-week mark, your knee may be strong enough to carry more weight. Most people are either using a cane or nothing at all by this point.
Three months after surgery, the majority of patients are 90% recovered. After six months, most patients feel 100% recovered.
My Predicament: How Long I Waited Before Getting Knee Replacement
I waited over 15 years after my first orthopedic surgeon told me I was a candidate for TKR. He told me that it was up to me and that when the pain became too much for me to handle that I should come back and make an appointment for TKR.
I had had two previous meniscus surgeries in my 20s. There had always been some pain after those surgeries.
The pain increased slowly over a period of 40 years and I just lived with the pain. By my early 60s the pain was severe, I had developed a limp and my leg had begun to bow.
I was still fearful of the procedure and wanted to put it off as long as possible. After many non-invasive procedures and after two visits to two different orthopedic surgeons who both wondered how I was even walking, I made my decision to go forward with the surgery.
After doing the surgery the doctor told me that the wear was extensive and he was surprised I was able to wait as long as I had.
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Is It Possible To Wait Too Long Before Getting Total Knee Replacement
There are definitely some disadvantages of waiting too long to have TKR. First, you dont need to be enduring the pain that you are suffering now.
My bone on bone pain is completely gone. As your bone wears you develop a limp that affects other parts of your body.
You may be making other parts of your body overcompensate for your bad knee. You may be putting undue stress on your hip and discover that it is causing you pain.
My hip was painful before surgery after long walks. Since my surgery, there has been no ache or pain in my hip.
The longer you wait and age, your body might not be able to heal and bounce back like it did when you were younger. The better shape that you are in prior to surgery the better the recovery.
How Long Does Knee Pain Last After Knee Replacement Surgery
One of the most common questions we hear is, How long does pain last after knee replacement?
Traditional total knee replacement will typically require one to three months of recovery with the use of a walker or a cane while partial knee replacement surgery requires significantly less time. But there is more to consider when trying to figure out how long pain will last after surgery.
How long the pain lasts after knee replacement surgery depends on a wide range of factors, before and after the surgery.
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Preparation For Total Knee Replacement Surgery
Patients undergoing total knee replacement surgery usually will undergo a pre-operative surgical risk assessment. When necessary, further evaluation will be performed by an internal medicine physician who specializes in pre-operative evaluation and risk-factor modification. Some patients will also be evaluated by an anesthesiologist in advance of the surgery.
Routine blood tests are performed on all pre-operative patients. Chest X-rays and electrocardiograms are obtained in patients who meet certain age and health criteria as well.
Surgeons will often spend time with the patient in advance of the surgery, making certain that all the patients questions and concerns, as well as those of the family, are answered.
The surgeons office should provide a reasonable estimate of:
- the surgeons fee
- the degree to which these should be covered by the patients insurance.
Total Knee Replacement Surgical Team
The total knee requires an experienced orthopedic surgeon and the resources of a large medical center. Some patients have complex medical needs and around surgery often require immediate access to multiple medical and surgical specialties and in-house medical, physical therapy, and social support services.
Finding an experienced surgeon to perform your total knee replacement
Some questions to consider asking your knee surgeon:
- Are you board certified in orthopedic surgery?
- Have you done a fellowship in joint replacement surgery?
- How many knee replacements do you do each year?
The Knee Cap Was Floating Because The Mcl Was Released Patellar Maltracking After Total Knee Replacement The Concern Of Catastrophic Laxity
Lets look at two studies surrounding the medial collateral ligament.
The first is from 2015, the second is from 2021
In June 2015 in the journal Knee Surgery, Sports Traumatology, Arthroscopy researchers wrote: Medial collateral ligament release is one of the essential steps toward the achievement of ligament balancing during the total knee arthroplasty in patients with varus deformity . When the varus deformity is severe, complete release of the MCL until balanced is often required. However, it is believed that a complete MCL release may lead to catastrophic laxity.
In March 2021, a study published in the journal Knee Surgery and Related Research continued that Medial collateral ligament release during knee replacement could lead to the surviving knee cap floating around the knee. Here are the studys observations: Patellar maltracking after total knee arthroplasty can lead to significant patellofemoral complications such as anterior knee pain, increased component wear, and a higher risk of component loosening, patellar fracture, and instability. . . Complete release of the MCL during surgery was associated with patellar maltracking. Surgeons should attend to patellar tracking during surgery in medially tight knees.
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