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If you believe that you are a candidate for total knee replacement, we invite you to reach out to us online to schedule an appointment at OrthoBethesda.
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- 4420 North Fairfax Drive, Suite 100 Arlington, VA
- Ph 419-3002
- 10215 Fernwood Road, Bethesda, MD 20817
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Pain After Knee Replacement: Six Months
If you are still experiencing pain six months after surgery, you may be wondering how long it will be until you feel normal again. Unfortunately, there is no easy answer.
In some cases, it may take up to a year for all of your swelling to completely go away. Your knee will continue to recover for years to come, as scar tissue forms and your muscles become stronger with continued physical therapy and light exercise.
As previously mentioned, if you are still experiencing debilitating levels of pain at this stage, you could be suffering from chronic pain. While you may be tempted to tough it out, its important to talk with your doctor. Together, you can find what is causing your persistent pain and come up with a plan to fix it.
Knee Replacement Recovery Continues Once Youre Home
Even though hospital stays for knee replacement surgery are shorter than they used to be, getting back on your feet still takes time, says Dr. Parks.
The next phase of recovery continues at home, as patients begin acclimating to normal activities, such as moving between rooms, getting up and sitting down in furniture, and using the bathroom. While everyone is different, many patients are likely to have similar experiences during the early weeks of recovery.
For Barnes, stability was a big issue. I became very aware of where I was placing feet, for example, when stepping off a curb. I just felt a little clumsy early on after surgery so I was afraid of falling.
In addition, she experienced a lot of swelling. The hospital gave me a special brace that circulates cold water around the knee, which was great and helped with swelling, she says.
Whether your doctor has prescribed formal outpatient physical therapy or has entrusted you with an at-home regimen of walking and exercises, patients progressing through recovery achieve some big milestones along the way.
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How Long Do You Have Pain After Total Knee Replacement Surgery
Youve just had a total knee replacement. While you know that this will definitely add years to your mobility, the pain from the surgery is the only thing you can focus on overcoming right now. While you may have been experiencing chronic pain before knee surgery, it may come as some relief that post-surgery pain should go away in a short time with proper recovery.
Immediately after surgery, you can expect to be in the care of hospital staff for anywhere from 2-5 days. They will keep you on regular pain medication and be able to keep you up to speed in your recovery process. Its when you head home that it is now up to you to make sure you are doing your stretches, monitoring and dosing your pain and subsequent pain medication accordingly, and following your doctors orders.
While the rest-ice-elevate rule applies to most injuries and surgeries, it is particularly important after a total knee replacement because your pain can be so significant, you will want to do everything you can to stay on track in your healing process.
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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Anatomy Of The Knee And Associated Ailments
The knee is comprised of three bones, the Tibia , the Femur , and the Patella . These bones align in such a way that allows them to bend. The muscles, tendons, and ligaments surrounding the knee serve as stabilizing agents. There is fleshy cartilage between the bones which acts as a cushion, preventing the bones from rubbing against one another called bursa.
When someone experiences pain in the knee, there are several potential causes. The three most common are:
- Osteoarthritis: soft tissues in the body degrade naturally over time. When the cushions between bones begin to deteriorate and the bones begin to rub against each other, this is called arthritis. This condition can cause a great deal of pain and occurs predominantly in people over the age of 50, but can occur to anyone at any time.
- Injury: an injury can occur for many reasons, including a sports injury, falling, or a traumatic injury such as a car accident. When these occur, the bones not only experience trauma but may realign in such a way that causes pain. These can include torn cartilage, a torn ACL, or broken bones.
- Overuse: repetitive motion in the knee can lead to more rapid degeneration of the soft tissue.
Certain individuals may be more prone to knee pain than others due to their lifestyle. These people include:
What And Why Of Swelling
Swelling is a physiological response within the body due to mechanical stress put on the body.
Thus, whenever you twist your ankle or have some acute injury, your affected body part swells. Along with there is pain, increased redness, temperature as well as pain.
So, when a Maryhad knee replacement surgery, their operated knee joint complex goes through a lot of mechanical stress, and thus, it swells.
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Nerve Damage From Surgery
Nerve damage can happen during surgery, but it usually goes away within six months.
Surgeons must cut and stretch skin and muscle during surgery. The American Academy of Orthopaedic Surgeons says pressure, stretching or cutting can damage nerves in the leg or around the joint.
Knee surgery may involve special tourniquets to restrict blood flow in the leg. According to a 2013 study in the journal Acta Orthopaedica, these devices may put damaging pressure on nerves.
Symptoms of nerve damage include radiating pain, tingling sensation in the leg, and numbness in the leg or foot.
How Long Will I Be In The Hospital After Total Knee Replacement
The length of hospital stay after knee replacement will depend on:
- Replacement and incision healing routinely.
- Manageable pain levels.
- The patient being able to perform bed mobility and walking without requiring someone else doing the majority of the work for them
- Help at home from family or friends for activities that will require assistance such as driving, cooking, cleaning, moving in and out of bed, sitting down and standing up, walking, or using stairs
These are important for ensuring a patient is safe to go home. The majority of patients meet these requirements and will be out of the hospital within 1-3 days.
If a patient has delayed healing or limited support at home, they may be a candidate to be transferred to a skilled nursing facility or rehabilitation hospital for 1-2 weeks for further recovery.
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Conventional Treatment Methods Of Knee Pain
Knee pain is treated in a variety of ways. Once the cause is diagnosed using proper techniques, a treatment plan is set in motion. Doctors use information such as a patientâs medical history, overall health, activity level, and comfort level to create a treatment plan that is unique to each patient. In the beginning, these plans typically enact the RICE method. This stands for Rest, Ice, Compression, and Elevation. Sometimes patients also take over the counter NSAIDS such as ibuprofen. Pain is often caused by a form of inflammation, so these methods can help subside the pain.
If these less invasive methods fail to relieve pain, doctors will turn to slightly more intense treatment methods such as physical therapy or corticosteroid injections. Physical therapy seeks to strengthen muscles surrounding an injury and increase a patientâs range of motion. Corticosteroid injections are used to inject a powerful anti-inflammatory agent directly into the pain area. This is most often successful at relieving pain in the short-term but has been proven to damage tissue over time. Corticosteroid injections are not considered a long-term solution to knee pain.
After undergoing slightly more invasive treatment methods and still failing to see results, doctors may discuss surgery as an option. Initial surgeries for knee pain are less invasive than a total knee replacement. These surgeries may include:
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Stiffness After Knee Replacement Surgery
In the days leading up to and following knee replacement surgery, patients face many questions. How long does it take for a knee replacement to feel normal? How long will pain and stiffness last? Will I experience any complications? Our team at OrthoBethesda has answers to your most common questions so you can prepare for surgery with peace of mind.
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How Long Do You Ice After Knee Replacement
According to the American Academy of Orthopaedic Surgeons, swelling after knee surgery can last for three to six months after surgery. To help reduce inflammation and pain, it’s generally recommended you use an ice pack three to four times a day for about 10-20 minutes during the first few days after surgery.
What Are The Risks And Complications Of Revision Knee Replacement
Any surgery can have potential complications. The complexity of revision joint surgery increases the chance of surgical complications, which include but are not limited to:
- wound drainage
- damage to nerves or blood vessels
- intra-operative fractures
- pulmonary embolism
Infection, bleeding, damage to nerves or blood vessels, and intra-operative fractures can be minimized by using antibiotics before and after surgery, employing sterile surgical techniques and utilizing well-planned surgical exposures. Patients who are obese are particularly at increased risk of infection and wound drainage issues post operatively.
Similar to primary knee replacement, some mild swelling of the knee or ankle may be present after surgery for as long as three to six months. Swelling can be treated by elevating the leg, applying an ice pack, and wearing compression stockings.
Prior medical conditions, such as heart and lung complications or stroke conditions, can be aggravated by a revision procedure. These conditions may also develop in patients after revision surgery. Very rarely, death can occur. The decision to perform revision joint surgery is made when the benefits of pain relief and functional improvement outweigh the risk of potential complications.
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Your Recovery Timeline: What To Expect After Knee Replacement Surgery
After knee replacement surgery, most patients wonder how long it will take before theyre back to feeling normal. For example, how long does it take to get a full range of motion? You may also be wondering how long you can expect any lingering stiffness to last. While every case is unique, there are typical timeframes you can use as a guideline.
Your range of motion capabilities often progress rapidly during the first three months following surgery, provided you are working with a physical therapist and following your doctors recommendations. Your range of motion may continue to improve for up to two years after your surgery.
You can expect to use a variety of stretches and exercises in order to achieve optimal motion with your replaced knee. The normal range of motion after a knee replacement is defined as being able to bend your knee back to 90 degrees.
What Are The Signs Of Knee Replacement Failure
The most common symptoms of a failed knee implant are pain, decrease in joint function, knee instability, and swelling or stiffness in the knee joint.
Persistent pain and swelling can indicate loosening, wear or infection, and the location of the pain can be all over the knee or in one particular area . A decline in knee function may result in a limp, stiffness or instability. Patients who demonstrate these symptoms and signs may require revision joint surgery.
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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.
Why Do I Have A Problem With My Patella
Her left kneecap was getting way off track, but not quite dislocating. This is called subluxation. In fact, both her patellae have this problem. The left subluxes most often, but the right actually dislocates. Shes had several falls right onto her knees. Both knees hurt, and shes having trouble getting up and down stairs.
In most cases, the kneecap shifts to the outside of the leg, but it can also move towards the inside. Heres what you need to know about patellar tracking disorder and keeping your knees healthy.
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How Can I Learn More About Recovering From A Knee Replacement
The best way to learn what to expect while recovering from knee replacement surgery is to talk to an expert orthopedist.
Our team of orthopedic doctors and orthopedic surgeons at TRIA are some of the best in the Midwest. Weve performed thousands of joint replacements, and 97 percent of our patients report being able to walk down stairs without difficulty a year after surgery.
When youre ready for surgery, our team of expert orthopedic surgeons, physical therapists and other care providers will be by your side every step of the way from your first appointment through your recovery.
About Amy Haynes, PT, DPT
Amy Haynes, PT, DPT specializes in orthopedic physical therapy with an emphasis on total joint replacement and osteoarthritis. She enjoys helping patients remain independent within their home environments for as long as possible and continue their recreational past-times.
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Looking After Your New Knee
- continue to take any prescribed painkillers or anti-inflammatories to help manage any pain and swelling
- use your walking aids but aim to gradually decrease the amount you rely on them as your leg feels stronger
- keep up your exercises to help prevent stiffness, but do not force your knee
- do not sit with your legs crossed for the first 6 weeks after your operation
- do not put a pillow underneath your knee when sleeping as this can result in a permanently bent knee
- avoid twisting at your knee
- wear supportive shoes outdoors
- do not kneel on your operated knee until your surgeon says you can
- raise your leg when sitting and apply an ice pack wrapped in a tea towel for 20 minutes every 3 or 4 hours to reduce any swelling
Page last reviewed: 02 August 2019 Next review due: 02 August 2022
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Knee Replacement Recovery Time: First 3 Months
For 6-8 weeks after knee replacement surgery you should avoid:
- Any pivoting on your knee
- Kneeling
- Squatting
You will need to continue with your knee replacement rehab programme for at least 3 months after knee replacement surgery, probably six months to get the best result from your operation.
You will be able to progress your exercises as your knee gets stronger and more flexible. Visit the rehab section to find out more. The more you stick to your exercise programme, the quicker your knee replacement recovery is likely be.
Types Of Arthritis That Affect The Knee
Inflammatory arthritis
This broad category includes a wide variety of diagnoses including rheumatoid arthritis, lupus, gout and many others. It is important that patients with these conditions be followed by a qualified rheumatologist as there are a number of exciting new treatments that may decrease the symptoms and perhaps even slow the progression of knee joint damage.
Patients with inflammatory arthritis of the knee usually have joint damage in all three compartments and therefore are not good candidates for partial knee replacement. However, inflammatory arthritis patients who decide to have total knee replacement have an extremely high likelihood of success. These patients often experience total, or near-total, pain relief following a well-performed joint replacement.
Osteoarthritis
Osteoarthritis is also called OA or degenerative joint disease. OA patients represent the large majority of arthritis sufferers. OA may affect multiple joints or it may be localized to the involved knee. Activity limitations due to pain are the hallmarks of this disease.
OA patients who have symptoms limited to one compartment of the knee sometimes are good candidates for minimally-invasive partial knee replacement .
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Possible Benefits Of Total Knee Replacement Surgery
Regardless of whether a traditional total knee replacement or a minimally-invasive partial knee replacement is performed the goals and possible benefits are the same: relief of pain and restoration of function.
The large majority of total knee replacement patients experience substantial or complete relief of pain once they have recovered from the procedure. The large majority walk without a limp and most dont require a cane, even if they used one before the surgery. It is quite likely that you know someone with a knee replacement who walks so well that you dont know he even had surgery!
Frequently the stiffness from arthritis is also relieved by the surgery. Very often the distance one can walk will improve as well because of diminished pain and stiffness. The enjoyment of reasonable recreational activities such as golf, dancing, traveling, and swimming almost always improves following total knee replacement.