Avoid Mistakes To Recover Faster
How long does it take to recover from total knee replacement? Will it be relatively easy or frustratingly hard, speedy or last over a year? This is the million dollar question. You can make a big difference in your recovery speed by avoiding the 5 biggest mistakes that most people make. Not doing any of your exercises would be the stupidest mistake but I am going to assume you are MUCH smarter than that after all you are here searching out and seeking the best answers to all your questions.
Here it is for all the wise ones. Listen up and take notes so that you too can avoid the 5 biggest mistakes that will shipwreck your recovery from a total knee replacement.
How Do Doctors Perform Knee Replacement
Total knee replacement is a surgical procedure performed under regional or general anesthesia.
The procedure is as follows:
- An incision is made in the front of the knee
- The lower part of the upper leg bone and the upper part of the lower leg bone are cut and removed
- The ends of the bone are modified so the knee replacement prosthesis can be attached in the optimal position
- The proper functioning of motion in the knee replacement is assessed and then the prosthesis is cemented into place
- The incision is repaired and the knee is bandaged and braced
- Total knee replacement surgery takes about two to three hours
- The patient is usually in recovery with observation for 24 hours
- Patients are given pain medications and cryotherapy to reduce postoperative swelling and pain
- Patients are encouraged to walk on the second day following the surgery and are usually supervised by a physiotherapist until discharge
What Is Knee Replacement
Total knee replacement surgery replaces parts of the knee joint with artificial parts.
What is Knee Replacement Used For?
Total knee replacement is usually used:
- To relieve pain caused by severe arthritis
- To restore function to an arthritic knee
- To correct significant deformity
- For severe patellofemoral arthritis
Total knee replacement may be considered when other treatments have failed to relieve the pain, which must be significant and disabling.
About 82% of total knee replacements last 25 years and can be affected by a patients activity levels. The procedure is usually reserved for older patients who perform modest activities or younger patients with limited function due to severe arthritis.
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Helping Patients To Make Informed Decisions
We’re funding research to improve patient experience before, during and after knee replacement surgery. This includes a project based at the University of Sheffield which aims to help patients make informed decisions about their surgery. The research team will use the UK National Joint Registry dataset to develop and validate a personalised, web-based decision aid to help patients considering knee joint replacement to make informed choices about their treatment.
When Can A Patient Return To Work
This is a common question after knee replacement surgery and entirely depends on the nature of work the patient performs as part of their occupation. For those patients who work in jobs that are relatively sedentary such as office work, returning to work after 2 to 3 weeks is perfectly reasonable however, for patients whose work demands more of them physically, e.g., fireman, police officer, these patients are usually recommended to wait at least 6 weeks before returning to work.
This is because muscle recovery is usually sufficient by 6 weeks to allow for the normal duties of these more physically demanding occupations at this point in time. However, it is also a case that even for the more physically demanding occupations, if a modification of these duties is available to the patients for the postoperative recovery period then this would potentially allow for an early return to work.
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What Does The Surgery Entail
Your orthopedic surgeon will make a front-of-the-knee incision running directly over the knee cap. Once the knee cap has been moved aside, your surgeon will be able to place the implants covering all surfaces of the knee. The anterior cruciate ligament , meniscus pads, bone spurs and sometimes the posterior cruciate ligament are all removed, while the medial collateral ligament and lateral collateral ligament are maintained.
- The damaged portions of the femur, tibia, and cartilage are cut away. The bones may be slightly reshaped to create a perfect fit for the implant.
- Implant components will be attached to the femur and tibia using bone cement. A polyethylene insert is attached to the metal component to act as cartilage between the two bones.
- The femur and tibia are placed back together to form a new joint. To make sure the kneecap moves smoothly over the surface of the joint, another polyethylene component is cemented to the back of the kneecap.
pOST-surgery questions
What Is Knee Replacement Surgery
Its a procedure in which a surgeon removes the cartilage in your knee thats been damaged by arthritis, as well as the nearby bone. The joint is replaced with an artificial joint thats made of smooth metal and plastic parts.
According to the American Association of Orthopedic Surgeons , the procedure has been performed for more than 50 years, and more than 790,000 people in the United States have a knee replaced every year.
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Learn What To Expect And How To Prepare From The Doctors Who Perform This Operation Every Day And The Patients Who Have Been Through Knee Surgery Successfully
If your knee arthritis has gotten so bad that your medication and physical therapy are no longer enough to keep the pain at bay or prevent mobility issues, it is a good time to consider knee replacement surgery. The procedure has come a long way from the extended hospital stays, bed rest, and narcotics-based pain relief of the past.
Fifteen to 20 years ago we told patients to wait until they could no longer take the pain of osteoarthritis to consider surgery, but thats not the case anymore, says P. Maxwell Courtney, MD, assistant professor of orthopaedic surgery at the Rothman Orthopaedic Institute at Thomas Jefferson University Hospital in Philadelphia. With todays advances, minimally invasive techniques, and accelerated rehab and recovery protocols, we now tell patients if the pain is limiting your daily activities and youve exhausted conservative options like injections and physical therapy its time to consider surgery.
That was certainly the case for Sharon Barnes, a teacher from Maine whose pain got so bad she couldnt sleep. My doctor said I had osteoarthritis in both knees it was literally bone on bone, she remembers. We did hyaluronic acid injections, and that got me about a year then didnt work as well. Thats when we started discussing surgery.
Robotic Assisted Total Knee Replacement
I need to have my second knee done and since I have had some problems with my first one, Iâm considering the Mako robotic assisted surgery and was wondering if anyone has had this done and your experience and advantages, if any.
I have not had that surgery, but I do know a woman who did have it and she had a great recovery and was extremely happy with it. Of course, much depends on the doctor doing it also.JK
I asked my surgeon about robotics and said the surgeries tend to go quite well, but he is holding off until more long term data is available.
My uncle had the robotic surgery done Feb 2019 and had a great recovery. I was reading that there can be less pain during recovery because the robot is able to more precisely adjust bone alignment and can use its computer brain to calculate individual measurements of the tendons, ligaments and muscle. I assume this means there is less manual manipulation of these soft tissues / stretching.
It is hard to know what to do.
I have not had that surgery, but I do know a woman who did have it and she had a great recovery and was extremely happy with it. Of course, much depends on the doctor doing it also.JK
I asked my surgeon about robotics and said the surgeries tend to go quite well, but he is holding off until more long term data is available.
It is hard to know what to do.
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When Surgery Is Recommended
There are several reasons why your doctor may recommend knee replacement surgery. People who benefit from total knee replacement often have:
- Severe knee pain or stiffness that limits everyday activities, including walking, climbing stairs, and getting in and out of chairs. It may be hard to walk more than a few blocks without significant pain and it may be necessary to use a cane or walker
- Moderate or severe knee pain while resting, either day or night
- Chronic knee inflammation and swelling that does not improve with rest or medications
- Knee deformity a bowing in or out of the knee
- Failure to substantially improve with other treatments such as anti-inflammatory medications, cortisone injections, lubricating injections, physical therapy, or other surgeries
Total knee replacement may be recommended for patients with bowed knee deformity, like that shown in this clinical photo.
Why Would I Need A Knee Replacement
Knees that are damaged by arthritis or injury often fail to function properly. The purpose of the knee, which is the bodys largest joint, is ambulation. Without a properly functioning knee joint, you will have trouble doing the simplest of tasks, such as walking from your bed to the restroom or sitting down and getting up from your couch. When your knees continue to worsen you may even have trouble sleeping because of pain in your knees.
Unless the knee has been injured in an accident of some sort, this is a gradual process where the joint gradually wears out over time. Your doctor may try a variety of treatments, from lifestyle changes, such as giving up running, to medications to help with the pain. For a time, you may try walking with supportive devices such as a cane or wearing leg braces. Eventually, though, when your efforts to manage the pain no longer work, its time to consider knee replacement.
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How Common Is Knee Replacement Surgery
The surgery is very common. Surgeons started doing it in the 1960s, with regular updates to techniques and implants along the way.
Almost 800,000 knee replacements currently get performed each year in the United States. The surgery is often done in older adults whose knees have worn down over time. But its also become popular in middle age, as people want to stay active.
How Long Does It Take To Recover From A Knee Replacement
There are many factors that determine how long it takes to recover from a total knee replacement.
Patients are typically discharged from the hospital within five to 14 days after knee replacement surgery.
Short-term recovery, in which a patient can walk with minimal aid or no aid and only needs over-the-counter pain relief generally occurs within twelve weeks after surgery, and most patients can return to full normal activities within 3 to 6 months.
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Why Is My Knee So Tight After Surgery
Arthrofibrosis is also known as stiff knee syndrome. The condition sometimes occurs in a knee joint that has recently been injured. It can also occur after surgery on the knee, such as a knee replacement. Over time, scar tissue builds up inside the knee, causing the knee joint to shrink and tighten.
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Total Knee Replacement Recovery: What To Expect After Knee Replacement
Nearly 1 million total knee replacement procedures are performed in the U.S. each year and that number is expected to continue rising exponentially to over 3 million in the next 15 years!
So it comes as no surprise that the most common joint replacement procedure Physical Therapists rehab in the outpatient clinic is a total knee arthroplasty or total knee replacement.
Many candidates want to know what to expect after a total knee replacement before they choose to have the surgery. Patients usually elect to have this procedure after nonoperative treatment options or knee replacement alternative surgeries fail to maintain knee function and pain levels.
For those patients that do decide to have total knee surgery, keep reading to learn more about the total knee replacement recovery process.
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Common Symptoms After Surgery
Your incision will be swollen, bruised and may be red after surgery. These symptoms are common and part of the healing process. The following symptoms are also common after surgery:
- temperature below 101.6 F
- warmth or numbness around your incision
- spotty drainage, red or clear in color, lasting for one to five days
It is important to monitor your symptoms every day to make sure your incision is healing properly.
What To Expect After A Total Knee Replacement
If you struggle with chronic knee pain and knee mobility, your doctor may recommend total knee replacement surgery once conservative treatment options are exhausted. Knowing what to expect after a total knee replacement can help you regain knee strength and mobility so that you can resume independent living more quickly.
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Focus On Your Surgeon Not On The Device Or Technique
Newer technologies like computer navigation can help surgeons be more precise in how they position the implant components during knee replacement surgery. But theres a lot of information to sift through.
Between advertising, the internet and conversations with other people whove had knee replacements, you may have questions about your prosthesis and your surgeons technique.
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 patient’s questions and concerns, as well as those of the family, are answered.
Costs
The surgeon’s office should provide a reasonable estimate of:
- the surgeon’s fee
- the degree to which these should be covered by the patient’s 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?
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Start Using The Knee Early
Recovery and rehabilitation must start shortly after you awake from surgery. On the first day, you need to start standing up and walking with an assistive device, like a walker or crutches, with the aid of a physical therapist. Use your artificial knee as soon as you can. Your therapist will guide you through exercises that will increase the strength of your muscles, as well as help you get in and out of bed.
Life After Knee Surgery
As a Physical Therapist, Ive seen firsthand the significant improvements in people following a knee replacement. However, there is no surgeon or PT out there who can 100% guarantee success. There certainly are risks following a surgery and this should be discussed with your doctor. But just as important, you should discuss the expected outcomes with your physician.
Returning to activities such as walking, golf, bowling, swimming, light dancing, and even light tennis is usually encouraged. However, ask your doctor about suggested timeframes for these activities.
Knee replacements have come a long way in the past 20 years and the technology continues to improve. Set your expectations appropriately with your physician and therapist. Heres to hoping your life after knee surgery is full of enjoyment and activity!
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What To Expect After Knee Replacement Surgery
Typically a patients knee will be swollen, stiff, weak, and sore following surgery. This makes functional activities such as walking and standing up difficult to perform.
The timeline for regaining strength and range of motion after knee replacement is variable. These two elements are key to successfully completing the total knee replacement recovery process.
Range Of Motion Basics After Knee Replacement Surgery
First, we need to start off by saying that everyone is different. Some people are naturally born with more flexion and extension in their knee joints, some people have complications or severe osteoarthritis degradation to overcome, some people may experience knee stiffness, and so forth. In fact, one of the best indicators of your knee range of motion after surgery is your ROM before surgery.
A completely straight, unflexed knee joint will measure 0° of flexion. A fully bent knee will max out at about a full range of motion of 135° degrees of flexion.
As a general rule, a knee flexion of about 125° will allow you to carry out most normal activities. For daily living, a minimum flexion of around 105°-110° is required. Heres the approximate range of motion flexion required for everyday activities:
- 65° to walk
- 70° pick an object off the ground
- 85° to climb up stairs
- 95° to stand from a sitting position
- 105° to tie shoelaces
- 115° to squat or sit cross-legged
- 125°+ covers most activities. However, squatting or sitting on your heel may always prove challenging.
In a study conducted with 108 total knee arthroplasty patients, the mean postoperative active flexion was 111°
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