Swelling After Knee Replacement
While some swelling is normal even up until 6 months post-surgery, swelling may also occur as a result of serious complications such as deep vein thrombosis or prosthetic joint infection.
Arthritis of the knee joint is the most common indication for replacement surgery. During replacement surgery, the surgeon gives an incision in front of the knee and cuts/separates tissues to reach the diseased knee joint. During the entire surgery, the patient remains under either general anesthesia or spinal anesthesia.
X-ray showing a total knee replacement.
The surgeon further proceeds to cut and remove the diseased ends of the thigh bone and the shin bone. The removed ends are replaced with metal alloy and plastic parts. The prosthetic joint functions to recreate the motion and alignment of the natural joint.
Swelling and pain are the most common complaints after knee replacement. The swelling is normal and is usually moderate to severe in the first week but gradually decreases for the next weeks and months. Mild swelling may persist normally as long as six months post-surgery.
The swelling persists even after the skin incision heals as the tissues in the body take a long time to get back to their condition before the surgery. The patients may complain of swelling around their knees, below or above their knees. The swelling may get worse at the end of the day with activity.
What Does The Doctor Do Prior To Revision Surgery
When the decision for revision knee replacement is made, the surgeon will do a thorough clinical exam and order and laboratory tests. If infection is suspected, aspiration of the knee may be required. The aspirated fluid will then be sent to a laboratory for analysis to identify the specific type of infection.
In addition to X-rays, other imaging modalities may be helpful, such as bone scans, or . These advanced imaging technologies can demonstrate changes in the position or condition of the prosthetic components as well help to pinpoint the cause, location and the amount of bone loss to help plan for the surgery.
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Infections Of The Surgical Site
By 2030, experts estimate that there will be up to 3.48 million knee replacement surgeries in the US alone. They also say that a rise in knee replacement revisions will contribute to this growth. All in all, they project knee revisions to grow by 601% from 2005 to 2030.
Infections are some of the possible causes behind knee replacement revisions. Most infections occur within the surgical wound itself. However, harmful germs can also invade the area around the artificial knee implant.
Researchers say that infections can affect between 0.4% and 2% of primary knee surgeries. This goes up to 3.2% to 5.6% in patients who undergo knee replacement revisions.
In any case, an infected knee replacement can result in both swelling and sharp pain. If you experience these two together, make sure that you let your doctor know. Your surgeon can determine if your knee has developed an infection.
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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.
Costs
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?
Why Is My Knee So Tight After Surgery
Arthrofibrosis, also known as stiff knee syndrome, occurs when excessive scar tissue forms around a joint, limiting range of motion and causing pain and disability. It can be a complication of knee replacement or anterior cruciate ligament surgery, with infections and bleeding as known contributing factors.
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Months After Tkr Surgery
Its been four months since I had my total knee replacement. Once again time is flying by. Immediately after TKR, time seemed to drag and the healing progress was slow.
Now that the real hard work is over I feel much better and Im able to do everything that I could do prior to TKR, only now its without pain. I still feel soreness and stiffness along with occasional swelling around my knee after activity.
However, I continue to work at my rehab and an exercise routine is still an important part of my day.
In this article, Ill share my experience during the last month and I hope it encourages you to work extra hard in the months after knee surgery. Those first few weeks after TKR surgery with the physical therapists are so important.
My Bruising After Surgery
After surgery, I was surprised by the pain and bruising in my thigh and around my incision. It doesnt look great in the days after surgery however the body is resilient and it heals quickly.
Why did I experience bruising in my thigh if the surgery was on my knee?
After surgery, I was promptly reminded by my care team that I had a tourniquet on my thigh during surgery. Tourniquets are applied to the upper thigh and are extremely tight. Their purpose is to cut off circulation, which reduces the amount of lost blood during surgery. It also allows a surgeon to work more effectively.
I was told by my medical team that the pain and bruising in the thigh area is normal.
I also experienced bruising around my incision, which I expected.
I did not have any bruising below my knee. However, I have seen several pictures on the internet of folks who had extensive bruising on their calf, ankle, and their foot.
Dont be surprised to find bruising in areas other than your knee!
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Elevation After Knee Replacement
Elevating your knee above the heart level helps reduce the swelling after knee surgery and help you control the fluid build up in your lower legs.
Having a right knee wedge can make your life much more comfortable. However, you can manage with regular pillows as well.
How to elevate knee after knee replacement surgery. query into the web comes out with a mixed result, which can confuse you.
It is not rocket science, and the whole aim of elevating your knee is to reduce swelling. Just stack three or four pillows so that your knee is above heart level.
Also, avoid dangling your feet and keep your legs above heart level position for a longer time.
Knee Replacement Pain After Three Months
Swelling and bruising can continue for three months or more following knee replacement surgery. However, it varies from patient to patient and depends on the condition you were in before surgery. Many patients are back to their activities without the pain they had before surgery by this stage of recovery.
If you find that any movement or activity is still exceedingly painful after three months, you may be experiencing chronic pain. Chronic pain is defined as pain persisting for three months or longer. Its a condition that affects roughly 20% of knee replacement surgery patients. It can develop and increase in intensity in the weeks and months following surgery. This can have a huge impact on your overall quality of life. Talk to your doctor for help.
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Will Swelling After Knee Replacement Surgery Go Down
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How Long Does Bruising Last After Knee Replacement Surgery
Typically, bruising around your surgically repaired knee will last 1 to 2 weeks. Bruising often appears as a purplish discoloration that indicates there is blood in the area .
Its common and normal to develop bruises in your thigh, calf, ankle and foot because that is where blood pools in the leg.
The blood will track along the tissue planes of your leg resulting in bruising .
In many cases patients are hooked up to compression machines right after surgery that stimulate the circulation of blood through the leg. This helps push blood in and out of the leg and may reduce the amount of bruising.
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When Will My Hip Incision Heal
The incisions for a hip replacement surgery nowadays are very small and are closed up with absorbable sutures, explains Thakkar. The incision is covered with a dressing and takes about six weeks to heal. During this time, its OK to shower, but to reduce the risk of infection, bathing and swimming should be put off until the wound fully heals.
Technical Details Of Total Knee Replacement
Total knee replacement surgery begins by performing a sterile preparation of the skin over the knee to prevent infection. This is followed by inflation of a tourniquet to prevent blood loss during the operation.
Next, a well-positioned skin incisiontypically 6-7 in length though this varies with the patients size and the complexity of the knee problemis made down the front of the knee and the knee joint is inspected.
Next, specialized alignment rods and cutting jigs are used to remove enough bone from the end of the femur , the top of the tibia , and the underside of the patella to allow placement of the joint replacement implants. Proper sizing and alignment of the implants, as well as balancing of the knee ligaments, all are critical for normal post-operative function and good pain relief. Again, these steps are complex and considerable experience in total knee replacement is required in order to make sure they are done reliably, case after case. Provisional implant components are placed without bone cement to make sure they fit well against the bones and are well aligned. At this time, good functionincluding full flexion , extension , and ligament balanceis verified.
Finally, the bone is cleaned using saline solution and the joint replacement components are cemented into place using polymethylmethacrylate bone cement. The surgical incision is closed using stitches and staples.
Anesthetic
Length of total knee replacement surgery
Pain and pain management
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What Could Slow Down My Recovery
As with any surgery, there is some risk of complications during and after a hip replacement, which may include infection at the incision site, bone fractures and hip dislocations, explains Thakkar. If you notice a fever, drainage from the incision site, difficulty moving your hip or severe pain that is not relieved by your medication, contact your doctor immediately.
Taking rehabilitation at a comfortable pace and avoiding sudden, sharp movements can help prevent dislocations and falls that may delay the recovery.
What Is Knee Replacement Surgery
Knee replacement surgery is a surgical technique to repair the knee joint. Plastic and metal prosthetic parts are attached to the bones in the knee joint. During the procedure, damaged cartilage and bone are cut away. Then an artificial joint is put in place.
This surgery might be required for someone with a severe knee injury or people who experience pain from chronic arthritis. A sports medicine doctor might recommend knee replacement surgery based on your knees strength, stability, and range of motion. A variety of surgical techniques and prostheses can be used, depending on your weight, age, knee size and shape, activity level, and overall health.
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What Should I Expect During Weeks 6 Through 12
This period after joint replacement is a time of continued improvement. You will probably notice an increase in energy, a desire to do more activities, and a noticeable improvement in your new joint. Please keep in mind that every patient is different and will improve at different pace. If you are not happy with the pace of your recovery, please contact your surgeons office to discuss your concerns.
Walking
After your six-week follow-up visit, you will likely start using a cane to walk and move about. Use the cane until you return for your 12-week follow-up visit. Walk with the cane as much as you want as long as you are comfortable.
Back to work
Many patients return to work after the six-week follow-up visit. Tips to remember for returning to work include:
- Avoid heavy lifting after you return to work.
- Avoid standing or sitting for long periods of time.
- Avoid activities such as frequently climbing stairs or climbing ladders.
- Avoid kneeling, stooping, bending forward or any position that puts the new joint under extreme strain.
- Expect a period of adjustment. Most people return to work with few problems. However, you may find the first several days very tiring. Give yourself time to adjust to work again and gradually this should improve.
Continue exercise program
Comply with all Restrictions
Treatments For Swollen Knee
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Your treatment will depend on whats causing your swollen knee and how painful it is. Your doctor will recommend the most appropriate treatment after diagnosing the underlying cause.
In most cases, youll be advised to take painkillers. You can also apply ice and elevate your knee to help reduce the swelling. Sometimes removing some of the fluid in your knee helps reduce the pain and stiffness.
Other treatments include:
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How Long Will It Be Before I Feel Normal
You should be able to stop using your crutches or walking frame and resume normal leisure activities 6 weeks after surgery. However, it may take up to 3 months for pain and swelling to settle down. It can take up to a year for any leg swelling to disappear.
Your new knee will continue to recover for up to 2 years after your operation. During this time, scar tissue will heal and muscles can be restored by exercise.
Even after you have recovered, it’s best to avoid extreme movements or sports where there’s a risk of falling, such as skiing or mountain biking. Your doctor or a physiotherapist can advise you.
Looking After Your Knee Replacement
Your new knee will continue to improve for as much as two years after your operation as the scar tissue heals and you exercise your muscles. You’ll need to look after yourself and pay attention to any of the following problems:
Stiffness Sometimes the knee can become very stiff in the weeks after the operation for no obvious reason. Try placing your foot on the first or second step of the stairs, hold on to the banister and lean into your knee. This should help to improve movement and flexibility in your knee. Its very important to continue with the exercises you were working on in the hospital.If the stiffness doesnt improve after about six weeks your surgeon may need to move or manipulate your knee. This will be done under anaesthetic.
Pain Pain caused by bruising from the operation is normal in the first two months, and you’ll probably still need to take painkillers at six weeks to help you sleep through the night. You may still have some pain for as long as six months. If you still have pain after this, speak to your physiotherapist or GP.
Infection You should speak to your GP or hospital if you notice any signs of infection, for example:
- breakdown of the wound with oozing/pus or sores
- increased pain
- redness and the affected area feeling warmer than usual or smelling unpleasant.
You should also look after your feet see a doctor or podiatrist if you notice any problems such as ingrown toenails that could become infected.
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Here Are A Few Things You Can Expect After Knee Replacement Surgery:
- Rest and Ice: The knee will be swollen and tender, which is why you need to follow doctor suggestions for keeping the leg elevated and icing the joint.
- Medications: Not only does medication help with pain management, but it is also vital to reduce inflammation. Sometimes antibiotics are needed for preventing infection.
- Follow Up: You will have follow-up appointments to talk to your sports medicine doctor about recovery. Surgical staples or stitches will be removed during the office visit. Reach out to your doctor if you notice unusual symptoms, such as redness, fever, incision drainage, or increased pain.
- Home Modifications: You might need certain modifications to help you navigate your home. Since the knee needs to heal, you must use crutches. Some patients transition to a cane or walker as the recovery progresses. Consider using other modifications, such as handrails, a shower bench, a reaching stick, and removing loose cords and rugs that could cause a fall.