Similar Conditions That Affect The Knee
Sometimes patients with knee pain don’t have arthritis at all. Each knee has two rings of cartilage called “menisci” . The menisci work similarly to shock absorbers in a car.
Menisci may be torn acutely in a fall or as the result of other trauma or they may develop degenerative tears from wear-and-tear over many years. Patients with meniscus tears experience pain along the inside or outside of the knee. Sometimes the pain is worse with deep squatting or twisting. Popping and locking of the knee are also occasional symptoms of meniscus tears.
Since some of these symptoms may be present with arthritis and the treatment of arthritis is different from that of meniscus tears, it is important to make the correct diagnosis. A good orthopedic surgeon can distinguish the two conditions by taking a thorough history, performing a careful physical examination, and by obtaining imaging tests. X-rays and Magnetic Resonance Imaging scans may be helpful in distinguishing these two conditions.
Knee Joint Infections
Also called infectious arthritis or septic arthritis, a joint infection is a severe problem that requires emergent medical attention. If not treated promptly knee infections can cause rapid destruction of the joint. In the worst cases they can become life-threatening.Symptoms of a knee joint infection include:
- severe pain
- fevers and
Again, a joint infection is a serious condition that requires immediate medical attention.
Who Needs To Go To A Skilled Nursing Or Rehabilitation Facility
Before you can go home after surgery, you must be able to:
- Safely get around using a cane, walker, or crutches.
- Get in and out of a chair and bed without needing much help.
- Walk around enough that you will be able to move safely in your home, such as between where you sleep, your bathroom, and your kitchen.
- Go up and down stairs, if there is no other way to avoid them.
Other factors may also prevent you from going directly home from the hospital.
- Your surgery may be more complicated.
- You do not have enough help at home.
- Because of where you live, you need to be stronger or more mobile before going home.
- Sometimes infections, problems with your surgical wound, or other medical issues will prevent you from going right home.
- Other medical problems, such as diabetes, lung problems, and heart problems, have slowed down your recovery.
What Should I Do When I Get Home
We ask that you rest. Even though our patients typically feel good, it has still been a long day. On the day of your surgery you will learn how to safely transfer in and out of both the bed and the car. We ask that you use the bathroom as needed, eat dinner and rest. You will have nursing and therapy services the very next day. Wait for further instruction from them.
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Day : The Initial Recovery
After a full knee replacement, you will likely wake up after 1½-2 hours under general anaesthetic with your knee elevated, a bandage covering the incision/s and possibly a drain to remove excess fluid from the joint.
The anaesthetic will leave your head feeling a bit foggy and the brain will be protecting the knee by avoiding movement.
The Night After Knee Replacement Surgery: My 30 Hour Hospital Stay
In a previous article I wrote about my experiences the day before and the day of my TKR surgery. In this article, I write about my first and only night in the hospital after knee replacement surgery.
I also share information about the second day until I was discharged at noon. I was at the hospital for less than 30 total hours and had some interesting experiences.
Most of the experiences were good but my stay in the hospital wasnt without challenges. Because this was my first TKR my frame of reference was limited.
If I had experienced TKR and knew what to expect I may have made some different decisions. I did do a lot of research prior to the operation but theres no lesson like experience.
Even though I was part of my medical team, I put my trust in the hospital staff and hoped they knew what was best for me. I hope this provides valuable insight as you prepare for your knee replacement surgery.
What Are The Advantages Of Knee Replacement
Long-term, you may still feel some discomfort and have to limit high-impact activity to protect the replacement joint. But knee replacement can relieve a lot of the pain and help you move much better. More than 90% of people who have a total knee replacement still function well 15 years after surgery.
Here Is An Overview Of What You Can Expect During These 12 Weeks:
- Days 1 3: In the hospital, you will work with a physical therapist and occupational therapist to work on straightening and bending the knee.
- Discharge Day: Most people are discharged from the hospital within a few days. You will be sent home with specific instructions for care, medication, and therapy.
- Week 3: By the time you reach week three, you will be able to move around a little more, and the pain will be decreasing.
- Weeks 4 6: The most noticeable improvements in your knee happen during this time if you are consistent with your rehab and exercise activities.
- Weeks 7 11: Physical therapy and rehabilitation continue. At this point, you will be working on range of motion, mobility, and strengthening the muscles.
- Week 12: You can start to return to normal activities but still need to avoid high-impact exercise .
Beyond this initial recovery time, you will notice that the pain will continue to decrease, and your function will improve.
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How Much Pain Will I Have After My Knee Surgery
This varies between patients, however, the advances in pain management have allowed our total knee patients sufficient pain relief to undergo this procedure on an outpatient basis. On average, the pain being reported is generally no more than four out of a 10-point scale. You will have one of us by your side when you wake up and throughout the day until you leave our facility. We can address any pain that you may have promptly and efficiently.
Motivation To Regain Physical Function
And finally, Dr. Courtney sees another factor speeding recovery for certain patients. Motivation is big one, especially with knee replacement surgery, he says. If patients are involved in sports, like golf, tennis, or swimming, their motivation to get back to their activities plays an important role.
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Will I Need Any Treatments After Knee Replacement
Your healthcare team will prescribe medications to help you manage pain after surgery, such as:
To prevent blood clots and control swelling, your healthcare team might also recommend:
- Blood thinners, such as aspirin or injectable Enoxaparin based on individual risk of blood clot formation.
- Compression devices, usually used while hospitalized. These are mechanical devises which provide intermittent compression.
- Special support hose.
Your team will ask you to move your foot and ankle around frequently to maintain blood flow at home. Theyll also show you special exercises to help strengthen your knee and restore motion. Exercises are very important to the success of your knee replacement. Initially, physical therapy will be in the home. Arrangements for this in home PT are made at the time of discharge from the hospital.
How Do You Know If You Need Knee Replacement Surgery
Each patient is unique, which is why it is essential to schedule an examination and testing with an experienced sports medicine doctor. Our team will determine a diagnosis before deciding if you need to schedule a date for surgery. The preference is always to use minimally-invasive treatments first before surgery is necessary.
But there are times when surgery is required. Whether the minimally-invasive treatments arent working, or youve had a severe injury, you might need to schedule surgery to achieve the recovery you desire.
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How To Prevent Blood Clots
Physical activity is the key to reducing your risk of developing deep vein thrombosis a dangerous blood clot deep inside your body. Walking even short distances promotes blood circulation, so during the day, get up every one to two hours and walk across the room. Point and flex your ankles frequently while seated. Also, remember to take your prescribed blood-thinning medication.
Symptoms of a blood clot include:
- New or increased swelling of the affected leg that doesn’t go down in the morning or after elevation
- Pain when you touch your calf in a distinct area that doesn’t subside with ice, elevation and pain medication
If you have one of these symptoms, contact our office immediately for guidance. If the office is closed, a doctor will be on call.
How Soon Will I Be Up And About
The staff will help you to get up and walk about as quickly as possible. If you’ve had keyhole surgery or are on an enhanced recovery programme, you may be able to walk on the same day as your operation. Generally, you’ll be helped to stand within 12 to 24 hours after your operation.
Walking with a frame or crutches is encouraged. Most people are able to walk independently with sticks after about a week.
During your stay in hospital, a physiotherapist will teach you exercises to help strengthen your knee. You can usually begin these the day after your operation. It’s important to follow the physiotherapist’s advice to avoid complications or dislocation of your new joint.
It’s normal to have initial discomfort while walking and exercising, and your legs and feet may be swollen.
You may be put on a passive motion machine to restore movement in your knee and leg. This support will slowly move your knee while you are in bed. It helps to decrease swelling by keeping your leg raised and helps improve your circulation.
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How Long Does It Take To Recover From Knee Surgery
The timeline for recovering varies from patient to patient, but typically the rehabilitation process takes 10-12 weeks of therapy to reach goals of achieving range of motion, strength, and performing functional activities such as standing from sitting, walking, and climbing up/down stairs independently without difficulty or pain.
Medical Issues To Consider
Prior to the operation, you will need to discuss a range of issues with your doctor or surgeon, including:
- Thorough assessment of your knee joint, which may include x-rays and other imaging techniques.
- Your medical history. If you are elderly, you will need to undergo tests to make sure you are fit for the operation. These tests may include an electrocardiogram and blood tests.
- Inform your doctor about any drugs you may be regularly taking, particularly drugs that affect the bloods ability to clot such as aspirin or Warfarin.
- Your expectations you need to understand that although the prosthesis is sophisticated, it cant replicate the full function of a healthy knee joint.Possible complications of surgery will also be discussed.
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No Pain No Gain Just Take The Medicine
There will be pain. There is no way around that, unfortunately. At first, the surgeon will likely have you on some pretty strong pain relievers. As the swelling goes down, you start to move and get used to your new knee, the pain will usually get much less. Well help you monitor and manage your pain. When the pain stops, well stop using the painkillers because there is no other need to continue taking them.
It is really important that the surgeons pain relief program is adhered to in order to achieve mobility through rehabilitation without restriction due to pain. Regaining movement will help to reduce the pain and therefore work to end the medication program.
Avoiding medication by choosing to tough it out or, using the medication for longer than you need it could lead to a delayed recovery. Its a joint effort to get the right pain relief with you and your medical team.
Interested in knowing more?
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.
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.
Get The Best Knee Revision Doctor
It is important to find a surgeon who has the skills and experience of performing successful knee revision replacement procedures.
Dr. Nakul Karkare is a distinguished orthopedic surgeon who owns and operates multiple clinics throughout New York and Long Island.
He has an extensive experience in revision knee replacements and provides patients with the broadest array of safe and effective treatment options for pain relief and other symptoms.
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Caring For Your Incision
You may remove your surgical bandage after five days. If you have sutures or staples, keep your incision clean and dry until they’re removed 10 to 14 days after surgery. When you shower, you’ll need to cover the incision so it doesn’t get wet. You’ll be given supplies and instructions for this when you’re discharged.
If you have adhesive skin closures , it’s fine to let soap and water run gently over your incision when you shower. Don’t submerge the area in water until all the strips have fallen off and the incision is well healed.
Contact our office immediately if you develop any signs of infection. These include:
- Redness around the incision
- Flu-like symptoms, such as fever and chills
Recovering From Knee Replacement Surgery
Recovery can take several months and youll need to do knee replacement exercises and have physiotherapy regularly to improve your mobility.
Short term side effects
Immediately after your surgery, you may need to be given oxygen and/or a blood transfusion. Your wound may need to be drained and your dressings will need to be changed regularly. You will likely feel very tired.
You will have some pain in your knee after the operation so youll be given painkillers and you can continue to take over-the-counter painkillers when youre home. You will need to use crutches or a walking frame at first.
Your knee, legs and feet may be swollen you can try keeping your leg raised or using an ice pack in a tea towel for 20 minutes every three to four hours to help. Your care team will encourage you to move your foot and ankle to improve the blood flow to your leg muscles and help reduce swelling and prevent blood clots. They will also recommend breathing exercises and gradually increasing your activity level.
Youll need someone to take you home after your operation and to help with errands around the house for the first few days as you regain some mobility. The stitches in your knee will need to be removed around 10-12 days after your operation or theyll gradually disappear if theyre dissolvable stitches.
Physiotherapy and ongoing treatment
You will need to use a walking aid for around six weeks after your surgery.
Your lifestyle after treatment
Looking after your new knee
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Is Total Knee Replacement Considered A Disability
If knee replacement surgery has left you unable to work, you could get Social Security disability benefits. If you have had knee replacement surgery on a knee with degenerative joint disease or after a bad knee injury, you may be able to get Social Security disability benefitsif you are unable to work.
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.
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Conditions That Can Be Treated With Knee Replacement
Knee replacement can be used to replace a knee joint affected by a range of conditions including:
- Severe osteoarthritis
- Ligament damage or infection that leads to severe osteoarthritis
- Rheumatoid arthritis
- Crystal deposition diseases such as gout and pseudogout
- Avascular necrosis death of bone following loss of blood supply
- Bone dysplasias disorders of the growth of bone.
When Should I Seek Medical Attention After Knee Replacement
After you go home, call your healthcare provider right away if you develop any of the following symptoms:
- Chest pain and/or shortness of breath.
- Fever higher than 101 degrees Fahrenheit .
- Incision problems, like bleeding, leaking, swelling, redness or odor.
- Pain in your calf, ankle or foot that is new and gets worse.
A note from Cleveland Clinic
If you have severe knee pain but medications and therapy arent helping, knee replacement may provide the answer. This common and effective surgery can reduce pain and get you back to everyday activities. Talk to your healthcare provider or an orthopedic provider about whether knee arthroplasty is a good option for you.
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