What To Expect After Knee Replacement
A patients recovery and rehabilitation plan is crucial to the overall success of knee replacement surgery. A recovery and rehabilitation plan can help the patient:
- Leave the hospital sooner
- Regain knee strength and range of motion more quickly
- Resume independent living sooner
- Avoid potential complications
Typically, knee replacement patients are able to leave the hospital within 1 to 5 days , and they can take care of themselves and resume most activities 6 weeks after surgery. The majority of patients are 90% recovered after 3 months, though it can take 6 months or longer before they are 100% recovered.
Some knee replacement patients do not follow the typical recovery timeline. For example:
- Patients who did knee-strengthening exercises in preparation for surgery sometimes recover more quickly.
- Patients who are older, smoke, or have other medical conditions may take longer to heal.
Deviation from the typical recovery timeline cannot always be predicted, but these differences are usually okay as long as the patient, doctor, and physical therapist, continue to work together towards a full recovery.
What Happens During Knee Replacement Surgery
Once you are under general anesthesia or spinal/epidural anesthesia , an 8- to 12-inch cut is made in the front of the knee. The damaged part of the joint is removed from the surface of the bones, and the surfaces are then shaped to hold a metal or plastic artificial joint. The artificial joint is attached to the thigh bone, shin and knee cap either with cement or a special material. When fit together, the attached artificial parts form the joint, relying on the surrounding muscles and ligaments for support and function.
How Will I Know If My Incision Is Infected
After surgery, you will notice discolored skin, some swelling and drainage around your incision. This is normal. If you experience painful redness, abnormal swelling or thick, bad smelling drainage from your incision, you might have an infection. A temperature over 101°F also could indicate an infection.
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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.
When Can I Take A Shower After Outpatient Knee Replacement
You can take a shower the day after your surgery. Please wait until the visiting nurse and physical therapist arrives. The nurse will check your dressing and your overall health that morning, and the therapist will educate you on how to safely get in and out of the shower.
Your outer padded dressing and tape can be removed. Underneath you will find a clear tape that is glued to your skin. Do not remove this. You may shower with this and get it wet. Please do not scrub the surgical area. Pat dry with a clean towel when you are finished. We also ask that you do not let your surgical site get soaked with water. Do not take a bath or get into a pool or hot tub.
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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.
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.
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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.
How The Operation Is Done
The worn ends of the bones in your knee joint are removed and replaced with metal and plastic parts which have been measured to fit.
You may have either a total or a partial knee replacement. This will depend on how damaged your knee is. Total knee replacements are the most common.
Read more information about what happens on the day of your operation.
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Getting Ready To Go Home
Before you go home, you will need to:
- Be able to move or transfer in and out of bed, in and out of chairs, and off and on the toilet without help and safely
- Bend your knees almost to a right angle or 90Â°
- Walk on a level surface with crutches or a walker, without any other help
- Walk up and down some steps with help
Some people need a short stay in a rehabilitation center or a skilled nursing facility after they leave the hospital and before they go home. During the time you spend here, you will learn how to safely do your daily activities on your own. You will also have time to build strength while you recover from your surgery.
Should I Have Knee Replacement Surgery
You might be a candidate for knee replacement surgery when other treatments no longer relieve severe pain and loss of function. Joint pain and immobility usually occur when the cartilage that protects and cushions the joints wears down. When this happens bones rub directly against each other, causing further damage and pain.
Not everyone is a candidate for knee replacement surgery. Your overall health is taken into account. If you have a history of other health problems such as heart attack, stroke or diabetes, surgery might not be right for you.
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Tests Before Knee Replacement Surgery
About six weeks or so before your operation you will have an appointment for a ‘pre-admission’ or ‘pre-assessment’ clinic. At this clinic a nurse will assess your fitness for your knee surgery.
There are several tests that may be needed and they include:
- Blood tests – to check that you aren’t anaemic and that your kidneys and liver are working well enough for you to undergo the operation.
- Urine test – to make sure you haven’t got a urine infection and that there isn’t any glucose in your urine.
- Blood pressure.
- Infection screen – this includes looking for meticillin-resistant Staphylococcus aureus . MRSA is a germ that is difficult to treat and can cause complications of a knee replacement.
- A heart tracing .
You may have the chance to speak with an anaesthetist, physiotherapist, occupational therapist or social worker at this clinic but this isn’t always possible.
What Are Recent Advances In Knee Replacement Surgery
Left knee showing pre and post-op total knee replacement.
Minimally invasive surgery has revolutionized knee replacement surgery as well as many fields of medicine. Its key characteristic is that it uses specialized techniques and instruments to enable the surgeon to perform major surgery without a large incision.
Minimally invasive knee joint replacement requires a much smaller incision, 3 to 5 inches, versus the standard approach and incision. The smaller, less invasive approaches result in less tissue damage by allowing the surgeon to work between the fibers of the quadriceps muscles instead of requiring an incision through the tendon. It may lead to less pain, decreased recovery time and better motion due to less scar tissue formation.
Currently this less invasive procedure is performed by only a small percentage of orthopedic surgeons in North America. Researchers continue looking at the short-term and long-term benefits of minimally invasive versus traditional knee replacement surgery.
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Revision Knee Replacement Surgery
If the prior knee replacement component doesnt work for a longer time then it must be replaced to avoid any physical problem. You can opt for a second surgery known as revision total knee replacement which becomes essential if the initial surgery fails to prove effective.
The wear-and-tear on components, infection, component loosening and knee joint problems are the most common cause for revision surgery. Other reasons are mostly knee stiffness and bone fractures.
Can Rehabilitation Be Done At Home
All patients are given a set of home exercises to do between supervised physical therapy sessions and the home exercises make up an important part of the recovery process. However, supervised therapy–which is best done in an outpatient physical therapy studio–is extremely helpful and those patients who are able to attend outpatient therapy are encouraged to do so.
For patients who are unable to attend outpatient physical therapy, home physical therapy is arranged.
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Risks And Complications Of Knee Replacement Surgery
Most people have knee replacement surgery without complications, but all surgery carries risks and your consultant will explain them to you before you go ahead.
Pain after knee replacement is a common short-term side effect pain at night is particularly common. Swelling and weakness often also occur in the short term.
Youll have some scarring, which will gradually fade with time.
Knee replacement surgery complications
Complications can include:
- A blood clot this can occur in your:
- Leg this is called deep vein thrombosis symptoms include hard, hot, red or painful areas in your leg
- Lungs this is called a pulmonary embolism it is rare but is a medical emergency symptoms include chest pains and breathlessness
Other complications include:
- Blood vessel, ligament and/or nerve damage around your knee joint
- Numbness around the site of surgery
- Unexpected bleeding into your knee joint
Signs of serious complications
Signs of infection after a knee replacement
How Long Does A Knee Replacement Last
Knee replacement implants are expected to function for at least 15 to 20 years in 85% to 90% of patients. However, the implants do not last forever.
After a period of 15 to 20 years, general wear and tear may loosen the implant. Depending on the patient, this may cause no symptoms, or it may cause any of the following:
- knee instability
When these symptoms arise, orthopedic surgeons recommend having to replace the original implant. Infection, especially, requires a prompt revision surgery. Infection after knee replacement surgery is rare, but a knee replacement implant cannot defend itself from infection if bacteria are introduced to the body. Learn more about the at HSS.
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Why Must I Take Antibiotics For Dental Work Or Other Surgical Procedures
Taking antibiotics is a precaution to help ensure that your new artificial joint does not become infected. Additional surgeries or dental work increases the chances of infection. No matter where the infection starts, if it spreads to your new knee, the results could be very serious. When artificial joints become infected, they must be removed surgically and then replaced. Please let your dentist or physician know that youve had joint replacement surgery. This is important no matter how small or straightforward the procedure.
What Happens After Knee Replacement Surgery
The average hospital stay after knee joint replacement is usually three to five days. The vast majority of people who undergo knee joint replacement surgery have dramatic improvement. This improvement is most notable one month or more after surgery. The pain caused by the damaged joint is relieved when the new gliding surface is constructed during surgery.
After knee joint replacement, people are standing and moving the joint the day after surgery. At first, you may walk with the help of parallel bars, and then a walking device such as crutches, walker, or cane will be used until your knee is able to support your full body weight. After about six weeks, most people are walking comfortably with minimal assistance. Once muscle strength is restored with physical therapy, people who have had knee joint replacement surgery can enjoy most activities .
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How Long Will My New Joint Last
In recent years, improvements in medical equipment and surgical techniques have meant that many knee replacements last longer than they did in the past.
A new study looking at over 6,000 people who have had knee replacement shows:
- More than 4 in 5 people who have total knee replacements can expect them to last for at least 25 years.
- 7 in 10 people who have a unicompartmental knee replacement can expect it to last for at least 25 years.
Clearly this will vary between different people, and you still need to take care of your new knee.
Strengths And Limitations Of This Study
Routinely collected data provided real-world information on trends in length of stay following primary knee and hip replacement and revision procedures.
Patient characteristics were controlled for to assess whether trends in length of stay and associated hospital reimbursement were explained by changes in patient characteristics or improved efficiency.
Codes used to identify diagnoses of osteoarthritis have not been fully evaluated.
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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.