How Do I Manage Pain And Discomfort After Joint Replacement Surgery
Try to take your pain medication as soon as you begin to feel pain. Don’t wait until the pain becomes severe. Follow the instructions on the prescription label. Remember to take your pain medication before activity and bedtime.
If you need to have stitches or staples removed and you’re still taking pain medications, be sure to have a friend or family member drive you to your appointment.
Pain medication may cause nausea. If this happens, decrease the amount you are taking or stop and contact your surgeons office.
If you need additional pain medication, please contact your surgeons office. Give at least a few days advance notice before you run out of the medication. Please plan ahead, especially for holiday weekends.
Also remember:
- You aren’t permitted to drive a car while taking narcotic pain medication.
- It may take several days to have a bowel movement. Anesthesia and pain medication often cause constipation. Drink plenty of fluids and eat whole grains, fruits, and vegetables. A stool softener or laxative can help bowel function return to normal.
- Don’t hesitate to call your surgeons office with any questions or concerns.
Incision care
Walker, crutches, cane
Use your assistive devices for balance as instructed by your surgeon or therapist. By your first post-op visit with your surgeon, you may have already improved and changed from using a walker or crutches to a cane .
Plan Meals Ahead Of Time
If you have a reliable caregiver that can prepare meals for you after TKR you are fortunate. Otherwise, you might consider preparing and freezing meals ahead of time.
Packaged cereal for breakfast is much easier than frying eggs, bacon and making toast. You may consider restaurants that deliver meals and some communities have meals on wheels for seniors.
Keep snacks and water close to where you will be sitting during the day so that they are within reach.
Understanding Why Some Joint Replacements Fail
We’re also supporting research to improve the outcome of knee replacement surgeries, such as a project aimed at increasing the understanding of why joint replacements sometimes fail by investigating whether there are genetic risk factors that influence surgery outcome. This research has the potential to improve patient experience and increase the life of the joint replacement.
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Physical Therapy After Knee Replacement Surgery
Outpatient physical therapy is typically prescribed after discharge and will usually begin within a week of surgery. A physical therapist will teach the patient:
- Knee strengthening exercises
- Knee exercises to encourage range of motion and reduce scar tissue
- How to use assistive walking devices, such as a walker and cane
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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Work On Your Walking Form
Pre-surgery my leg was bowed and walked with a noticeable limp. Once you start walking after TKR you may have to relearn to walk correctly.
My in-home therapist made it a point to walk behind me reminding me to walk with proper form. On your other walks, have your caregiver or walking partner critique your walking form.
Discard those old shoes that show wear from walking incorrectly.
If you can, video record you walking form before surgery and then have your walking partner video your new form occasionally.
What Does Knee Replacement Surgery Involve
The team at Tri-State Orthopaedics provide the latest advancements in treating chronic knee problems. When conservative options arent enough, your provider may recommend knee replacement surgery. Also called arthroplasty, this procedure involves replacing the structure of the damaged knee joint with metal and plastic parts to restore the normal function of the knee and relieve chronic pain.
Knee replacement is an incredibly common and successful procedure. Over 90% of people who have knee replacement experience significant improvement in pain and their ability to get around. For most people, knee replacement restores a good quality of life, giving back independence and allowing you to engage in activities you used to enjoy. However, recovery is often a long road. If youre scheduled for or considering knee surgery, here are some helpful dos and donts in your path to recovery.
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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.
Walk As Soon As Possible
Recovery from joint replacement surgery isnt always easy, but getting back on your feet as soon as the doctor says its okay can help you recover. Walking helps prevent complications like blood clots, improves circulation, and keeps your joints limber. You dont have to wait until you return home after surgery. Most patients can start walking while still in the hospital. Walking helps deliver important nutrients to your knee to help you heal and recover. You can expect to use a walker for the first couple of weeks. Most patients can walk on their own roughly four to eight weeks after knee replacement.
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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 .
What Activities Will I Be Able To Engage In
Most patients require an assistive device for approximately 3 weeks after knee replacement surgery although this varies significantly from patient to patient.
You will also be able to do low-impact exercise such as riding a stationary bike, walking, and swimming after 68 weeks. Your physical therapist can advise you on introducing new activities during this time.
You should avoid running, jumping, as well as other high-impact activities.
Discuss with your orthopedic surgeon any questions concerning your activities.
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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 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?
When Should I Have A Double Knee Replacement Done
A total knee replacement may be performed if there are signs of advanced joint disease and treatment has failed to provide pain relief. The pain will affect the patients quality of life. A patients age is also determining the factor to a knee replacement should be performed. It is preferred for a patients age in order to perform a total knee replacement.
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Characteristics Of Severe Arthritis Of The Knee
Pain
Pain is the most noticeable symptom of knee arthritis. In most patients the knee pain gradually gets worse over time but sometimes has more sudden flares where the symptoms get acutely severe. The pain is almost always worsened by weight-bearing and activity. In some patients the knee pain becomes severe enough to limit even routine daily activities.
Stiffness
Morning stiffness is present in certain types of arthritis. Patients with morning stiffness of the knee may notice some improvement in knee flexibility over the course of the day. Rheumatoid arthritis patients may experience more frequent morning stiffness than patients with osteoarthritis.
Swelling and warmth
Patients with arthritis sometimes will notice swelling and warmth of the knee. If the swelling and warmth are excessive and are associated with severe pain, inability to bend the knee, and difficulty with weight-bearing, those signs might represent an infection. Such severe symptoms require immediate medical attention. Joint infection of the knee is discussed below.
Location
The knee joint has three compartments that can be involved with arthritis . Most patients have both symptoms and findings on X-rays that suggest involvement of two or more of these compartments for example, pain on the lateral side and beneath the kneecap . Patients who have arthritis in two or all three compartments, and who decide to get surgery, most often will undergo total knee replacement .
Risks Of The Procedure
As with any surgical procedure, complications can occur. Some possiblecomplications may include, but are not limited to, the following:
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Bleeding
-
Blood clots in the legs or lungs
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Loosening or wearing out of the prosthesis
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Fracture
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Continued pain or stiffness
The replacement knee joint may become loose, be dislodged, or may not workthe way it was intended. The joint may have to be replaced again in thefuture.
Nerves or blood vessels in the area of surgery may be injured, resulting inweakness or numbness. The joint pain may not be relieved by surgery.
There may be other risks depending on your specific medical condition. Besure to discuss any concerns with your doctor prior to the procedure.
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When Can I Stop Using A Cane After Knee Replacement
Within two weeks of surgery, some patients may walk without any device in the morning, but become tired in the afternoon and need the device again. The same concept applies to changing surfaces , inclines, or steps. It may be easier to walk in the house on a firm and predictable surface without a cane or walker, but going outside on uneven and unpredictable ground would be safer with an assistive device.
On the other hand, walking without a limp while using a walker will be necessary before moving on to walking with a cane or no assistive device at all. Tossing the walker or cane to the closet too soon can cause delayed recovery and possibly not regain a normal gait pattern.
Almost every PT has had a strong-opinionated patient that chose to walk without a walker or cane before the therapist was in agreement and had less successful outcomes in terms of their walking abilities. It is highly recommended that an assistive device is used for as long as needed to achieve the required strength, flexibility, and gait pattern.
This process requires patience and understanding from the patient that every surgery and recovery is different. This means that even though someone they know was walking without a walker after surgery before they are that they are not necessarily behind.
Use Walking Poles In The First Few Month
You will need to use a walker immediately after TKR. In a few days, you will transition to walking poles or a cane.
I recommend walking poles and it is important to have them on hand. The poles will help you maintain balance when you begin walking again and they will also take some weight off of the knee and hip.
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What Should I Expect After My Total Hip Or Total Knee Replacement
NOTE: The following is a general guide to care following your procedure. Your healthcare provider may have somewhat different instructions for you. Please follow those.
After total knee or total hip replacement surgery you can expect gradual improvement over the coming months. You should gradually expect less pain, stiffness and swelling, and a more independent lifestyle. Returning to work depends on how quickly you heal and how demanding your job may be on a new joint.
After you are discharged from the hospital or rehabilitation facility, there will be a few weeks before you return for a follow-up visit with your surgeon. This period of time is critical in your rehabilitation and you may require outpatient therapy services for positive long-term results from your surgery.
In general, patients do very well after discharge. However, its important that you contact the surgeons office if any of these occur:
- You have increasing pain in the operative site.
- There is new or increased redness or warmth since discharge.
- There is new or increased drainage from your incision.
- The operative site is increasingly swollen.
- Your calf becomes swollen, tender, warm or reddened.
- You have a temperature above 101 degrees Fahrenheit for more than 24 hours.
- For total knee replacement, your ability to flex has decreased or remains the same as when you were discharged from the hospital.
Refuse The Urge To Be Sedentary
Besides prescribed exercise routines, your therapist will want you to take walks. Make yourself get out of the recliner and outside for at least 3 walks a day once your therapist gives you the go ahead.
If your caregiver or a friend or family member will walk with you, their encouragement and conversation make taking walks easier. Do ankle pumps and ankle rolls even when you are sitting down.
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Is A Knee Replacement Painful
Knee replacement surgery is a common orthopedic surgery in the U.S. with the number of surgeries performed each year expected to hit 1 million by 2040. Knee replacement surgery is proven to provide pain relief, improve mobility and quality of life, but it has a reputation of being painful. Patients considering this procedure are often hesitant because theyve heard that the surgery itself has a long recovery time and they wonder if the pain and time recovering will be worth the benefits.
Are you considering knee replacement surgery? Lets first look at the facts- Most knee replacements are expected to last more than 15 years, and according to recent statistics, three to six weeks after surgery is the average time it will take to resume to most daily activities.
Increase The Strength Of Your Knee
Stay on your exercise schedule. Youll gradually observe improved bending and strength in your knee joint. Your therapist may also ask you to stop using your assistive device and start taking walks as long as half a mile. After six weeks, you should be able to do your household chores with ease. You can also ask your surgeon or therapist to tell you when youll be able to return to work and normal driving.
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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.