Knee Replacement Pain: A Year And Beyond
pain post knee replacement surgery, Credits: pixabay
- The goal of knee replacement surgery is to help you get back to your normal routine activities. Your doctor will motivate you to stay fit through activities like swimming, cycling, and even golf.
- On the contrary, there are certain activities that could negatively affect the prosthetic joint materials in place. Even normal use will begin to wear out the implants, but excessive weight or activity can cause your knee replacement to loosen and become painful. You may need to avoid running, jogging, high-impact exercises, and contact sports for the rest of your life following surgery.
- Studies have shown that more than 90% of total knee replacements are still functioning properly 15 years after surgery.
- While its possible for pain to persist for a year and beyond, it shouldnt be debilitating. Scar tissue can continue to heal, as well as the muscles in your knee. But if youre suffering from ongoing pain after a year, always consult your doctor.
Dos And Donts After Knee Surgery
After knee surgery, youll likely encounter challenges and pain on your path to recovery. While it may seem difficult, remember that what happens after your surgery is just as important as the surgery itself.
Here are some dos and donts to help you recover:
If you experience problems during recovery, call your doctor immediately for proper healing and to prevent further health issues.
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.
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How Long Do You Have Pain After Total Knee Replacement Surgery
Youve just had a total knee replacement. While you know that this will definitely add years to your mobility, the pain from the surgery is the only thing you can focus on overcoming right now. While you may have been experiencing chronic pain before knee surgery, it may come as some relief that post-surgery pain should go away in a short time with proper recovery.
Immediately after surgery, you can expect to be in the care of hospital staff for anywhere from 2-5 days. They will keep you on regular pain medication and be able to keep you up to speed in your recovery process. Its when you head home that it is now up to you to make sure you are doing your stretches, monitoring and dosing your pain and subsequent pain medication accordingly, and following your doctors orders.
While the rest-ice-elevate rule applies to most injuries and surgeries, it is particularly important after a total knee replacement because your pain can be so significant, you will want to do everything you can to stay on track in your healing process.
A Realistic Assessment Of What We Can Do To Help With Your Pain After Knee Replacement
In our clinic, we try to provide information on helping people explore other treatment options before joint replacement. One of those options is simple dextrose Prolotherapy. This regenerative injection technique helps rebuild damaged ligaments and tendons.
When the patients have already had a joint replacement, we will do a physical examination of the knee to assess how we may be able to help.
- Prolotherapy fixes soft tissue, it cannot fix hardware failure,
- Prolotherapy works by stabilizes the knee by strengthening the natural muscle and bone attachments, ligaments, and tendons.
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Patients Had Knee Pain After A Knee Replacement Because After The Fact It Was Determined That Knee Replacement Was The Wrong Surgery The Knee Was Not The Problem And The Patient Was Inappropriately Rushed To Surgery
Are you getting a knee replacement because of undiagnosed back and hip pain? Above we spoke about doctors looking for knee pain that was actually coming from the spine, hip, ankle, and feet.;The knee was perhaps not the problem and the patient was inappropriately rushed to surgery
Doctors warn that in the case of chronic knee pain, a thorough examination is imperative in identifying the correct diagnosis. That sounds like common sense, but the truth is that the source of pain is often missed and treatment then will present a significant challenge with less than desired results.
One study sought to understand why up to 20 percent of patients who undergo total knee replacement still have persistent pain and why secondary surgery rates are on the rise. ;Forty-five patients were studied. What the researchers found was somewhat shocking. The pain was not originating in the knee here is what they said:
What About Exercise Following A Knee Replacement
Exercise and sport are recommended after knee replacement, apart from;contact sports,;which may weaken the cement and lead to loosening of the joint components.;Recreational sports including golf, tennis and skiing will gradually become possible depending on how fit and sporty you were before the operation. Cycling is a very good way of building up strength and mobility after knee surgery.
Exercising the main muscle groups around your knee is very important both before and after having a;knee replacement. You can download a selection of exercises that are designed to stretch, strengthen and stabilise the structures that support your knee. Try to perform these exercises regularly, for instance for 10 minutes six to eight times a day. However, its important to find a balance between rest and exercise so you dont overwork your knee. Its a good idea to get advice from your doctor or;physiotherapist about specific exercises before you begin.
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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.
How Much Weight Can Be Put On The New Knee
Knee replacement patients are given weight-bearing guidelines to follow in the hospital and at home. Exactly how much pressure the new knee can initially support will depend on factors such as:
- The type of surgery preformed
- The type of prostheses and how it is fixated to the natural bone
- The condition of the patients natural bone
Over time, patients will be asked to put incrementally more weight on the new knee.
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Patients May Still Be Undergoing Knee Replacement For Degenerative Lumbar Spine And Hip Osteoarthritis
Patients may still be undergoing knee arthroplasty for degenerative lumbar spine and hip osteoarthritis. . . We suggest heightened awareness at pre-and post-operative assessment and thorough history and examination with the use of diagnostic injections to identify the cause of pain if there is doubt.
In other words, patients received a knee replacement when the cause of pain came from the hip and spine.
In the journal Modern Rheumatology, Japanese doctors wrote:
We suggest that rheumatologists be aware of hip disease masquerading as;knee;pain;or low back;pain.
In the case of chronic joint pain, a thorough examination is imperative in identifying the correct diagnosis. That sounds like common sense, but the sad truth is that the source of pain is often missed because of misinterpretation of MRI and other imaging scans. Please see our article on MRI accuracy.
The Biggest Mistake With Pain Managment
The biggest mistake most people make is not utilizing the opioids to their fullest extent early when they are really needed,; focusing on restoring range of motion first and foremost. If the range task lingers, so will the opioid use, they go together hand in glove.
If youve restored your range of motion and are slowly progressed your strength exercises you should not have a great deal of pain going forward.
The longer one takes an opioid prescription, the more difficult it will be to get off opioids after knee replacement surgery, which leads into this next section about the consequences of using a lot of opioid pain medication prior to surgery.
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Follow Your Recommended Exercise Regimen
Your doctor and physical therapist will create a progressive exercise regimen for you. This means that you’ll have specific activities to follow for each “phase” of your recovery.
For instance, you may try bending your knees 90 degrees a week after the surgery. Don’t worry if you still can’t; what’s vital is that you attempt to and that you do it slowly. Within seven to 10 days, you should also be able to fully extend and straighten out your knee.
A month after your surgery, your doctor or PT may already allow you to take long walks. They may also likely recommend reducing your reliance on your crutches or cane. However, you should still avoid crouching or squatting at this point.
So long as you stick to your exercise plan, you should be able to do more of your usual daily activities within a month. Pain, stiffness, and discomfort should also have improved significantly at this point.
The Problem Of Paradoxical Pain
A little known phenomenon of chronic opioid use is something called hyperalgesia, which means an increase in pain. This is a paradoxical effect. The remedy that is supposed to reduce pain is actually increasing it. Paradoxical effects can occur with other medications like those taken for depression. At times the very same medication that help some, will cause suicide or violence in others. There is still much we do not know about the effects of medications.
A study in 2015 reported that, although the effect of opioid tolerance and dependence has gained considerable attention, the problem of opioid-induced hyperalgesiacharacterized by a paradoxical increase in pain sensitivityis a less recognized consequence of opioid use.;; In fact, it is little known and little studied.
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What To Expect After Knee Replacement Surgery
When the surgery is over, you will need to stay in the hospitals recovery room for observation. Usually, patients can return to their hospital rooms within a few hours after their pulse, blood pressure, and breathing are stable. Since knee replacement is major surgery, its common for the patient to be in the hospital for a few days before returning home. You will begin physical therapy during this in-hospital time.
When its time to head home, your medical team will have a transition plan to help with continued physical therapy and pain management. Its crucial that you are diligent about following these recommendations to regain the range of motion and strength needed in the joint.
What Does Knee Replacement Surgery Recovery Look Like
A typical total knee replacement will typically require one to three months of recovery with the use of a walker or a cane. Whereas, a partial knee replacement is less invasive comparatively. Patients usually walk without assistance within two weeks because the incision is much smaller and there is significantly less blood loss. While this may sound more appealing than a total knee replacement, only about 10% of patients are good candidates for a partial knee replacement procedure.
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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.
How To Encourage Healing
For anyone who has had knee surgery, it is essential to keep the wound as dry as possible until it has thoroughly healed. Covering the wound with a bandage will also help prevent irritation from support stockings and other clothing.
Having a healthful, balanced diet helps encourage healing, though a person may have a poor appetite for the first few days after their surgery.
The AAOS recommends exercising in the first few weeks after the operation. A physical therapist may recommend specific exercises that help restore movement and build strength in the knee, and a person may need to do these several times a day.
Otherwise, the best approach to aftercare largely depends on the type of surgery that a person has had.
Anyone who has undergone arthroscopy should exercise regularly. A doctor or physical therapist usually recommends 2030 minutes of exercise two or three times a day and walking for 30 minutes two or three times a day during early recovery.
A physical therapist may design a personalized activity program. This may involve gradually increasing the amount of walking and a timetable for resuming everyday activities, such as climbing stairs. They will also recommend rehabilitation exercises.
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What Can Cause Sharp Pain After Knee Replacement
When people feel sharp pain, they usually refer to a sudden, shooting kind of pain. The pain can also feel like stabbing, piercing, or cutting sensations. Either way, the highly unpleasant feeling can be quite intense and may also fade and reoccur.
Sharp pain can occur in patients whove had a knee replacement. Such cases often arise from surgical complications, such as infections.
An implant that becomes loose can also cause stabbing pains. The same goes if a misalignment of the operated knee occurs.
Will Your Bones Even Allow For A Revision Knee Replacement
An August 2019 study in the Journal of Orthopaedic Surgery and Research offered this warning to surgeons concerning the problems of identifying whether a patients bones were strong and dense enough to withstand another knee replacement procedure.
Revision total knee arthroplasty is a demanding procedure, with a high complication and failure rate and a high rate of bone losses and poor bone quality. Different classifications for bone losses have been proposed, but they do not consider bone quality, which may affect implant fixation.
Look at the study findings:
- Fifty-one patients were included .
- The most frequent cause of failure was:
- aseptic loosening of the implant .
- 18.9% of the cases demonstrated poor bone quality.
What the researchers of this study were seeking to point out is that if revision knee replacement is required, a plan to address and repair the possibility of bone loss, bone weakening, a loss of bone density should be undertaken. This would significantly increase the success of the replacement.
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What Not To Do After Knee Replacement
After undergoing a partial or total knee replacement, there are certain movements to refrain from to avoid re-injuring your knee or causing pain.
Avoid any risk of falling; After knee surgery, it will take a while before you regain strength and balance in the leg, making you more likely to experience a fall. Avoid activities like climbing ladders and take care to hold on to handrails when using stairs. Hiking or walking on the uneven ground should also be avoided until your knee is properly healed.
Dont sit for long periods; Sitting for long periods after knee replacement surgery is correlated with a higher risk of blood clots. Make sure youre getting enough light activity to support healing after your operation.
Running; Running puts three times the amount of pressure on the knee as walking. Avoid running while youre healing from knee replacement surgery until cleared to do so by your doctor.