What Is A Knee Replacement
A knee replacement can be total or partial, depending on how advanced a patients condition is. A total knee replacement involves the resurfacing of a knee joint. The surgeon will first remove diseased cartilage and bone from the joint. Then, metal and plastic parts are used to cap the ends of the bones and the kneecap. This creates a smooth joint that can move and bend without pain.
Why Would I Need Surgery
Osteoarthritis is the main reason why people go for knee replacement surgery. The age-related condition is very common and occurs when cartilage — the cushion between the knee and the bone joints — breaks down.
Other reasons include:
- Rheumatoid arthritis: Rheumatoid arthritis is when the bodyâs immune system attacks and destroys the lining of the knee.
- Deformities: People with bowed legs or âknock-kneesâ often get surgery to restore the position of the knee.
- Knee injuries: A broken bone or torn ligaments around the knee sometimes will result in arthritis that causes great pain and limits your movement.
Whats It Like To Recover From Knee Replacement Surgery
The rehabilitation period after knee surgery is just as important as the surgery itself. Recovering from knee surgery is a weeks-long process that gradually strengthens the knee and returns you to your normal level of activity. The 12 weeks after surgery are critically important to regain your mobility, and your recovery begins the very day your surgery is complete.
A typical timeline for recovery after knee replacement looks something like this:
Day 1. After youve recovered from the anesthetic, your physical therapist will help you stand up and walk slowly by using an assistance device.
Day 2. You may walk for brief periods with the aid of an assisted device. Youll work during this time on flexing the knee as much as possible.
Week 1. You should be able to bend your knee by 90 degrees, although the pain and swelling may make this comfortable. Youll start to bathe, dress, and use the toilet on your own and likely change your own bandages, although you may still require the help of a caregiver.
Weeks 2 3. Youll start work with a physical therapist. You will have a daily work schedule to keep the knee mobile. You will likely use a continuous passive motion machine that keeps the joint slowly moving while preventing the buildup of scar tissue and stiffness. During this time, your healthcare team will work closely with you to rehabilitate the joint safely.
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What Not To Do After Knee Replacement
Post-Total Knee Replacement Surgery, you will have to take some precautions like how much walking or How Far to Walk After Knee Replacement is required.
Here are some Things You Cant Do After Knee Replacement Surgery:
- Dont cross your legs
- Dont kneel and place anything behind your knees
- A pillow or any item for that matter should not be placed behind the knees
- If you require elevation and/or support under the operative leg, it is to be placed under the heel
- You should not torque or twist on your new knee
- You also have to avoid running, trekking, and playing contact sports like football, cricket, etc.
Prolotherapy And Platelet Rich Plasma Therapy
We are going to briefly address two treatment options that we offer here at Caring Medical. These are non-surgical, injections. These treatments may help the patient who has difficulty kneeling by restoring stability in a loose and wobbly knee following knee replacement.
Prolotherapy is an injection technique utilizing simple sugar or dextrose which causes a small controlled inflammation at weakened tissue. This triggers the immune system to initiate repair of the injured tendons and ligaments. Blood supply dramatically increases at the injured area. The body is alerted that healing needs to take place and reparative cells are sent to the treated area of the knee that needs healing. The body also lays down new collagen in the treated areas, thereby strengthening the weakened structures. Once the tendons and ligaments are strengthened, the knee, even one that has been replaced, stabilizes.
Platelet Rich Plasma Therapy is the use of a patients blood platelets and healing factors to stimulate repair of a tendon it is considered when tendon damage is more severe.
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 and Platelet Rich Plasma Therapy fix soft tissue, it cannot fix hardware failure,
- Prolotherapy
- and Platelet Rich Plasma Therapy works by stabilizing the knee by strengthening the natural muscle and bone attachments, ligaments, and tendons.
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Do I Need To Make Any Preparations For The Surgery
Even though Dr. Hsu told mama that its not necessary for her to stay home to care for me, she still did for the first two weeks. Im glad she made that decision because I was feeling extremely manja the first few days. It helped a lot that she was around to accompany and comfort me.
- Cut your pups nails as long nails will affect its balance, especially with only three legs!
- Mama bathed me right before sending me to surgery because I wouldnt be able to touch water for the next 2 weeks
- If you dont already have one, get an inflatable or e-collar to prevent your furkid from licking and nibbling on the incision area
- I had to refrain from food and water after 10pm the day before surgery
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Thoughts On Limping After Tkr
chris00938
I was thinking about this yesterday. They send you home a day or two after the op, on crutches, telling you to move the crutches first, and then the operated foot up to the crutch level and then the other one. Fine. But I had to ask roughly when to go on to two sticks but actually found I could go on at about two weeks, and then on to one very shortly after. BUT there was no instructions on gait when walking on crutches etc. OR at what point to start a normal stride rather than operated leg up to crutches and then the other one up to that. What did others do? A few days after I came home I started lengthening stride so I was gradually walking more normally by the time I went on to two sticks, and also making sure I wasnt leaning forward, but when you dont get to see a physio, this is rather left to the patient to think about! Nothing was mentioned in exercise sheets or anything about going from walking up to crutch/stick level and then increasing it to normal gait.
0 likes, 8 replies
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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.
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 .
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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.
What Would I Have Done Differently In The Past Year
As I mentioned above I am happy with the progress I have made to date. When thinking back, I dont think I would have done anything different during my rehab.
I must stress that I was concerned and fearful about the surgery and the rehab so much so that I strictly followed my doctors orders and was especially diligent following the plan my physical therapists set out for me.
Talking with friends that have also had TKR, the ones that seem to be having the most trouble post TKR are those that didnt take their physical therapy as seriously as I did.
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Its Not My Knee Replacement That Is The Problem It Is My Other Knee Expanding On The Other Knee Problem
In Australia, doctors at the University of Wollongong, examining why patients who should be able to kneel after knee replacement, did not kneel, wrote in the Journal of Orthopaedics and Traumatology , about the problems of the other, non-replaced knee.
Here is what they found:
- Seventy-two percent of patients in this study could, or thought they could kneel at 12 months post knee replacement
- However, some did not because of the pain and discomfort they felt during kneeling.
- BUT, it was not the pain and discomfort in the replaced knee, 75 % of the patients in this study had other health concerns why they could not kneel including obesity, other health problems, but the number one reason was problems with the other knee.
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Interesting Fact About Physiotherapy Funding In Ontario
To date, the Ontario Health Insurance Plan pays for a brief amount of physiotherapy following your total knee replacement. This can occur in a hospital or clinic setting. Given the restrictions to funding for physiotherapy services, often you will be seen by a physiotherapy assistant or be placed on machines. Many patients will not have access to a complete plan of care that will help them reach full recovery.
At MUV Therapy Physio & Sports Medicine, we believe that high quality physiotherapy should be delivered by Registered Physiotherapists and that everyone should have a 100% customized plan to help them achieve their maximum recovery.
If you would like to speak with one of our expert physiotherapists, please request a call using the button below
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Knee Replacement Recovery Time Guide
Here we will look at total knee replacement recovery time, including what happens at what stage post-op and how long it typically takes to get back to your usual activity.
If are having or have had only one side of your knee replaced, visit the partial knee replacement recovery time section instead to found out how it will be for you.
Knee replacement recovery time will vary from person to person, and may be affected by:
- Severity of arthritis
- Compliance with exercises pre and post-op
Let’s have a look at a typical knee replacement recovery time process.
Fear Bending And Baby The Knee
I have been in the field working as a therapist for over 20 years and havent yet seen an incision split open with active bending exercises, however I do understand how this fear can overwhelm early on in the recovery. The rule is baby the knee went it comes to walking but dont baby the knee when it comes to bending. That doesnt mean you aggressively bend the knee. You must use frequent low loads and the knee will respond delightfully and give you back your range of motion in steady increments.
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Similar Conditions That Affect The Knee
Meniscus tear
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.
What Are The Benefits Of A Tkr
Over 90% of people who have total knee replacement surgery experience significant pain relief and improved joint function. Patients wont be able to recover function lost before developing arthritis, but the improvements in daily living often far outweigh the risks. People enjoy a wide range of physical activities after recovery, including walking, swimming, hiking, biking, and other low-impact sports.
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Exercises To Improve Outcomes After Knee Replacement
As an orthopedic surgeon, I understand that total joint replacement patients are eager to get up and start using their new knee as soon as possible. During your treatment for this major surgery, well talk about how you should recover, what your range of motion will be, and how you can prevent complications while building your strength after surgery.
As an orthopedic surgeon, I understand that total joint replacement patients are eager to get up and start using their new knee as soon as possible. During your treatment for this major surgery, well talk about how you should recover, what your range of motion will be, and how you can prevent complications while building your strength after surgery.
In most cases, returning to your level of activity that you had prior to the degeneration of your knee joint is within reach. You need to rebuild the muscle strength in your leg, which may have been weakened while you suffered from knee problems.
I have addressed the injury or damage to your knee surgically. Now, its up to you to put in some hard work to maximize your improvement. In order to continue healing and improving, you must follow the instructions developed by your physical therapist with your specific needs in mind.
Some exercises can begin as early as the recovery room at the hospital. Youll want to make sure you have healthy circulation, to prevent blood clots. Starting exercise as early as you can will help you in your recovery and should lessen post-operative pain.
Why Is My Knee So Tight After Knee Replacement Surgery
Arthrofibrosis is also known as stiff knee syndrome. The condition sometimes occurs in a knee joint that has recently been injured. It can also occur after surgery on the knee, such as a knee replacement. Over time, scar tissue builds up inside the knee, causing the knee joint to shrink and tighten.
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When Can A Patient Return To Work
This is a common question after knee replacement surgery and entirely depends on the nature of work the patient performs as part of their occupation. For those patients who work in jobs that are relatively sedentary such as office work, returning to work after 2 to 3 weeks is perfectly reasonable however, for patients whose work demands more of them physically, e.g., fireman, police officer, these patients are usually recommended to wait at least 6 weeks before returning to work.
This is because muscle recovery is usually sufficient by 6 weeks to allow for the normal duties of these more physically demanding occupations at this point in time. However, it is also a case that even for the more physically demanding occupations, if a modification of these duties is available to the patients for the postoperative recovery period then this would potentially allow for an early return to work.