Recommendations For Patient Activity After Knee Replacement Vary Among Surgeons
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During recovery after knee replacement surgery, exercise is critical. After initial recovery, patients will want to resume more strenuous activities. In addition to exercise prescribed by a physical therapist, several studies have shown patients who participated in athletic activities prior to surgery will want to continue this practice after surgery. However, how much activity and how strenuous this activity should be remains unclear.
We just have gut instinct as to what is best for the implant and what is not,Richard Iorio, MD, told Orthopedics Today. In general, if it feels comfortable with the patient, if they are educated and trained well in the activity and they can do it without pain or discomfort and it is good for their cardiovascular fitness, we will encourage participation.
A literature review by Michael R. Bloomfield, MD, and his colleagues showed total joint procedures are increasingly being performed in more active patients, with 19% of patients returning to athletic activities after knee replacement. However, other research has shown there is limited peer-reviewed information to help orthopedic surgeons advise their patients on the appropriate athletic activity after knee replacement.
Low vs. high impact
Image: Frank Martucci, NYU Langone Hospital for Joint Diseases
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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.
Exercises To Avoid After Hip Replacement
Essentially you cant do anything that produces more than 40 micrometers of motion between the bone and metal. You just lost me Doc! I know, I know stick with me here.
Its been well-documented that there can be as much as 40 micrometers of motion between the bone and the metal implant before you create problems. Beyond that rage, you will prevent the bone from growing into the hip.
To put that in perspective, that means the metal can wiggle no more than four one-hundredths of a millimeter. Hopefully, you just realized that deadlifting 300 lbs probably exceeds that limit and youd be right.
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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.
Exercise And Activity Guidelines
After surgery, you may be looking forward to moving without pain, but nervous that youll damage your new knee joint if you participate in physical activity.
Artificial knees are designed to mimic a natural knee. This means that, like a natural knee, they need exercise to function properly.
Exercise will enable you to strengthen your knee muscles and help you maintain a healthy weight.
According to the American Academy of Orthopaedic Surgeons , your doctor or physical therapist may recommend doing both of the following each day:
- exercising for 2030 minutes, 23 times
- walking for 30 minutes, 23 times
In other words, you could be exercising for 2 hours each day.
Your doctor will provide recommendations for activity based on your needs and overall health. In general, they will recommend low-impact exercises over high-impact versions that can add stress to your knees.
Here are a few examples of low-impact activities and sports that you should be able to do once you recover from surgery.
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Do Follow Your Doctors Instructions On Caring For The Wound
To avoid post-op infection, be sure you understand how and when to change your bandage. If the skin aroundthe wound becomes red or drains, or if you develop a fever and chills, call your doctor right away. To avoidcomplications of a clot, call your doctor if your leg is tender, swells unduly below or above the knee, orif you develop pain in your leg or calf.
Biggest Take Away: Dont Judge Your Recovery By Other Peoples
Every hip replacement is different. Some people recover faster or slower. But more importantly, that coach on Insta may be great at training Olympic hopefuls but he knows next to nothing about orthopedic surgery.
Those people have a financial incentive to attract views on social media. But your focus should be on the long term success of your hip replacement. Is squatting 6 weeks earlier really worth taking twenty years off the life of your hip replacement? Sounds like a bad trade to me. After all, there are plenty of reasons you should keep working out into your 60s, 70s, and beyond.
Once again, just because you arent experiencing much pain immediately after an anterior hip replacement doesnt mean its safe to return to your normal exercise routine. Be safe. Be smart. Theres simply no arguing with biology.
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Naively Trusting Your Recovery To Rehab Professionals
This is the toughest one for people to understand. The medical model is focused on you being treated by rehabilitation professionals on an intermittent basis.
This frequency is by necessity low because it is costly. At most you will be seen twice a day in a rehab facility, daily to start with in home care and then usually 2-3 times per week for further home care and then in outpatient therapy.
The problem is that you will have the most success and get well the quickest if you perform your knee replacement recovery exercises 4x a day. What you really need to get into your head is that you are responsible for your success and refuse to adopt the traditional knee replacement rehab timetable which will ultimately slow down your progress.
Think That Walking And Moving Around Is The Major Achievement
Patients mistakenly think that walking is a major achievement after surgery and that walking without a walker is even better. Other healthcare professionals can misguidedly feed into that misconception making the problem even worse. The truth is that getting up and moving around after surgery is encouraged but for the first two weeks you should be protecting the joint from full weight bearing forces by using the walker. This allows you to carry a percentage of your body weight through your arms instead of on your surgical knee.
During your knee replacement surgery, the ends of your long bones have been cut and a prothesis placed over the top. Bone that has been cut can be very painful, just ask someone who has had a small piece of bone taken from their iliac crest for use in a back surgery. That bone removal site can ache for months.
If you walk around without any protection for your new knee you will likely inflame and aggravate the bones. This can cause a person to have a real problem controlling their pain. All things considered you dont want to be dealing with more pain than is already associated with the post surgical period. So use your walker.this means actually putting weight through your arms. A 4 wheeled walker is a horrible choice for this. Get the regular 2 wheeled walker and slow down a bit. Your knee will thank you and your recovery will go much faster.
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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.
What Is The Best Exercise After Meniscus Surgery
Following are some of the exercises one may perform after knee arthroscopy:
- Straight leg raises
- Partial squats
- Quadriceps stretch
One should think about returning to cycling after knee arthroscopy. Cycling is a low effort activity which implies that there is insignificant pressure on the knees. As per some research, any form of bicycling is good for the recovery process. Thus, cycling after knee arthroscopy is an advisable activity to undertake.
However, the question arises whether running after knee arthroscopy is a good idea or not. To answer that, the key isnt to surge the interaction and guarantee you return when you are prepared. It relies upon the knee activity however we generally consider rehabilitation achievements instead of time periods. Its just when you meet the achievements would you be able to get back to running/sport.
However, walking after arthroscopic knee surgery is a very good way for the movement of the joints which are operated on. It does not cause any locking in the surgery area. Thus, with a proper and slow recovery, one will feel the walking without any pain.
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How Soon Can I Go Swimming After Knee Replacement
How soon can i go swimming after knee replacement? Many people with knee replacements can resume swimming 36 weeks after surgery. But check with your doctor or physical therapist before diving into the pool.
What exercises can I do in a pool after knee replacement? Generally, it is okay to swim once the stitches come out or dissolve, which can be one to two weeks after the procedure. Any post-operation soreness should also be taken into consideration.
Can I swim 2 weeks after surgery? You will probably be able to walk on your own in 4 to 8 weeks. You will need to do months of physical rehabilitation after a knee replacement. Rehab will help you strengthen the muscles of the knee and help you regain movement.
How long does it take to walk normally after knee replacement? Baseball, basketball, football, hockey, soccer, gymnastics, jogging, rock climbing, hang gliding, parachuting and high-impact aerobics are activities that should be avoided.
How Long Does It Take To Walk Or Work After Meniscus Repair Surgery
Meniscus tears of the knee are one of the most common problems seen by orthopedic surgeons. The meniscus is a c-shaped pad of cartilage that acts as the shock absorber of the knee and lower stress on the bones and cartilage. It can be pretty painful when damaged.
All patients and meniscus tears are different, and there are many variables when deciding how to treat these tears. The treatment of meniscus tears usually falls into one of two categories:
- A true repair that involves sowing the tissue back together with stitches
- Damage that is not repairable, treated with partial meniscectomy, or trimming out the torn portion of the meniscus
The treatment approach for a particular meniscus tear depends on many factors. For one, there are many different types of meniscus tears large or small, simple or complex, acute or chronic, associated with arthritis or not, and more. In addition, we have to take into account the location of the tear with regard to its blood supply. If there is no blood supply it may have a hard time healing or scarring back together. As you can see, there are many variables to consider and it would be impossible to apply a one size fits all type of approach to the treatment of meniscus tears. This is where physician expertise and experience becomes important.
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Opinions About Swimming After A Total Knee Replacement
The general advice given by most surgical teams is that people avoid extreme sports following this type of surgery. But what about swimming after a total knee replacement would this be considered an extreme sport? Well the good news is that most surgeons agree that swimming after a total knee replacement can be a good idea. This is because swimming is considered a low impact sport on the knee. When you do something like running it will put up to nine times your bodyweight on your knee, but with swimming the impact is far less than this.
The reason why you are advised against certain sports following a total knee replacement is the risk that it could damage the artificial knee. These are very strong but they are just not as resilient as the real knee. The risk is that if you damage the knee because of high impact sports you will need to return to surgery and have the whole procedure repeated again. Obviously this is not something you want or that the surgical team wants there are risks with every surgery and you want to avoid these wherever possible. This is why doctors can be very negative about the idea of you doing high impact sports like running. They can be quite positive about activities like swimming after a total knee replacement though, because these are less likely to cause damage.
Waste Time On The Easy Exercises
Its simple. Human beings seek pleasure and avoid pain. The harder exercises like bending your knee) can be tough but they get massively better each day if you just stay at it. Many people are adept at avoiding the tough exercises by working extra on the easy exercises and guess what they will prolong their recovery time from total knee replacement, an outcome that virtually no one wants.
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Our Patient Jeannette Had Issues With Spinal Stenosis And Problems Post Knee Replacement
- Jeannette starts discussing the knee replacement complications at 3:50 in the video. Jeannette is 81 years old.
Jeannette describes a foot-tingling problem. She cannot sit down and relax at the end of the day, it is uncomfortable for her to put her feet up or down because it is tingling. She had a nerve conduction study that shows an injury to her peroneal nerve. The peroneal nerve branches out from the sciatic nerve. As it provides sensation to the front and sides of the legs and to the top of the feet, damage to this nerve would result in burning and tingling or numbness sensation in these areas. Further damage to this nerve would also cause loss of control in the muscles in the leg that help you point your toes upward. This can lead to walking problems and possibly foot drop, the inability to lift the front of the foot or ankle. Knee and hip replacement are leading culprits in the cause of peroneal nerve injury.
In Jeannettes case, she had two knee replacement surgeries in that knee. After the first knee replacement surgery, the implant started to protrude away from the limb. The knee replacement became loose. The second surgery to fix the first one occurred in 2015.
It was determined after examination that Jeannettes knee ligaments were loose. Her knee was hypermobile and unstable. This was causing pressure on her peroneal nerve. Knee ligament damage and weakness is also a complication of knee replacement surgery and is discussed further below.
Total Knee Replacement Surgery
TKR surgery is performed to treat the pain, stiffness, and loss of mobility caused by severe arthritis or a severe knee injury.
After your TKR operation, you may receive physical therapy services in the hospital. There, you may use a continuous passive motion machine to help improve the ROM in your knee.
You will also learn exercises to help regain normal strength and mobility in your knee. If you are not well enough to leave the house, you may start home-care physical therapy.
Biking can be a great exercise after a total knee replacement. Just be sure to ask your healthcare provider or physical therapist if it is right for your specific condition.
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