Exercise And Getting Around
Your physical therapist will encourage you to begin walking as soon as possible. At first, you will use an assistive device, but it is best to use this only as long as you need it. Walking without a device will help you regain strength in your knee.
Working with the physical therapist for those first weeks is important as it will allow the therapist to detect any knee problems.
You can start walking farther and begin to engage in other activities after about 12 weeks.
Swimming and other types of water exercise are good options, as these low-impact activities are easy on your knee. Make sure your wound has completely healed before entering a pool.
Avoid placing weights on your leg and doing leg lifts on weight machines for the first few months, until you get the go-ahead from your physical therapist or doctor.
Your new knee will make it much easier to engage in a diverse array of activities. However, its important not to put too much stress on the joint.
The AAOS recommends the following activities:
Go Back To Work Too Soon
Like Saggio, you may be tempted to return to your job ASAP. But don’t give in.
“I’ve seen plenty of people try to do work while they’re still in the hospital — with a computer and cell phone,” Whiteson says. “They’re not coherent, let alone able to make good decisions.”
Plan in advance for time off and ask your doctor when you can return.
Our Patient Jeannette Had Issues With Spinal Stenosis And Problems Post Knee Replacement
- Jeannette starts discussing the knee replacement complications at 3:50 into 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.
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Why Does My Knee Replacement Hurt So Much At Night
At the same time, your activity level has likely increased due to the demands of your ReHab program. This can cause even more physical pain that can spike during bedtime. Narcotic Pain Medications: It seems there are several vicious cycles youre a part of when it comes to joint replacement recovery and sleep.
Getting Cleared To Drive After Tkr Surgery
Before driving youll want to consult with your doctor. My doctor did not give me a timeline on when I could drive. He told me that when I felt like I was ready that I should take short drives around the neighborhood . I had surgery on my right knee, which of course is the leg you use most to accelerate and break with.
If I had a front bench seat I think I would have been able to drive earlier using my left leg while propping my right leg up on the seat. Years ago when I broke my right leg I drove left-footed with my right leg on the bench seat for several months using a car with an automatic transmission.
After taking a short drive in the neighborhood, I began driving myself to physical therapy appointments on week five post-surgery. I also drove on short errands. It was nice to be self-sufficient again, but for any driving over 20 minutes it was nice to let someone else take the wheel.
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How Long Before You Can Drive After A Full Knee Replacement
When can I drive? If you had surgery on your right knee, you should not drive for at least 4 weeks. After 4 weeks you may return to driving as soon as you feel comfortable. If you had surgery on your left knee, you may return to driving as soon as you feel comfortable if you have an automatic transmission.
Total Knee Replacement Guide For Your Return Home
Getting Into Your Car
- Sit down on the edge of the car seat
- Swing one leg over into the car, then the other
- Pivot in seat to face forward, buckle seat belt
Getting Out Of the Car
- Reverse the above process, but be sure to bend and straighten your operative knee first before you get out of the car as it can get stiff during your ride home
Opening A Door
- When door swings away: Walk up as close to the door as possible, while holding onto your walker/cane with one hand, open the door fully and then walk through
- When door swings toward you: Stand to the side of the door, open the door then walk through
- DO NOT PLACE THE WALKER LEGS OR THE CANE TIP ON THE DOOR SADDLE
Home Environment – Sitting/Seating Preferences
- In general, you can shower approximately 3 days after surgery if the wound is dry. Limit the amount of time water is exposed to the incision site. Pat the incision dry when finished
- Do not immerse the incision in a tub or Jacuzzi for at least 3-4 weeks after surgery
- Remember, you just had major joint surgery. Your joint needs time to heal and has to be eased back into daily activities
- Slowly increase your daily activities to a level similar to your normal daily activity level
- While there is no physical restriction related to your total knee replacement that would prohibit kneeling, many do not feel comfortable doing so. Speak with your doctor or therapist if you have difficulty kneeling
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The Unexplained Noises My Knee Is Making
This is something we typically hear in a post-knee replacement patient who is having some challenges.
I started to become concerned when I noticed a clunking and clicking sound coming from my knee. Like metal on metal. My doctor told me that this was no concern, some people who get knee replacements have these old car, sounds come from their knee. Not to worry. My doctor did advise me that the sounds if they continued could be caused by weakened muscles and tendons in my knees and I should consider an exercise program to tighten them up.
I did ask if the knee implant was coming loose. My doctor said, if it were, I would not be able to walk up and down stairs or even put weight on that foot. I would have a lot of swelling and I would feel like my knee may give out. I looked at the doctor and said, BUT I DO HAVE THOSE SYMPTOMS, Yes you do, the doctor said, but it is not from implant loosening. You probably just need to strengthen that knee up.
Sport And Exercise After A Hip Replacement
If you want to enjoy any outdoor activities whilst on holiday these can all be managed the same way as before but remember you should get advice from your doctor or physiotherapist, especially if you have had the operation recently.
Arthritis Research UK suggests that regular exercise is really important when it comes to lessening the risk of developing arthritis in later life. Having a large operation like a hip replacement shouldnt leave you bed bound long-term, nor should it discourage you from exercising regularly.
They also say that it is perfectly fine to walk and swim, but remember that cycling should be avoided until around 12 weeks post-operation. Running on hard surfaces like the road is discouraged, as it can have negative long-term effects. So, sports that involve sudden turns or impacts like squash or tennis are not ideal for those who have had a hip replacement. But we always advise consulting your physiotherapist for more in-depth guidance on what should and shouldnt do.
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Characteristics Of Severe Arthritis Of The Knee
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.
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.
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 .
Things To Check Before You Fly
If youve had any kind of major surgery, ask Dr McLean to clarify your restrictions and any help you may require, prior to booking your flight.
Airline Each airline has its own regulations about flying after surgery. Check with your airline before you fly, particularly if youve had complex surgery. Also, check the hand luggage restrictions with your airline. No airline will not allow you to sit in an emergency seat. You may have to purchase an extra seat if you cannot sit normally .
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Travelling With Your Medicines
Always carry medicines and medical equipment in their original, correctly-labelled packages. Carry your medication in your hand luggage with a copy of your prescription .
Pack a spare supply of medication in your suitcase or hold luggage in case you lose your hand luggage. Check that the expiry dates of your medicines will be valid for the duration of your visit abroad.
Some medicines need to be kept at room temperature or stored in the fridge. If you are travelling to a warm country, get advice from your pharmacist about storing your medicine. For example, to keep your medicine at the right temperature, you may need to store it using:
- A thermos flask
Security Screening When Traveling After Joint Replacement
Hip and knee replacements are made of metal and will be detected by most metal detectors at airports and other security screening stations. Prior to the terrorist attacks of 2001, airline screeners would accept a card or physician note stating that a metal implant had been placed and no additional screening was needed. That is no longer the case. The TSA will not accept any card as proof of a joint replacement. If a metal detector is set off, additional screening will be required.
The use of full body X-ray scanners at most airports in the United States has made travel much easier for the millions of travelers with metal implants. Although the metal implant will be picked up by the X-ray scanner, it will be clear that the metal is in the bone. Occasionally, a simple pat down of the body part is done, but the screening process is much less time consuming than it was previously. Additionally, people with pacemakers or other implanted electronic devices who used to have to bypass the metal detector and be screened by hand now can usually pass safely through the X-ray scanner.
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When Can You Travel After A Hip Replacement
Again, as recommended by the Royal College of Surgeons, travelling is to be avoided for at least three weeks following surgery.
Getting in or out of a car, or sitting for long periods of time is potentially damaging for soft body recovery tissues. Post-surgery therapy usually includes a strict daily routine that shouldnt be interfered with in the first few weeks. So its important to rest up and allow yourself to recover before thinking about any travel plans.
When Can You Resume Swimming After A Surgery
Although recognized as a low-impact sport, swimming is a relatively poor choice in activity after surgery. If youre bound in a cast or stitched up, the water can soften the materials and reduce their efficacy. Worse, if you still have an open wound, you risk infecting it underwater. This includes public pools, fresh water lakes, oceans and even tubs.
Everyone recovers at a different pace, so you should consult your doctor before jumping into the water. 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.
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Doctors Dont Know Who Can And Who Cant Kneel After Knee Replacement
A February 2021 study comes to us from the Australian National University. In this paper, the researchers suggest that despite patients desires to kneel after knee replacement, there is no evidence or guidelines to offer patients on which knee replacement hardware would be best for them. Here is what the researchers wrote in the journal Knee Surgery, Sports Traumatology, Arthroscopy.
Modern total knee replacement prostheses are designed to restore healthy kinematics including high flexion . Kneeling is a demanding high-flexion activity. There have been many studies of kneeling kinematics using a plethora of implant designs but no comprehensive comparisons. . .The aim of this systematic review was to determine whether there are any differences in the kinematics of kneeling as a function of total knee replacement design.
In this study, the researchers examined 26 previously published articles on different knee replacement implant designs. What they found were limited findings. Too many designs, too many differently conducted studies. What does this mean to the patient who asks their surgeon about their ability to kneel after knee replacement? The researchers concluded: There remains a need for high-quality prospective comparative studies to directly compare designs using a common method. In other words, we cant tell you for sure.
Riding In A Car Home From The Hospital
One of my first big challenges after TKR was getting into a car for the ride home from the hospital. I was wheeled out of the hospital in a wheelchair.
My son was waiting with his compact car . A larger car like our SUV would have made things much easier.
Our first idea was for to me to sit in the back with my leg outstretched on the seat. Getting from the wheelchair, standing up and then getting in the car was harder than I had thought.
I tried several times to get in the back seat from both doors but I could not get in easily because I could not bend my knee. After several attempts, I gave up.
I was able to get in the front seat passenger seat without much trouble but I was afraid that it would be painful because I could not elevate the knee. The twenty-minute ride home was actually pretty comfortable probably due to the pain medication I had recently taken.
Once I arrived home it took a few minutes to get out of the car and up with my walker. My son parked in the garage so that I had a short walk into the house with no stairs .
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Orthopaedic Surgery Will Impact Your Physical And Psychological Ability Travel Comfortably By Plane
Surgery will impact your ability to transit the airport, tolerate turbulence and sit comfortably in a chair for the required duration of the flight. A broken bone will significantly impact your ability to tolerate turbulence. The following factors should be considered and understood BEFORE choosing to book or board your flight.
Climbing The Stairs After Hip Replacement Surgery
As with walking, climbing the stairs after hip replacement surgery is a process. Once you can walk confidently and have been discharged from hospital you should be able to climb stairs.
During recovery, the NHS will provide you with crutches , so any physiotherapy programme will involve the use of a walking aid in terms of navigating you back to a certain level of mobility.
The walking aid will be crucial in helping you get up and down flights of stairs. To climb stairs, you need to lead with your stronger leg and to come downstairs you should lead with your weaker leg on the side where the hip has been replaced. The walking aid should always be positioned on the opposite side of your repaired hip.
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