Total Knee Replacement Surgery: What To Know And What To Expect
What is knee replacement?
Knee replacement surgery is a technique first used in 1968 in which the doctors replace the knee joint with pieces of metal alloy, polymer, and synthetic plastic. Since, 1968 the improvements in surgical techniques and materials greatly increase the effectiveness of knee replacement surgery. Total knee replacement is one of the most successful surgical procedures in the history of medicine. Whether you are just exploring the treatment options or already deciding to have total knee replacement surgery. It is important to understand a lot of things before getting this procedure done. If your knee is suffering from severe damage due to an injury or arthritis, then it may be hard for you to perform daily activities such as climbing stairs or even walking.
If non-surgical treatment such as walking supports and medications are no longer beneficial then you might want to consider total knee replacement surgery. Total knee replacement surgery also known as knee arthroplasty is an effective and safe procedure to help in correcting leg deformity to relief pain and helping you to resume daily activities. In the procedure of total knee replacement surgery a surgeon resurfaces the damaged knee by either plastic or metal parts to cap the bony ends forming the knee joint. The option of total knee replacement surgery is only for those who have severe knee injury or severe arthritis.
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Climbing Stairs The Same Day After Knee Replacement Its True
By Joon Nah– Certified Vestibular Physiotherapist and Founder, Therapia Posted on April 15, 2018
In a recent article in the Toronto Star, Dr. David Backstein operated on a patient at Womens College Hospital who walked hours after a knee replacement. He went home on the same day as surgery and even was able to climb stairs prior to discharge.
The key to successful outpatient total joint replacement appears to be the use of modern anesthetic techniques that encourage early mobility, motivated and healthy patients, and effective multi-modal pain management strategies.
While there is a great deal of expertise and coordination involved in sending patients home using such a day-surgery model, the road to recovery requires further optimization of the home for navigating the post-operative journey. Early physiotherapy focusing on quadriceps activation, swelling control, and range of motion is critical to managing inflammation and encouraging mobility and function. With the right home physiotherapist, early gait training and attention to performing activities of daily can make the transition from hospital to home smooth and seamless.
Install Fall Prevention Equipment
While you wont be walking much right after your knee surgery, its inevitable that youll need to move around your house. Walking is an essential part of your recovery.
A loss of balance and a need for space can increase the risk of a fall. Apart from decluttering, other preventive measures include:
- installing a handrail in the bathtub or shower and next to the toilet
- having a bath mat ready to prevent slipping
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Loss Of Muscle Power Discovered After Unilateral Knee Replacement
Knee replacements are common among older adults with painful joint arthritis. It has been assumed that the decrease in pain after recovery from joint replacement surgery translates into improved motion, strength, and function. But Physical Therapists working with these patients have noticed problems with climbing stairs and a slower walking speed long after recovery and rehab.
Rehabilitation researchers around the world have confirmed these observations. Measures of muscle strength, CT scans showing muscle cross section, walking speed, and time to complete stairs have provided quantifiable evidence to back up this finding. Now similar results have been observed in patients who have a unilateral knee replacement . Unilateral knee replacement refers to an implant for half of the joint. Usually the medial side of the knee is replaced most often because that’s where most of the wear and tear occurs in many patients.
In this study, Physical Therapists from Finland take a look at just how bad is this muscular weakness and loss of power. Being in the business of rehabilitation, they need to pay attention to this problem in their patients. They measured strength of flexor and extensor muscles of patients who had a unilateral knee replacement within the last 18 months. Adults in good health between the ages of55 and 75 years old were selected to participate.
How Long Does The Implant Last
All joint implants have a limited life expectancy, and many factors play a role in the longevity of the implant. These include the patients age, weight, activity level, quality of bone stock, and compliance with doctors orders.
Proper alignment and positioning of the implants is also crucial to the life expectancy of the implant. With our Robotic-Arm Assisted Surgery System, our surgeons can achieve superior results in the alignment and positioning of the knee and hip joint implants, which results in overall better outcomes for our patients.
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Insomnia After Joint Replacement
One of the most common complaints after knee or hip replacement is difficulty sleeping. By six weeks after surgery, most people are having less pain in their new joint and increasing their activity. But they often lay awake at night, unable to sleep. Why does this happen and what can be done about it?
Many people have difficulty sleeping in the hospital immediately after surgery. This has many causes, including the stress response to surgery, cytokine release from soft tissue injury, the pain, medications, and the hospital environment. REM sleep is diminished for the first few days after surgery.
Surprisingly, there are no published studies on the frequency of sleep disturbance several weeks or months following joint replacement surgery. However, in one study of patients with broken bones, 41% of patients with shoulder fractures and 36% of patients with knee fractures had difficulty sleeping 3 months after the injury. Even a year later, 20% of patients still reported insomnia.
Insomnia after joint replacement surgery can have many causes. Pain and discomfort are common complaints. Narcotic pain medicines can also disrupt sleep patterns, and decrease the time spent in REM sleep.
Depression is not uncommon after surgery. Sometimes the recovery period can be quite overwhelming. Symptoms can include persistent feelings of sadness and hopelessness. Difficulty sleeping, loss of energy, anxiety, and irritability can also be symptoms of depression.
Hip Replacement Surgery In Farmington Hills Michigan
If you are suffering from chronic hip pain that has been hindering you from performing regular, routine activities on a daily basis, hip replacement surgery is an effective treatment option. Your rehabilitation and recovery will include learning how to climb stairs with your new prosthetic hip joint. Following your doctors orders will make the process easier and speed up your recovery.
Here at Tri County Orthopedics in Farmington Hills, Michigan, our orthopedic surgeons are highly skilled and experienced in the evaluation and diagnosis of various musculoskeletal conditions. We are dedicated to helping you navigate the steps toward treatment and recovery.
You can get in touch with us by calling 474-5575 or by filling out our appointment request form. We look forward to serving you.
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Returning To Activities / Sports
With knee replacement recovery time is one of the biggest healers. Over time the swelling will reduce, your muscles will get stronger and your knee should free up becoming more flexible than beforehand.
It is important to take things easy for the first few weeks but after that, you can start thinking about returning to your favorite activities. Here are some helpful tips on knee replacement recovery time:
- You can resume most activities after 6-12 weeks, for example swimming
- Some activities should be carried out with care e.g. golf dont wear shoes with spikes
- Some activities are not advised following a total knee replacement as they put too much stress on the new knee joint. These include: jogging, contact sports e.g. basketball and football, squash, badminton, jumping activities and skiing. If you are unsure, discuss things with your doctor.
Pain and swelling can take up to 3 months to settle and knee replacement recovery time continues up to 2 years after your operation.
Preventing Or Avoiding Total Knee Replacement
If injections and Physical Therapy have failed to provide pain and function improvements, a scope surgery may help put off or avoid an otherwise inevitable total knee replacement.
Knee replacement surgery is a much more involved and drastic change of structures to the knee compared to a knee scope.
This makes knee replacement recovery much longer and more difficult.
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How Can I Climb Stairs Without Hurting My Knees
Follow these strategies to make navigating stairs easier and less painful. Go up with your stronger leg, and down with the other. Always use the handrail. Put your entire foot on the step of the stairs. Carry items in the right bags. Get up to move regularly throughout the day. Do simple exercises to strengthen your legs.
The Knee Replacement Recovery Timeline
Looking forward to an improved quality of life after knee surgery? Knee replacement surgery is a highly effective solution for repairing the knee and restoring its function. Its been common in the sports medicine industry for some time, and has provided remarkable results for people of all ages. Older adults are candidates for a knee replacement if they have swelling, stiffness, and pain that makes it difficult to walk, stand or climb stairs, bothers them while resting, or disrupts their sleep. The good news is that for older adults, the risks are relatively low.
Youre ready to feel less pain and move more easily, but you may have questions about knee replacement recovery time:
- How long will it take to recover?
- What can I do after the surgery?
- How can I make sure its successful?
- Where can I get help afterward if I need it?
Knowing what to expect and what to do after surgery is vital to a quick and full recovery. The first few weeks will take planning, and youll probably feel fully recovered after 6 to 12 months. Read on to understand what to expect during the knee replacement recovery time.
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Climbing Stairs During Physical Therapy
Learning to climb stairs with an artificial hip is an important part of your physical therapy program after surgery. Your physical therapist will focus on strengthening muscles that work against gravity to help you progress as quickly as possible. These muscles are responsible for keeping you upright while you walk. Exercises that you may complete during physical therapy and at home include:
- Calf and ankle strengthening
- Hip hikers
- Bridging
Your physical therapist will decide which of these exercises are right for you and explain them in detail if he or she asks you to do them.
Common Anterior Hip Replacement Recovery Questions
When Can I Use The Stairs
- As soon as you feel comfortable and stable
When Can I Drive Again
- Driving depends on which hip had surgery and your individual use of pain medications but often patients start driving after 1-2 weeks
When Can I Resume Sexual Activity
- Sexual activity can be resumed at your comfort so long as anterior hip precautions are abided by
When Can I Return To Work
- It all depends on what you do for work, patients with sedentary jobs can return as early as 1 week, others with high impact jobs may require 4-6 weeks.
When Can I Start Exercising
- Walking starts day 1
- Non-impact exercises like the exercise bike, swimming, and elliptical can be started within 1 week of surgery
- Heavy impact exercises like tennis and weight lifting can be resumed after 6 weeks
When Can I Travel On An Airplane?
- 2-4 weeks after a hip replacement with restrictions. Please speak to the office about air travel recommendations as it can vary from patient to patient
Will I require antibiotics for dental cleanings or dental work?
- Dental work poses a risk for infection close to surgery so it is recommended you wait 4 weeks after surgery prior to any dental work. Additionally, for 3 months from the date of surgery, Dr. Martin recommends an antibiotic for any dental work. After this time period, the dentists or treating specialist will decide.
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How Do You Go Down Stairs Without Hurting Your Knees
Follow these strategies to make navigating stairs easier and less painful. Go up with your stronger leg, and down with the other. Always use the handrail. Put your entire foot on the step of the stairs. Carry items in the right bags. Get up to move regularly throughout the day. Do simple exercises to strengthen your legs.
How Does The Pre
Every patients anatomy is different. The robotic-arm technology allows the surgeon to create a customized plan for each patient based on a 3D virtual model of their individual anatomy. This allows the surgeon to perform the procedure as accurately as possible.
First, a CT scan is taken of the diseased joint. This scan is then uploaded into the robotic system software, where a 3D model of your hip/knee will be created. The surgeon uses this 3D model to pre-plan your surgical procedure. In the operating room, the surgeon will know precisely where to prepare the bone for the implant, and the robotic-arm system guides the surgeon to stay within the pre-defined area. This helps to provide optimal placement and alignment of your implant.
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How Should I Climb Stairs After Knee Replacement Surgery
After knee replacement surgery, be safe with stairs. If you must climb stairs, there are a few things to keep in mind to be safe:
- Avoid stairs if you are unsteady or dizzy.
- Climb the stairs one at a time.
- Do not switch feet for each new stair.
- Use crutches if instructed by your therapist. Your therapist will have you practice stair climbing, if needed.
What To Expect During And After Your Joint Replacement
When you arrive on the day of your surgery, youâll meet with an anesthesiologist to discuss your options. Youâll also meet with your surgeon to go over any last-minute questions and confirm the surgical site.
Once in the OR, your surgeon will use your pre-op CT scan to precisely guide the robotic arm and replace the joint.
After surgery, you will stay in the recovery room until youâre awake and comfortable. You may have therapy before you go to the nursing unit to settle in.
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What Does Up With The Good And Down With The Bad Mean
When you first learn how to ascend or descend stairs after your knee replacement surgery you will hear the phrase, up with the good and down with the bad.
This basically means that your surgical leg will be your support leg while going upstairs. Each step you take up the staircase will be led by the non-surgical leg. Then the surgical leg will trail the non-surgical leg.
When you are walking downstairs you will do the opposite. Your surgical leg will lead the way because your non-surgical leg will be your primary support leg.
Here is a video explain this process.
Is It Ok To Elevate Legs While Sleeping
When youre sleeping, when youre lying on the couch for a night of TV or movie-viewing, and even if you can get horizontal for a little while during the day, arrange some pillows in a comfortable formation to get your legs elevated 6 to 12 inches above your heart. Leg elevation, youll notice, feels good immediately.
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Guidelines To Protect Your New Knee Joint
It is very important to KEEP YOUR KNEE STRAIGHT WHILE RESTING, never place a pillow under the back of your knee. Place your heel on a rolled up towel, ottoman, or chair so air is under the knee, push the knee down in extension. This is the most important stretch or exercise after knee replacement, this will help you regain full extension.
We encourage you to walk, get outside, and work on your motion. We strongly encourage the use of ice for the first few weeks after surgery. You will receive a polar care or ice machine which cools the knee which is particularly helpful after therapy.
Lying in Bed: You may lie on either side. Remember never to put a pillow under your knee. Keep your knee out straight while lying down.
Sitting in a Chair: Use a firm, sturdy chair with arm rests.Allow your foot to rest on the floor if you can. Use a cushion or pillow to raise you up, if needed, to facilitate getting out of the chair.
Walking: YOU MAY PLACE ALL OF YOUR WEIGHT ON YOUR KNEE. The physical therapist will teach you to use a walker or crutches when you walk until your knee heals. Most people are walking normally after 3 weeks. Most only use crutches to provide balance and to ensure a normal gait in the first few weeks of recovery. Once a normal gait is established you may discontinue using your crutches, cane, or walker.
Your balance might be shaky for a while, we recommend that you:
Dangers Of Doing Certain Exercises Too Soon
Performing movements or exercises that are too intense can increase the chances of loosening or fracturing the bones around the implant.
Pushing too much can also lead to increased pain and swelling around the knee, slowing down the rehabilitation process and making it more difficult to exercise.
Symptoms of pushing too hard during the recovery program might include:
- increased pain
- swelling of the knee or lower leg
- warmth around your knee
If you experience any of these symptoms, its best to back off of the activity and ice your knee for 15 to 20 minutes.
If the symptom persists, call your healthcare provider.
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