Recovery After Knee Cartilage Surgery
For the first few days after knee cartilage surgery, patient recovery guidelines for cartilage repairs are similar to the guidelines for any knee surgery. The focus is on knee elevation, pain relief, ice to control swelling, incision protection, and rest.
A few days after surgery, I meet with my patients to evaluate the healing process and begin postoperative treatment, says Dr. Skendzel. Patients should be prepared to be on crutches for six weeks. To encourage cartilage healing, patients will also use a continuous passive motion machine. Cartilage isnt fed by nutrients from blood vessels, but by nutrients from the synovial fluid in the joint. We know from the scientific literature that in order for the fluid to deliver proper nourishment to the cartilage, the knee has to be moving. The CPM machine straightens and bends the knee without pressure or stress on the joint. This continual motion supports good nourishment to the cartilage cells.
Most patients are able to return to some physical activity after six to eight weeks, but full recovery after cartilage repair surgery can take anywhere from three to six months.
Knee Extension Stretches And Exercises
Expect to perform a variation of these knee extension exercises:
- Quad Sets
- Seated calf stretch with towel/belt
- Standing TKE
Some patients will use a continuous passive movement machine that will repeatedly assist bending and straightening your knee slowly for hours each day for a couple weeks until they have reached a desired range of motion.
Physical Therapy Continues At Home
After your hospital stay, the CPM machine continues to keep your knee moving, even when youre sitting down. This motion helps prevent stiffness, immobility, and scar tissue buildup. For roughly the next three weeks, either at home or in a rehab facility, you continue to gain strength and mobility, with less dependence on a walker, crutches, or cane.
As you continue your daily routine of gentle, strength-building exercises, the pain gradually decreases. Dr. Woodson and your physical therapist give you personal goals to achieve each day and each week, until you can move around more comfortably.
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Total Knee Replacement Recovery: What To Expect After Knee Replacement
Nearly 1 million total knee replacement procedures are performed in the U.S. each year and that number is expected to continue rising exponentially to over 3 million in the next 15 years!
So it comes as no surprise that the most common joint replacement procedure Physical Therapists rehab in the outpatient clinic is a total knee arthroplasty or total knee replacement.
Many candidates want to know what to expect after a total knee replacement before they choose to have the surgery. Patients usually elect to have this procedure after nonoperative treatment options or knee replacement alternative surgeries fail to maintain knee function and pain levels.
For those patients that do decide to have total knee surgery, keep reading to learn more about the total knee replacement recovery process.
Getting The Best Surgical Outcomes
Final surgical outcomes depend in part on the amount of cartilage damage done, and on the type of replacement surgery used. The studies we have show that these replacement procedures are successful in about 80 percent of cases, notes Dr. Skendzel. In an ideal world, you dont want to damage your cartilage. But we live in the real world, where injuries happen. When they do, Summit has advanced surgical options to offer. Our team works with you through treatment, surgery, and rehabilitation to encourage cartilage regrowth and support the best possible surgical outcome.
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Characteristics Of Severe Arthritis Of The Knee
Pain
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.
Stiffness
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.
Location
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 .
What Can I Do To Help Ease The Pain
Once the knee replacement surgery is completed, its imperative that the patient gets up and walking on the new knee as soon as possible to prevent blood clots. Putting pressure on the newly operated joint, as well as bending the knee will cause initial pain but will fade as the healing continues. Fortunately, knee replacement surgery technology and pain management have come a long way since the first days of the procedure, so today knee replacement surgeries involve less pain and patients are able to heal faster than ever before.
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What Should You Expect After Knee Revision Surgery
Most patients who undergo revision procedures can expect to have good to excellent results. Although expected outcomes include pain relief with increased stability and function, complete pain relief and restoration of function is not always possible.
Up to 20% of patients may still experience some pain following revision knee surgery. This can persist for several years after the procedure. Additionally recovery after revision total knee surgery is heavily dependent on the state and function of the knee prior to the revision surgery.
Knee Replacement Recovery At Home And Outpatient Therapy
It would be nice if a knee replacement was like getting a new car part installed and away you go. The surgery is just the beginning of the knee rehabilitation process.
Swelling, stiffness, and strength are necessary to improve in order to decrease pain and progress therapy to higher level activities. They will be the primary focus of therapy early on to set up the patient for successful rehabilitation. It will take time for the knee tissues to heal and gradual loading to improve strength and flexibility.
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What Is Knee Replacement Surgery
Knee replacement surgery is a surgical technique to repair the knee joint. Plastic and metal prosthetic parts are attached to the bones in the knee joint. During the procedure, damaged cartilage and bone are cut away. Then an artificial joint is put in place.
This surgery might be required for someone with a severe knee injury or people who experience pain from chronic arthritis. A sports medicine doctor might recommend knee replacement surgery based on your knees strength, stability, and range of motion. A variety of surgical techniques and prostheses can be used, depending on your weight, age, knee size and shape, activity level, and overall health.
How Long Will I Be In The Hospital After Total Knee Replacement
The length of hospital stay after knee replacement will depend on:
- Replacement and incision healing routinely.
- Manageable pain levels.
- The patient being able to perform bed mobility and walking without requiring someone else doing the majority of the work for them
- Help at home from family or friends for activities that will require assistance such as driving, cooking, cleaning, moving in and out of bed, sitting down and standing up, walking, or using stairs
These are important for ensuring a patient is safe to go home. The majority of patients meet these requirements and will be out of the hospital within 1-3 days.
If a patient has delayed healing or limited support at home, they may be a candidate to be transferred to a skilled nursing facility or rehabilitation hospital for 1-2 weeks for further recovery.
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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.
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 Should I Expect During The First Six Weeks After Discharge
During the first six weeks after discharge, you should be making progress week by week. Most patients are eager to report their progress at follow-up visits and are ready to move to the next level in their recovery. Most patients can accomplish the following during the first six weeks after total joint replacement:
- Walk without help on a level surface with the use of walker, crutches or cane as appropriate.
- Climb stairs as tolerated.
- Get in and out of bed without help.
- Get in and out of a chair or car without help.
- Shower using a tub bench once staples are removed as long as there are no issues with the incision.
- Resume your activities of daily living including cooking, light chores, walking and going outside the home. You should certainly be awake and moving around most of the day.
- Some patients return to work before the first follow-up visit. This is approved on an individual basis and should be discussed with your surgeon.
Icing and elevation
After a joint replacement, swelling is expected. Swelling can cause increased pain and limit your range of motion, so taking steps to reduce the swelling is important. Continue using ice packs or some form of cold therapy to help reduce swelling.
Sexual activity after joint replacement
Many people worry about resuming sexual activity after a joint replacement.
Resuming your diet
If youre not eating well after surgery, contact your healthcare provider about nutritional supplements.
How To Assist Your Recovery After Discharge
To ensure your recovery process is as successful as possible, its important to follow your orthopedic surgeons directions as closely as possible. After discharge from the hospital, you will need to:
- Perform strength and mobility exercises and attend physical therapy.
- Maximize rest to minimize the risk of falls
- Use an assistive device such as a walker or cane
- Treat pain, discomfort and swelling with medication, cold packs and elevation
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What Should I Expect After My Total Hip Or Total Knee Replacement
NOTE: The following is a general guide to care following your procedure. Your healthcare provider may have somewhat different instructions for you. Please follow those.
After total knee or total hip replacement surgery you can expect gradual improvement over the coming months. You should gradually expect less pain, stiffness and swelling, and a more independent lifestyle. Returning to work depends on how quickly you heal and how demanding your job may be on a new joint.
After you are discharged from the hospital or rehabilitation facility, there will be a few weeks before you return for a follow-up visit with your surgeon. This period of time is critical in your rehabilitation and you may require outpatient therapy services for positive long-term results from your surgery.
In general, patients do very well after discharge. However, its important that you contact the surgeons office if any of these occur:
- You have increasing pain in the operative site.
- There is new or increased redness or warmth since discharge.
- There is new or increased drainage from your incision.
- The operative site is increasingly swollen.
- Your calf becomes swollen, tender, warm or reddened.
- You have a temperature above 101 degrees Fahrenheit for more than 24 hours.
- For total knee replacement, your ability to flex has decreased or remains the same as when you were discharged from the hospital.
What Happens In The First Few Days After A Knee Replacement
After knee replacement surgery, youll remain in the hospital for 1 to 5 days and youll most likely start working with a physiotherapist immediately.
Its perfectly normal to experience pain, swelling and bruising in the first few days after your knee surgery but its still important to do your best to move your knee as much as possible as soon as possible. But, you shouldnt be putting any weight on your leg at this point.
Generally, knee replacement patients can leave hospital when theyre able to:
- Get in and out of bed and walk a short distance with the help of a walker or crutches
- Walk up and downstairs with a walking aid
- Bend the affected knee 90 degrees
- Understand the precautions to avoid potential injuries
However, different hospitals have discharge criteria. Keep in mind, you might continue to use a walking device once you leave the hospital.
You might have to stay in hospital longer if:
- You have had two knees replaced at the same time
- Uncontrolled pain
- General weakness
- Other pre-existing medical conditions
Some doctors also prescribe whats called a Continuous Passive Motion machine that will move your leg manually without your assistance. Its important for the health of your knee joint that it doesnt stay still for too long.
While your knee is bandaged, you may not be able to have a full shower for 5 to 7 days and it could be up to 3 or 4 weeks before the wound should be soaked in water at all.
Remember, youre recovering from major surgery.
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Individualized Workouts At The Fitness Center
When I am not going to the therapist, I go to my Fitness Center on alternate days. It has been easy to take what I have learned from therapy sessions to the gym.
I now ride the stationary bike for up to 30 minutes. I use the leg press machine for leg extensions. I use other machines to push and pull with my leg.
I use the Captains Chair for knee lifts and extended leg lifts . Im sure you have your favorite exercises too.
I use exercise balls for squats and ankle slides and I use the bands for leg extension exercises.
I am also using the machines for upper body workouts while I am at the fitness center. My wife drops me off at the center and then I walk the mile home after my workout and then immediately ice my knee.
What To Expect After Meniscus Surgery
Here are a few things to keep in mind about the recovery process for meniscus surgery:
- Most patients are on crutches for only 1 or 2 days after surgery on the meniscus. Sometimes, you may be instructed to be on crutches for 4-6 weeks, but this is much less common. Prior to scheduling surgery, youll want to have a discussion with your orthopedic doctor about whether you will have such restrictions. This way, you can prepare accordingly by obtaining crutches if necessary.
- You may also need to wear a brace after meniscus surgery to help stabilize your knee and control range of motion while it heals.
- Physical therapy is commonly prescribed to help strengthen the knee and restore range of motion following meniscus surgery. Asking your orthopedic doctor whether you are likely to need physical therapy will help you know what to expect after meniscus surgery.
- The timeline for your recovery will depend largely on what type of meniscus procedure you undergo. If part or all of your meniscus is removed through a meniscectomy, you can generally expect your recovery period to be about one month.
- The recovery time for surgical meniscus repair can be a bit longer around three months, generally speaking. Your physician can give you an idea of what to expect in terms of recovery time. Bare in mind that this will only be an estimate, as healing time varies from patient to patient.
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Recovering From A Total Knee Replacement : A Surgeon / Caregivers Perspective
I had the opportunity to experience recovery from a TKA through the eyes of a close family member, who I, as a joint replacement surgeon was the primary caregiver. This experience gave me a new appreciation of what our patients experience in the weeks after TKR. I will break this up into segments: pre-op, day of surgery and the first day of recovery, day 2- day 6, and weeks 2-6.
Day of Surgery and First Day of Recovery
You are on your way to enjoying your new knee but some hard work will be required. Dont get discouraged remember to ice and elevate. See the picture above the post. Notice the foot is higher than heart and ice cuff on the knee. Remember, the knee is straight to assist in gaining knee extension.