What Is Physical Therapy
Physical therapy is a health care service that helps you restore body movement and your physical functionality through non-invasive methods.
For example, a physical therapist may help someone learn to walk again following a stroke or injury. For those who have had a knee replacement, a physical therapist is an important part of the healthcare team. By working closely with your physical therapist, you can regain the range of motion in your leg, helping you return to the activities you once enjoyed.
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.
Preparation Before Surgery Is Just As Vital To Healing As What You Do Afterward
A little preparation can go a long way. At HSS, we take many steps before and after surgery to help our patients heal faster. For example, we offer specialized programs to help people lose weight and quit smoking before surgery, since research has shown those measures can help speed recovery. Our pre-habilitation program gives patients a chance to build strength in certain muscles around the knee prior to surgery. We also provide very personalized support for patients with sleep apnea, and other conditions that could have an effect on recovery.
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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.
When Can A Knee Replacement Patient Leave The Hospital
Most knee replacement patients will be discharged once pain is under control and they are able to:
- Get in and out of bed and walk short distances with the aid of a walker or crutches
- Get into and out of bed and get up and down stairs
- Bend the knee 90 degrees
- Follow precautions to avoid injuring the new knee
Discharge criteria can vary depending on the patient and the hospitals policy. For example, some hospitals may require the patient to only bend the knee 80 degrees.
Some patients meet the criteria for discharge after just one or two days. People who have two knees replaced at the same time, certain pre-existing medical conditions, uncontrolled pain, or general weakness may be kept in the hospital longer.
Discharge to a rehabilitation facilityPatients who live in multi-level homes, who do not have live-in caregivers, or who face other rehabilitation challenges may be discharged to a short-term care facility that provides health care and physical and occupational therapy. These stays may be covered by insurance, depending on the policy and patient circumstances.
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Looking For Alternatives To Total Knee Replacements
We’re also funding research which is investigating alternative approaches to total knee replacement. For example, total knee replacement is not recommended for many young people. This study aims to develop a new method called ToKa®, which uses images of the patient’s joint and specially designed software to design a patient specific implant that will be made via 3D printing. If successful, this technique could prevent osteoarthritis patients from needing total joint replacement.
Risks Of The Procedure
As with any surgical procedure, complications can occur. Some possiblecomplications may include, but are not limited to, the following:
Blood clots in the legs or lungs
Loosening or wearing out of the prosthesis
Continued pain or stiffness
The replacement knee joint may become loose, be dislodged, or may not workthe way it was intended. The joint may have to be replaced again in thefuture.
Nerves or blood vessels in the area of surgery may be injured, resulting inweakness or numbness. The joint pain may not be relieved by surgery.
There may be other risks depending on your specific medical condition. Besure to discuss any concerns with your doctor prior to the procedure.
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How Long Will The New Knee Joint Last
For 8090% of people who have total knee replacement, the new joint should last about 20 years, and it may well last longer.
If you’ve had a partial knee replacement, you’re more likely to need a repeat operation about 1 person in 10 needs further surgery after 10 years.
The chances of needing another operation is greater if you’re overweight and/or involved in heavy manual work.
How Long Does Recovering From Knee Replacement Surgery Take
When patients and their orthopedic surgeons agree that knee replacement surgery is a good option, one of the first questions or concerns usually is how long will the recovery process take? The simple answer would be about 13 weeks to recover. This timeline is dependant on a lot of factors such as type of procedure, limiting complications, and being consistent with their doctor and physical therapy visits.
Patients typically have a good understanding of the benefits of having a knee replaced, but they also appreciate knowing what is required to reach those benefits. A knee replacement, otherwise known as knee arthroplasty, is one of the most successful surgeries performed throughout the world. If you want to be a part of the 90% of people with a well-functioning knee, 15 years post-surgery, understanding each part of the recovery process can help you with that goal.
Balanced Physical Therapy has combined real-world experience with proven clinical research from around the internet to help you better understand each part of the recovery process, specific timelines for recovery, and why each element is essential.
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How To Get Rid Of Unused Opioids
Do not keep unused medicine in case you think you may need it. Having it in the house where other adults, children or pets could reach it is unsafe.
- To get rid of unused opioids, bring them to a drop-off location or to an Allina Health Pharmacy. To find a location near you:
- Minnesota: Go to pca.state.mn.us and type household hazardous waste in the search box.
- Wisconsin: Go to dnr.wi.gov and type health care waste in the search box.
A Few Alternative Exercises I Prefer
I have been very active all of life and I continue to be active after knee replacement. I have been able to continue with some of my old activities but I have also found new activities that I can enjoy.
Until I was 55, I played softball and basketball on a regular basis. I still play catch now and then, shoot a few baskets, and make a trip to the batting cages but I no longer engage in competitive play.
Pickle-ball has taken the place of softball and basketball. I play doubles and the reflex reactions and cardio workout keep me fit and sharp.
I can choose to play recreationally or I can opt for more competitive games. Pickle-ball was a great way to meet new friends when I moved to a new area.
Occasional games of golf and ping-pong also help to fill the gap left by basketball and softball. Before knee replacement I walked, hiked, swam and cycled.
All four are enjoyable ways to get outside and build up the muscles in my legs and get some cardio benefit as well.
Swimming as become one of my favorite exercises because I am able to get a full body workout. Continue to work out 3 to 4 times in the gym .
Have your physical therapist develop a workout program for you once you complete formal physical therapy.
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When Can I Stop Using A Cane After Knee Replacement
Within two weeks of surgery, some patients may walk without any device in the morning, but become tired in the afternoon and need the device again. The same concept applies to changing surfaces , inclines, or steps. It may be easier to walk in the house on a firm and predictable surface without a cane or walker, but going outside on uneven and unpredictable ground would be safer with an assistive device.
On the other hand, walking without a limp while using a walker will be necessary before moving on to walking with a cane or no assistive device at all. Tossing the walker or cane to the closet too soon can cause delayed recovery and possibly not regain a normal gait pattern.
Almost every PT has had a strong-opinionated patient that chose to walk without a walker or cane before the therapist was in agreement and had less successful outcomes in terms of their walking abilities. It is highly recommended that an assistive device is used for as long as needed to achieve the required strength, flexibility, and gait pattern.
This process requires patience and understanding from the patient that every surgery and recovery is different. This means that even though someone they know was walking without a walker after surgery before they are that they are not necessarily behind.
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Knee Replacement Pain A Year And Beyond
The goal of knee replacement surgery is to help you get back to the activities you love. Your doctor will encourage you to stay fit through activities like swimming, cycling, and even golf. This type of exercise will help you stay limber and pain-free.
On the contrary, there are certain activities that could negatively affect the prosthetic joint materials in place. Even normal use will begin to wear out the implants, but excessive weight or activity can cause your knee replacement to loosen and become painful. You may need to avoid running, jogging, high-impact exercises, and contact sports for the rest of your life following surgery.
The good news is that studies show more than 90% of total knee replacements are still functioning properly 15 years after surgery. Staying healthy and following the advice of your doctor will help you achieve these long-term benefits.
While its possible for pain to persist for a year and beyond, it shouldnt be debilitating. Scar tissue can continue to heal, as well as the muscles in your knee, but if youre suffering from ongoing pain after a year, always talk to your doctor.
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Try To Recover Using The Least Possible Pain Medicine
The first 7-10 days after surgery, you will be struggling with chemical pain induced by the trauma that your knee has undergone. Marines, and other really tough guys get humbled by this pain and you do yourself a grave disservice to try to muscle through this period. You will waste valuable time feeling poorly and will have limited success advancing your range of motion, the most improtant goal. This tactic will also ensure that you are taking narcotic pain medication for a longer period.
However if you take your pain meds as prescribed, and work hard, you can be off narcotic pain medicine in two weeks or at least by the time you finish gaining back your range of motion. Gotta get the range then you can back off pain medicine.
Reasons For The Procedure
Knee replacement surgery is a treatment for pain and disability in theknee. The most common condition that results in the need for kneereplacement surgery is osteoarthritis.
Osteoarthritis is characterized by the breakdown of joint cartilage.Damage to the cartilage and bones limits movement and may cause pain.People with severe degenerative joint disease may be unable to donormal activities that involve bending at the knee, such as walking orclimbing stairs, because they are painful. The knee may swell or”give-way” because the joint is not stable.
Other forms of arthritis, such as rheumatoid arthritis and arthritis thatresults from a knee injury, may also lead to degeneration of the kneejoint. In addition, fractures, torn cartilage, and/or torn ligaments maylead to irreversible damage to the knee joint.
If medical treatments are not satisfactory, knee replacement surgery may bean effective treatment. Some medical treatments for degenerative jointdisease may include, but are not limited to, the following:
Cortisone injections into the knee joint
There may be other reasons for your doctor to recommend a knee replacementsurgery.
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Home And Outpatient Physical Therapy
If you are sent home from the hospital, you may choose to have a home care physical therapist come to your house for your rehabilitation. This is usually reserved for people who may have a difficult time traveling to an outpatient physical therapy facility.
The focus of home physical therapy is to maximize your safe functional mobility in your home. You will likely continue on working on knee ROM and strength. Functional mobility like walking and stair climbing may also be a part of your home physical therapy after TKR.
As your surgical incision heals, your physical therapist may begin gentle scar tissue massage and mobilization to help improve the mobility of your incision. This can help the skin and other tissues around your knee move better and more freely.
If you are able to travel to a physical therapy facility, you may begin outpatient physical therapy. Here, your physical therapist will continue to work on improving your knee ROM, and it is expected that you are able to bend your knee to a 90 degree angle be the end of week 2.
Activities You Cannot Do After Full Recovery
You shouldn’t downhill ski or play contact sports such as football and soccer. In general, avoid sports that require jerking, twisting, pulling, or running. You should be able to do lower-impact activities, such as hiking, gardening, swimming, playing tennis, and golfing.
Other directions you will always need to follow include:
- Take small steps when you are turning. Try not to pivot on the leg that was operated on. Your toes should be pointing straight ahead.
- DO NOT jerk the leg that was operated on.
- DO NOT lift or carry more than 20 pounds . This will place too much stress on your new knee. This includes grocery bags, laundry, garbage bags, tool boxes, and large pets.
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A Physical Therapy Timeline
If youre having physical therapy in Myrtle Beach or in any of the surrounding Horry County areas we serve, you will have an individualized treatment plan tailored to your specific situation. Therefore, there may be some slight variations of this timeline. However, it should provide you with an idea of how long youll need physical therapy after a knee replacement.
How Long Will It Be Before I Feel Normal
You should be able to stop using your crutches or walking frame and resume normal leisure activities 6 weeks after surgery. However, it may take up to 3 months for pain and swelling to settle down. It can take up to a year for any leg swelling to disappear.
Your new knee will continue to recover for up to 2 years after your operation. During this time, scar tissue will heal and muscles can be restored by exercise.
Even after you have recovered, it’s best to avoid extreme movements or sports where there’s a risk of falling, such as skiing or mountain biking. Your doctor or a physiotherapist can advise you.
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Providing Better After Care For Patients
We’re funding research which aims to provide a standardised approach and assessment for virtual clinic follow-up of total joint replacement patients and subsequent management of patients identified as ‘at risk’ by this approach. This study would enable us to deliver better and more streamlined after care for patients.
Total Knee Replacement Precautions Physical Therapy
Sometimes Physical therapy sessions can help to strengthen the muscles around the knees and make it more stable for the mechanical movements. Therefore, doctors might recommend to work with a physical therapist as it help to avoid injuries or further worsening of an injury.
They will guide you about every exercise and helps you to practice it for quick recovery. They will also tell you How Much Walking after Knee Replacement and How Far to Walk after Knee Replacement.
Lets move to the next section that deals with some of the essential Precautions after Knee Replacement that should be taken care of.
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