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What To Do Before Knee Replacement Surgery

Why Wear A Custom Knee Brace While You Wait For Knee Surgery

6 Best Exercises To Do Before Total Knee Replacement – Prehab

With the wait times for knee surgery what they are in Nova Scotia, it can be difficult to fathom having to live with the pain, instability, and/or decreased function for the months or years it can take before you get a call for surgery. That being said, wearing a custom knee brace in the interim can have a significant positive impact on your comfort level and overall function. The two most common conditions in which a knee brace would be beneficial prior to surgery:

  • Osteoarthritis awaiting a knee replacement
  • ACL tear awaiting an ACL reconstruction surgery

A full frame custom knee brace can help in both these cases.

Severity Of Pain Vs Patient Age Vs Life Span Of Knee Replacement

If you are like me, I was concerned that if I had the surgery too soon that I might wear out the new joint and need another replacement later on. I had been told that the life of a knee replacement would be 15-20 years.

I preferred to wait and tolerate the pain so that the knee joint would outlive me. I did not want to have the surgery in my late 40s or early 50s hoping that new medical improvements might eliminate the need for surgery or that a better, longer lasting knee replacement might be developed.

These are all thoughts that went through my mind while I was considering TKR.

If the pain was sudden and had come on without notice I may have thought different. But, when the pain slowly increases over a period of 40 years you learn to live with it.

Why Might Surgery Be Cancelled At The Last Minute

If you have an unexpected health problem, it may be safest to postpone the surgery until the situation is addressed. Let your doctor know if you have any of the following close to your scheduled surgery: symptoms of a cold or flu pain, burning or frequency when you urinate cuts, scratches, rashes, bug bites, non-healing sores on your skin new swelling on the leg undergoing surgery or a change in your medical condition, such as high blood sugar or chest pain. These situations could mean that surgery has to be rescheduled.

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Knee Replacement Recovery Tips

Here’s some top tips for four common questions about total knee replacement recovery time:

  • How Long Does The Pain Last? Many people find they have less pain after their knee replacement as the arthritis pain is no longer there. The post-op pain usually settles down within 6-12 weeks although their may be some residual pain and swelling for up to a year.
  • How Do I Sleep After A Knee Replacement? Typically people find it most comfy to sleep on a firm mattress, either lying on their back or on their side with a pillow between their legs.
  • Can I Kneel Down With My Knee Replacement? Yes you can although it may be uncomfortable in which case use a cushion or knee pad. Kneeling won’t cause any damage to the knee replacement and certainly won’t delay your knee replacement recovery time.
  • How Do I Make the Best Recovery? In order to make the best knee replacement recovery, follow all the advice from your doctor and physical therapist. Start exercises prior to surgery, get up and about as soon as possible, stick to your rehab program, take medications regularly when advised and keep going. There may be ups and downs along the way, but stay focused and positive
  • You can find the answers to loads more similar questions in the total knee replacement recovery questions section.

    Preparing For Knee Replacement Surgery

    4 exercises to do before a knee replacement.

    If you and your surgeon decide that knee replacement surgery is the best treatment for you, our medical team will give you the information you need to prepare, including personalized instructions, during appointments before your surgery. To get started, here are the basics.

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    Is It Possible To Wait Too Long Before Getting Total Knee Replacement

    There are definitely some disadvantages of waiting too long to have TKR. First, you dont need to be enduring the pain that you are suffering now.

    My bone on bone pain is completely gone. As your bone wears you develop a limp that affects other parts of your body.

    You may be making other parts of your body overcompensate for your bad knee. You may be putting undue stress on your hip and discover that it is causing you pain.

    My hip was painful before surgery after long walks. Since my surgery, there has been no ache or pain in my hip.

    The longer you wait and age, your body might not be able to heal and bounce back like it did when you were younger. The better shape that you are in prior to surgery the better the recovery.

    Why Does Someone Need A Knee Replacement

    Over time , damage to the knee can lead to severe pain and decreased function.

    Osteoarthritis is the most common reason someone needs a knee replacement .

    Other potential causes include:

    *Disorders that cause excessive bone growth

    *Blood supply issues, which cause bone tissue in the knee to die

    *Knee injury

    *Deformity causing loss of cartilage and pain1

    A knee replacement is usually recommended after things like steroid injections and seeing a physical therapist havent reduced the pain.

    This doesnt mean that seeing a physical therapist before and after surgery isnt important or effective! In fact, its very, very important to do so . It just means that the joint needs to be replaced in order for your therapy program to have the most impact.1

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    How Long Will I Be On Pain Medication After My Knee Replacement Surgery

    Every patient experiences recovery from a knee replacement surgery differentially and as such, everyone will require pain medication at different intervals and for different amounts of time. There is no standard approach to this, although generally we do expect patients to be weaned off their narcotic analgesics within 2 to 3 weeks of the surgery and by 6 weeks after the surgery should only be requiring occasional Tylenol or a less potent analgesic to control their pain.

    With that being said, there are a number of different factors that can affect a persons ability to tolerate pain medication or indeed their ability to have the pain medication kill their pain. As such, each medication regimen will be tailored to the individual. It is important to regularly communicate with your surgeon or healthcare provider regarding your experience of the pain and your current pain medication regimen, so that it can be altered to suit you and your needs.

    Who Should Consider Total Knee Replacement Surgery

    Total Knee Replacement Surgery – Top 4 Exercises Before Surgery

    It is usually reasonable to try a number of non-operative interventions before considering knee replacement surgery of any type. Prior to surgery an orthopedic surgeon may offer medications knee injections or exercises. A surgeon may talk to patients about activity modification weight loss or use of a cane.

    The decision to undergo the total knee replacement is a “quality of life” choice. Patients typically have the procedure when they find themselves avoiding activities that they used to enjoy because of knee pain. When basic activities of daily life–like walking shopping or reasonable recreational pastimes–are inhibited or prevented by the knee pain it may be reasonable to consider the surgery.

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    Minimal Invasive Surgery Approaches

    The needs to reduce surgery complications, hospital stay, and the need to accelerate functional postoperative recovery have lead surgeons to use smaller incisions that disrupt less tissue. Additionally, blood loss is significantly lower than that in the classic incision cases some patients may experience less postoperative pain, some may be able to resume their daily activities sooner, and some prefer the aesthetic aspect of the shorter scar .

    Figure 21.

    MIS incision versus classical in TKA.

    The need for faster recovery time in total knee arthroplasty with less tissue disruption helped develop the mini-incision TKA technique in which the same surgical concepts are utilized, the same alignment goals are followed, but the original instruments have been minimized. A surgeon performing this technique should first have a good background in using the standard TKA procedure and should be familiar with the classical prosthesis components.

    The mini-incision TKA is not indicated for all patients. Candidates for mini-incision arthroplasty must have preoperative flexion greater than 90% and must not be obese.

    Extreme varus or valgus cases are contraindicated and also patients suffering from rheumatoid arthritis, for structural tissue reasons.

    Figure 22.

    MIS skin incision vs classical.

    Figure 23.

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    Education And Exercise Program

    Your surgeon may ask that you participate in an education and exercise program prior to surgery. Research suggests that such a program can reduce your hospital stay and improve knee functioning after surgery.

    The exercise portion of the program usually starts with simple range-of-motion exercises. It will then progress to strengthening exercises to help prepare your muscles and knee for the joint replacement surgery.

    Some of these preparatory exercises include:

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    Physical Therapy After Knee Replacement Surgery Goals

    Your first two weeks of recovery will be focused on:

    • Pain management
    • Restoring your ability to walk normally

    Your physical therapist will customize a rehabilitation program specific to your goals that will include:

    • Range-of-motion exercises: Swelling can limit your mobility, so your therapist will show you exercises that promote healthy movement that will allow you to perform daily activities.
    • Strengthening exercises: You may be required to use a cane after youre no longer on crutches or a walker because of weakness in the muscles surrounding your knee. Based on your condition, your therapist will determine the best strengthening exercises for you.
    • Balance and stability exercises: Once youre able to put your full weight on your knee, your therapist will introduce exercises that will help you adjust to daily challenges, such as walking up and down hills, making quick starts/stops, or changing direction quickly.
    • Functional exercises: Once youre walking pain-free, your therapist will add the activities that you participated in prior to surgery. The therapist will tailor an activity-specific plan that will focus on the activities or sports your play or the requirements of your job.

    Depending on your goals, physical therapy will vary from person to person, and your recovery timeline will depend on the time and effort you dedicate to your rehab.

    No 6 Walking Poles Or A Cane

    Exercises Prior to Surgery

    Whether youre a young guy/gal or a senior like me, the early days after surgery will take a toll on you. Your balance will be slightly off as you manage the pain from TKR. The pain will gradually subside and your body should quickly adjust to its new knee. Even months after recovery youll want some support and thats why walking poles are a must-have item after knee replacement.

    Even patients in top shape shouldnt be ashamed of using a little help. A cane in the weeks following surgery will help take some pressure off the knee although it will put more pressure on your arm.

    Walking sticks can also be used while around the house or exercising outside. Unlike canes, walking poles come in a pair. Feel free to only use 1 or both depending on the situation.

    > > read my review on the best walking poles

    While walking/hiking they can help with shock absorption. Just as important, the might help you avoid a fall and further injury to your knee or hip.

    Ive used walking poles for a number of years. They are lightweight so my arms dont fatigue when using them and I notice my knee is less sore the following day after Ive used them.

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    Exercise The Muscles Around The Knee

    In the weeks leading up to surgery, targeted exercises to build up strength in the muscles surrounding your knee is quite impactful. The stronger and more flexible your surrounding muscles are, the easier it will be to resume your favorite activities after the replacement. In addition to helping you bounce back, these purposeful, low-impact exercises will reduce fatigue, muscle soreness, swelling and the risk of blood clots.

    Before surgery, exercises should primarily target your hamstrings and quadriceps.

    3 Simple Exercises with Impact

    Quad Sets

  • Lie on your back in bed with your legs straight.
  • Tighten your thigh muscle by pushing your knee down into the bed. Sometimes placing a small towel under your ankle facilitates this.
  • 10 reps, 2x per day

    Sitting Knee Flexion

  • Sit on a chair with a towel under your surgical leg. Your feet should be flat on the floor.
  • Slide one foot back, bending your surgical knee.
  • Hold for 5 seconds, the slide your foot forward.
  • 10 reps, 2x per day

    Side Leg Raises

  • Lie on your side in bed with your legs straight.
  • Keep your knee straight and lift the up leg 2-3 inches.
  • Hold for 5 seconds and then lower the leg in a controlled manner.
  • 10 reps, 2x per day

    What About Alcohol And Drug Use

    Regular alcohol consumption should be disclosed to your anesthesiologist and surgeon ahead of time. Alcohol withdrawal can happen to anyone, regardless of economic or social background. When it happens, it can be life threatening and can complicate your recovery from surgery. If your physicians know about alcohol consumption, they can take steps to avoid withdrawal. The same is true of recreational drugs. Be sure to talk about this with the anesthesia doctor.

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    Prehabilitation For Knee Replacement

    Evidence suggests that patients who engage in prehabilitationpre-surgical physical therapy to strengthen the muscle surrounding the kneemay experience slightly less pain and better knee function after surgery. However, these reported effects do not seem to significantly affect patients length of stay in the hospital, medical costs, or post-surgical quality of life.1

    Exercises To Do Before Your Knee Replacement Surgery

    Knee Exercises â Before Your Joint Replacement Surgery

    You may think you have everything you need to buy before a knee replacement, like a grab bar or a sock aid, or maybe you even purchased a knee kit. But youre not done preparing yet! While those products will help you care for yourself after your knee replacement, these pre-surgery exercises will help your knee recover after surgery.

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    Troubled By Knee Arthritis But Not Ready For Knee Replacement Here Are 5 Alternatives

    Millions of Americans suffer from knee arthritis, which can cause pain, stiffness and a decrease in activity level and quality of life. Eventually, this often leads to knee replacement surgery, which remains the most effective treatment for permanent pain relief. However, knee replacement should be reserved as a last resort. There are several minimally invasive options you and your surgeon can try before committing to knee replacement surgery:

  • Physical therapy Knee arthritis typically makes the knee joint painful and stiff. Consulting with a physical therapist can increase the strength of the muscles supporting the knee and reduce pain. Therapists can use ice and heat, electrical nerve stimulation and other therapies to increase blood flow to the knee. Working with a licensed therapist can be much more effective than what you can do on your own.
  • Medications Although physicians typically try to limit the number of medications prescribed, there are several medications for knee arthritis that have been proven to help. Over-the-counter anti-inflammatory medications can be quite effective in reducing the pain, swelling and stiffness associated with knee arthritis. These are readily available and typically well-tolerated by most patients. In addition to NSAIDs, there are several supplements that have been successful in reducing knee arthritis symptoms. The two most common supplements used for knee arthritis are glucosamine sulfate and hyaluronic acid.

    The Benefits Of Physical Therapy Before Knee Replacement Surgery

    Daily exercises, as prescribed by a physical therapist, will prepare your body and improve your overall health before surgery.

    With as little as two 15-minute sessions , youll reap the following benefits:

    • Improved circulation
    • Reduced muscle fatigue and soreness
    • Strengthened muscles and
    • Reduced risk of developing blood clots

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    What If I Have Bowel Problems

    Pre-existing trouble with constipation usually leads to constipation and related problems after knee replacement. If you regularly take supplements to encourage bowel movements, let your doctor know so they can plan accordingly, since medicines used during and after surgery can result in serious constipation.

    You will be given a stool softener before surgery to avoid problems with constipation later. Even so, you can probably expect disturbance of bowel patterns and at least some degree of constipation after knee replacement surgery.

    Where Can I Get A Disabled Parking Sticker

    Top 5 Exercises To Do Before Knee Replacement

    Your doctor should have forms that allow you to get a temporary disabled parking placard. A permanent disabled placard is not necessary after knee surgery, since the new knee is designed to increase your mobility. Some patients need a few weeks or months of parking in disabled zones, and others do not.

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    Assemble Your Personal And Medical Information

    During the weeks before your surgery, many people will ask about your insurance coverage, medical history, and legal arrangements. You may feel that you are answering the same questions over and over again, but this repetition is necessary to meet quality assurance and medical insurance guidelines.

    When you have a quiet moment, take a few minutes to put together a careful list of your personal and medical information. This will help speed the process and ensure that you provide your healthcare team with all the critical information needed for a successful surgery. Be sure that your list includes the following:


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