The Timeline For Knee Replacement Recovery
According to the American Association of Knee and Hip Surgeons , it may be as long as 12 weeks before you can resume most of your normal activities, and 6-12 months before the joint is strong and resilient. AAKHS breaks down the timeline of knee replacement recovery as follows:
Weeks 1- 3: Focus on building up to standing or walking for 10 minutes or longer, switching from crutches to a cane, and building strength with prescribed exercises.
Weeks 4-6: Return to daily activities, including driving and household chores, while still performing physical therapy and strengthening exercises as directed.
Weeks 7-12: Begin returning to low-impact physical activities, including swimming and cycling, and continuing physical therapy to regain full range of motion in the joint.
After three months, your activities and further treatment should be discussed with your surgeon and physical therapist. Depending on how well you have healed and progressed with recovery, you may be cleared to return to more strenuous activity, or require additional therapy.
How Long Does The Pain Last After A Knee Replacement
Over 90% of patients who have knee replacement surgery experience a significant improvement in their pain and mobility. But remember that this is a major surgery, which means that it takes time to recover after going under the knife.
It often takes three months to return to normal activities and six months to 1 year before your knee is strong and resilient.
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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Looking After Your New Knee
- continue to take any prescribed painkillers or anti-inflammatories to help manage any pain and swelling
- use your walking aids but aim to gradually decrease the amount you rely on them as your leg feels stronger
- keep up your exercises to help prevent stiffness, but do not force your knee
- do not sit with your legs crossed for the first 6 weeks after your operation
- do not put a pillow underneath your knee when sleeping as this can result in a permanently bent knee
- avoid twisting at your knee
- wear supportive shoes outdoors
- do not kneel on your operated knee until your surgeon says you can
- raise your leg when sitting and apply an ice pack wrapped in a tea towel for 20 minutes every 3 or 4 hours to reduce any swelling
Page last reviewed: 02 August 2019 Next review due: 02 August 2022
What To Expect From Knee Replacement Exercises
Exercise is one of the keys to knee replacement recovery. In the early days, exercise helps reduce blood clot risk. Staying on track with your physical therapy program helps speed healing and strengthen muscles, letting you get back to your normal life sooner.
Immediately after surgery, your surgeon or physical therapist may use a Continuous Passive Motion machine. The CPM elevates and gently rotates your knee while in bed to help improve blood circulation and move the muscles.
While you are in the hospital, a physical therapist or your nurse will lead you through a series of exercises within a few hours post-surgery. These moves may be uncomfortable at first but are crucial to preventing blood clots, strengthening your muscles, and improving your knee movement. They also help you have a faster, less painful recovery.
Some of the exercises you may be asked to perform include:
- Quadricep sets
- Ankle pumps
- Knee straightening exercises
- Knee bends, in bed, and both supported and unsupported in a chair or on the side of the bed
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What To Expect After Knee Replacement Surgery
When the surgery is over, you will need to stay in the hospitals recovery room for observation. Usually, patients can return to their hospital rooms within a few hours after their pulse, blood pressure, and breathing are stable. Since knee replacement is major surgery, its common for the patient to be in the hospital for a few days before returning home. You will begin physical therapy during this in-hospital time.
When its time to head home, your medical team will have a transition plan to help with continued physical therapy and pain management. Its crucial that you are diligent about following these recommendations to regain the range of motion and strength needed in the joint.
Six Months After Surgery
Once six months have passed, patients are ready to graduate. At this point, the majority of patients are pain-free however, some patients do experience aches related to the weather.
Individuals suffering from shoulder pain who reside in the Pensacola area should contact OGrady Orthopaedics today. Dr. Christopher OGrady is an Orthopaedic Surgeon who is dedicated to helping those experiencing shoulder pain. Seeking treatment is critical to ensuring the damage occurring to the shoulder is addressed. at OGrady Orthopaedics.
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Six Weeks After Surgery
Once the patient regains full shoulder movement, he or she will probably be able to resume driving. Dr. OGrady may also permit the patient to return to work, depending on the physical activity necessary to perform his or her job. Patients will also begin strengthening exercises at this time.
Many times, it takes from three to six months for the shoulder to heal. Regaining full strength and range of motion can take up to a year.
Recovery After 12 Weeks
After three months, routine activities become easier. You typically will feel much more functional than you have in a long time. After six months, most of the healing has completed. Occasional aching or soreness is still common. It may take nine months to a year before the sense of stiffness fully resolves. Significant pain from the knee replacementpain from the knee replacement during this period should be evaluated by your orthopaedic surgeon.
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Pain After Knee Replacement: Six Months
If you are still experiencing pain six months after surgery, you may be wondering how long it will be until you feel normal again. Unfortunately, there is no easy answer.
In some cases, it may take up to a year for all of your swelling to completely go away. Your knee will continue to recover for years to come, as scar tissue forms and your muscles become stronger with continued physical therapy and light exercise.
As previously mentioned, if you are still experiencing debilitating levels of pain at this stage, you could be suffering from chronic pain. While you may be tempted to tough it out, its important to talk with your doctor. Together, you can find what is causing your persistent pain and come up with a plan to fix it.
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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No Pain No Gain Just Take The Medicine
There will be pain. There is no way around that, unfortunately. At first, the surgeon will likely have you on some pretty strong pain relievers. As the swelling goes down, you start to move and get used to your new knee, the pain will usually get much less. Well help you monitor and manage your pain. When the pain stops, well stop using the painkillers because there is no other need to continue taking them.
It is really important that the surgeons pain relief program is adhered to in order to achieve mobility through rehabilitation without restriction due to pain. Regaining movement will help to reduce the pain and therefore work to end the medication program.
Avoiding medication by choosing to tough it out or, using the medication for longer than you need it could lead to a delayed recovery. Its a joint effort to get the right pain relief with you and your medical team.
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Recovery Up To Six Weeks
Initially, it is very common for patients to have trouble getting a restful night sleep. This is due to the knee being unconfutable and swollen. Some surgeons will want their patients to wear a brace to bed for several weeks to help reduce the chance of developing a flexion contractureflexion contracture of the knee. A good night’s sleep will return over time. Check with your physician if medication is recommended as a sleep aide. Some patients can consider over the counter Benadryl® to assist with sleep.
Traveling during the first 3 weeks after surgery should be limited to certain activities such as going to an out-patient physical therapyout-patient physical therapy program. Some patients may opt for home based physical therapyhome based physical therapy in the early recovery period to reduce the need for traveling. Patients may still have difficulty getting in and out of the passenger side of a car at this stage. Driving should be avoided during this time.
By the time you reach the third week, the most significant pain will fade. Deep aching becomes more prominent rather than sharp pain. Most patients will start to feel comfortable returning to drivingreturning to driving approximately 4 to 8 weeks after surgery. We recommend to avoid longer trips for up to 6 weeks following surgery.
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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:
- walking
The Ability To Make A Living
The researchers made an interesting statement in their conclusion: Total knee replacement surgery is being performed on an increasingly younger population of knee osteoarthritis patients for whom participating in work is of critical importance. . . .clinicians should be aware that proxies for participating in work go beyond outcomes like pain or function.
In other words, patients will go back to work, if they can, regardless of pain and function improvements. We find that for many patients we see, it is the ability to make a living. They have to work.
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Physical Therapy Is Crucial To Your Return To An Active Lifestyle
It helps to think of knee replacement surgery as the first step of your journey to a pain-free, more active lifestyle. After you schedule your surgery, make a commitment to take an active role in your rehabilitation in the weeks and months that follow. Physical therapy is essential to getting back on your feet and helping you resume your desired activity level.
Types Of Arthritis That Affect The Knee
Inflammatory arthritis
This broad category includes a wide variety of diagnoses including rheumatoid arthritis, lupus, gout and many others. It is important that patients with these conditions be followed by a qualified rheumatologist as there are a number of exciting new treatments that may decrease the symptoms and perhaps even slow the progression of knee joint damage.
Patients with inflammatory arthritis of the knee usually have joint damage in all three compartments and therefore are not good candidates for partial knee replacement. However, inflammatory arthritis patients who decide to have total knee replacement have an extremely high likelihood of success. These patients often experience total, or near-total, pain relief following a well-performed joint replacement.
Osteoarthritis
Osteoarthritis is also called OA or degenerative joint disease. OA patients represent the large majority of arthritis sufferers. OA may affect multiple joints or it may be localized to the involved knee. Activity limitations due to pain are the hallmarks of this disease.
OA patients who have symptoms limited to one compartment of the knee sometimes are good candidates for minimally-invasive partial knee replacement .
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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.
Here Is An Overview Of What You Can Expect During These 12 Weeks:
- Days 1 3: In the hospital, you will work with a physical therapist and occupational therapist to work on straightening and bending the knee.
- Discharge Day: Most people are discharged from the hospital within a few days. You will be sent home with specific instructions for care, medication, and therapy.
- Week 3: By the time you reach week three, you will be able to move around a little more, and the pain will be decreasing.
- Weeks 4 6: The most noticeable improvements in your knee happen during this time if you are consistent with your rehab and exercise activities.
- Weeks 7 11: Physical therapy and rehabilitation continue. At this point, you will be working on range of motion, mobility, and strengthening the muscles.
- Week 12: You can start to return to normal activities but still need to avoid high-impact exercise .
Beyond this initial recovery time, you will notice that the pain will continue to decrease, and your function will improve.
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Technical Details Of Total Knee Replacement
Total knee replacement surgery begins by performing a sterile preparation of the skin over the knee to prevent infection. This is followed by inflation of a tourniquet to prevent blood loss during the operation.
Next, a well-positioned skin incision–typically 6-7 in length though this varies with the patients size and the complexity of the knee problem–is made down the front of the knee and the knee joint is inspected.
Next, specialized alignment rods and cutting jigs are used to remove enough bone from the end of the femur , the top of the tibia , and the underside of the patella to allow placement of the joint replacement implants. Proper sizing and alignment of the implants, as well as balancing of the knee ligaments, all are critical for normal post-operative function and good pain relief. Again, these steps are complex and considerable experience in total knee replacement is required in order to make sure they are done reliably, case after case. Provisional implant components are placed without bone cement to make sure they fit well against the bones and are well aligned. At this time, good function–including full flexion , extension , and ligament balance–is verified.
Finally, the bone is cleaned using saline solution and the joint replacement components are cemented into place using polymethylmethacrylate bone cement. The surgical incision is closed using stitches and staples.
Anesthetic
Length of total knee replacement surgery
Pain and pain management