What To Expect After Full Knee Replacement

Taking Care Of Your Wound

Taking care of the surgical site is another vital component of recovery.

Most likely, youll have suture underneath your skin that wont have to be removed. If your surgery requires exposed stitches or staples, those will be removed in the weeks following surgery in your surgeons office.

Remember to keep the wound dry until its completely sealed. A sterile bandage will be placed after surgery and you will be given instructions when you can take this off.

Contact Orthobethesda To Learn More

If you believe that you are a candidate for total knee replacement, we invite you to reach out to us online to schedule an appointment at OrthoBethesda.

• 1635 N. George Mason Drive #180 Arlington, VA
• Ph 567-4706

• 4420 North Fairfax Drive, Suite 100 Arlington, VA
• Ph 419-3002

• 10215 Fernwood Road, Bethesda, MD 20817
• Ph 804-1137

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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How Long Will Your Total Knee Replacement Last

Theres a common misconception that knee replacements only last 10 years, but this isnt exactly the case.

In fact, a knee replacement actually lasts longer than the hip replacement does.

Theres also less wear and tear and loosening of the knee replacement, as compared to a hip replacement.

So these new knee replacements are very durable, much like a crown on a tooth.

They also operate in a similar fashion to a crown: the caps go on the end of the knee, just like a crown goes on the end of a tooth.

And when the knee replacement is the right size and in the right position, and its carefully cemented in, its going to remain durable enough that you can walk on it the way you want and be active, without any issues, and for years to come.

Knee Replacement Recovery In The Elderly

Although the process of recovering from a knee replacement is no different for an elderly patient than it is for a younger patient and the steps are identical, it is important to remember that elderly patients typically lack the physiological reserve of their younger counterparts. This will mean that essentially the process takes longer and gaining strength back in the knee and subsequently having a well-functioning and asymptomatic knee may take longer in patients that are significantly deconditioned or have been living with arthritis for such a long period of time that this has caused their gait patterns to alter significantly and their muscles to atrophy.

This should be taken into consideration when counseling patients who are elderly that require knee replacement surgery and consistent reminders of this during rehabilitation help to highlight the altered expectation for the recovery timeline in this patient population.

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How Long Does The Healing Process Take

Immediately after surgery, there will be some general swelling from the surgery and some pain from the actual procedure. It is essential to use your walker or crutches until your physician says you no longer need them.

After four to six weeks, most people can resume normal day-to-day activities, including walking, driving, and doing light chores around the house. Your knee replacement recovery time will be dependent on your situation and if you consistently follow your physical therapy plan.

Exercise And Physical Activity

The final phase of recovery, as Dr. Parks considers it, is returning to exercises and extra activities, including hiking and biking. It typically takes eight to 12 weeks to get to this phase, he says.

In terms of full knee replacement recovery, patients generally need a year to completely heal and regain total function.

After a couple of years, you forget that youve even had knee surgery, says Barnes, who would go on to have her left knee replaced a year after the surgery on her right. Before surgery I couldnt garden. Now I walk, snow shoe, and climb ladders. I do what I want and dont have pain.

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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.

About Stephen Raterman Md Facs

Dr. Stephen Raterman has been treating Florida patients since 1990 as a board-certified orthopedic surgeon. In addition to seeing patients, Dr. Raterman is also a Clinical Associate Professor of Orthopedics at the University of South Florida.

Dr. Raterman specializes in joint replacement surgery, including hip resurfacing and partial knee replacements. By focusing on the latest procedures, Dr. Raterman aims to reduce the amount of time patients spend recovering and get them back on their feet faster.

Disclaimer: This blog is not intended to substitute professional medical advice. Every patient is different, so talk with your orthopedic doctor to learn what treatment options are best for you.

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What Does Knee Replacement Surgery Recovery Look Like

During knee replacement surgery, your doctor will make an incision before moving your knee cap and cutting away any damaged bone, cartilage, and joint surfaces. Artificial joints will then be attached and tested by bending and rotating your knee before your doctor closes your incision with stitches.

Whether youre having a total or partial knee replacement will have an effect on your pain level and recovery.

A traditional total knee replacement will typically require one to three months of recovery with the use of a walker or a cane. On the other hand, a partial knee replacement is much less invasive. Patients usually walk without assistance within two weeks. This is because the incision is much smaller and there is significantly less blood loss. While this may sound more appealing than a total knee replacement, only about 10% of patients are good candidates for a partial knee replacement procedure.

After your surgery, youll follow weight-bearing guidelines. How much pressure your new knee can initially support will depend on the condition of your natural bone, as well as the type of prosthesis you have.

Where Will I Feel Knee Replacement Pain

As mentioned above, knee replacement pain can come in many different forms depending on the cause. Knee pain is to be expected due to the surgical procedure itself, with swelling, bruising, and the introduction of prosthetic parts.

Beyond that, it is possible to feel pain in parts of the body other than your knee. This is known as referred pain.

Your hips, lower back, groin area, and calves may initially hurt due to the change in your stance and the way you walk. Of course, it is also typical to feel sore due to extended amounts of time in bed during your recovery.

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Thoughts On 3 Months After Knee Replacement Surgery

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.

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What To Expect 5 Weeks After Knee Replacement Surgery

When you reach 5 weeks post-knee replacement, youll likely notice a huge improvement. Generally, youll be able to walk on your own anywhere between 4 and 8 weeks after a knee replacement. The pain will have mostly subsided, and the swelling and inflammation should be greatly reduced.

You still wont be able to drive until about 8 weeks after your knee replacement but so long as youve been sticking with your physiotherapy, normal everyday activities should require much less assistance.

You should wait a full 12 weeks before lifting anything heavier than 4.5 kg and all weightlifting for exercise purposes is still off-limits unless prescribed by your physio.

Life After Knee Replacement

The goal of knee replacement surgery is to improve your quality of life and restore function that has been lost as a result of arthritis in the knee, there are a number of activities that knee replacement patients find that even years after the surgery, they are unable to do comfortably. The most common complaint in knee replacement patients is that they have difficulty performing tasks that require kneeling. This is normal and whether or not the patient has had their kneecap replaced as part of their knee replacement does not seem to affect this phenomenon.

Total knee replacement prosthetic components

The image shows the prosthetic components consisting of cobalt chromium alloy metallic tibial and femoral components and polyethylene insert. The femoral component and insert are cruciate retaining. The choice between cruciate retaining and posterior stabilized implant is made depending upon the disease in the knee joint and the integrity of the posterior cruciate ligament.

Modular femoral and tibial components along with polyethylene insert

Modular prosthetic components differ from primary knee replacement components as they allow the surgeon to make intraoperative changes. The surgeon may add bone augments or stems to achieve additional stability. The constrained insert allows stable range of motion.

Modular femoral component

Femoral component stem

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Knee Replacement Pain: The Week Following Surgery

You should expect to stay in the hospital for several days following knee replacement surgery. This is often considered the most painful stage of the recovery process. Your doctor will prescribe medications to help you manage your pain level.

In addition to icing your knee, you may be encouraged to move your foot and ankle to increase blood flow and lower the risk of swelling and blood clots. Your doctor may also use blood thinners, support hose, and compression boots to prevent further complications.

Generally the day after surgery, a physical therapist will show you exercises that will help you recover your range of motion and continue to heal. You may even be asked to get up and take a few steps . Patients who get up and put a safe amount of weight on their new knee typically experience a quicker recovery.

After leaving the hospital, most patients continue to take some form of pain medication for two to six weeks. Your doctor will determine the best method of pain relief for your specific needs, whether it is over-the-counter medications or something stronger.

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.

Interested in knowing more?

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What Would I Have Done Differently In The Past Year

As I mentioned above I am happy with the progress I have made to date. When thinking back, I dont think I would have done anything different during my rehab.

I must stress that I was concerned and fearful about the surgery and the rehab so much so that I strictly followed my doctors orders and was especially diligent following the plan my physical therapists set out for me.

Talking with friends that have also had TKR, the ones that seem to be having the most trouble post TKR are those that didnt take their physical therapy as seriously as I did.

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.

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What Can I Expect After My Total Knee Replacement

A total knee replacement is an excellent procedure to relieve pain that comes from diseased cartilage in your knee. In What is a Total Knee Replacement I detail what occurs during the surgery and note that most of the soft tissues around the knee are retained. It is also important to understand that perfect human knee mechanics cannot be fully achieved with current total knee implants and techniques. Because of that, the muscles and tendons that support the knee joint and cause it to move see the world in a little different way than they are used to. Up to 20% of total knee patients are not fully satisfied with their new knee due to some residual pain and tenderness. Despite that fact, 95-99% of patients are very happy they had the procedure and would choose to do it again.

Once the early postoperative pain is adequately subsiding, and that varies quite a bit from patient to patient, you can start to increase the walking distance, try a stationary bike, and do any low impact activities that are comfortable. By 4-6 weeks the incision is generally healed enough to submerge in water for swimming, hot tubs, or baths. Increased pain is likely from too much activity in the preceding days, and generally improves with a little more rest. You may use heat to soothe the knee and leg during this time as well. Most patients use a combination of heat and ice to get them through the day. Often heat is used to warm up the knee before activities and ice to calm it down afterwards.

Surgery Recovery And Beyond

Flash forward to January 31, 2017surgery day. In hospital, everything went according to plan. Allan was out of bed the day after surgery and the following day was able to climb stairs and work through physical therapy. He had surgery on Tuesday and was discharged straight home on Thursdayin just over 48 hours. Even Allan was surprised at how seamless everything went, My hospital experience went way better than imaginable. I was imagining worse things. I was worried about the spinal injection, but again, it wasnt as bad as anticipated.

Tuesday morning I went in and by Thursday afternoon, I was out. I was surprised by the speed. I put that down largely to the daily PeerWell exercises.

But how has recovery been since Allan went home? He shares the mantra that he seems to abide by when overcoming lifes obstacles, no gain without pain. He puts it honestly, It was a bit grueling. Since Ive been home, I wasnt feeling too goodsickly because of pain medication. Ive been restless because I wasnt sleeping well. But over the last day or so , I am feeling like my old self.

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