Preparing For Knee Replacement Surgery
Having a recovery and rehabilitation plan in place will help reduce your hospital stay, accelerate strength and mobility gains, and improve your overall outcomes. The key to preparation is following all the pre- and post-surgery guidelines your doctor gives you.
In addition to making sure your space is clear of any loose cords, rugs, or other tripping hazards, heres a preparation list to have at the ready so that your recovery is as smooth, speedy, and pain-free as possible:
- A ride to and from the hospital
- A family member or professional health aid to help with cooking, cleaning, bathing, etc.
- A walker or crutches
- A downstairs bedroom or cot for your convalescence
- Remotes, books, water, medications, etc. at your bedside
- Safety bars or a secure handrail in the shower or bath
- Secure stairway handrails
- Chair with firm seat cushion and back, and footstool for elevation
- Bench or chair for shower
- Toilet-seat riser for a low toilet
Your surgeon may also prescribe a continuous passive motion machine that slowly straightens and bends the affected leg while you lay on your back or sit halfway upright. It can be used for up to 8 hours a day between physical therapy sessions and sleeping and has been shown to help patients regain range of motion faster.
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.
What Not To Do After A Knee Replacement
As previously mentioned, removing the dressings too early or before you are instructed to do so by your healthcare provider will increase the risk of developing an infection. This is important to avoid and as such leaving your dressings and following the postoperative care instructions that you are given is essential.
Trying to do too much too quickly is a common scenario particularly in younger patients. Recovery from the knee replacement is a slow process and many patients want to be back to a baseline level of activity within a few weeks of the surgery. This is simply not possible and we would encourage you to be patient and consistent with your exercises and rehabilitation protocols. Regular communication with your surgeon or healthcare provider if you have any concerns will be able to reassure you of your progress through the process of recovering.
Avoid trying to enter into sporting activity too quickly. Although it does frustrate patients when find they are unable to perform their sports as quickly as they want after the surgery, it can also put you at risk of developing an injury around tissues that are still in the process of healing. This can cause problematic injuries such as disruptions to your extensor mechanism of your knee and even periprosthetic fractures. These are major injuries that usually require surgical intervention and should be avoided at all costs.
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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 .
Walk As Soon As Possible
Recovery from joint replacement surgery isnt always easy, but getting back on your feet as soon as the doctor says its okay can help you recover. Walking helps prevent complications like blood clots, improves circulation, and keeps your joints limber. You dont have to wait until you return home after surgery. Most patients can start walking while still in the hospital. Walking helps deliver important nutrients to your knee to help you heal and recover. You can expect to use a walker for the first couple of weeks. Most patients can walk on their own roughly four to eight weeks after knee replacement.
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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.
What Can I Expect At Hss
Hospital for Special Surgery has been at the forefront of modern knee replacement since the operation was first introduced in the late 1960s. We have led the field ever since in a number of ways:
- : HSS has been ranked the No. 1 hospital for orthopedics by U.S. News & World Report for 11 years straight.
- Along with high rankings in patient satisfaction, HSS performs the most knee replacements with the lowest reported infection rates in the United States.
- Research and advancement: Smaller incisions, new implant materials and design, and sophisticated instrumentation have been â and continue to be â the areas of expertise of the hip and knee replacement surgeons of the HSS .
- HSS routinely uses the latest surgical techniques and technology, such as robotic-assisted and computer-assisted surgery.
- : Isolating the anesthesia to a particular body area helps avoid the potential problems that may accompany a general anesthetic. These techniques have been developed and refined by the HSS . Learn more about
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Knee Replacement Recovery Tips To Maximize Healing
Recovering from a total knee replacement is a slow process and can feel, in the immediate postoperative period, like very little progress is being made. However, a dedicated and consistent approach to recovering will always yield the best results. It is important to try to mobilize as soon as possible after your knee replacement surgery. This will be tricky immediately following the surgery as you will feel sore and have some pain, which will hopefully be controlled by the pain medications your surgeon will prescribe you.
If your pain is poorly controlled, it is important to let your surgeon know this so that your analgesic regimen can be altered to suit your needs. In the immediate postoperative period, you will have physical therapist assistance in getting up and on your feet in a safe and timely manner. They will help you get used to the feeling of your new knee and will teach you how to walk safely while your knee and tissues within the knee are still recovering from the surgery.
X-ray showing Total Knee Replacement.
It is important that you continue physical therapy assistance in the longer term recovery from your knee replacement surgery, as studies have shown consistently that patients who undergo a dedicated and standardized physical therapy regimen to recover from that knee replacement experience much better outcomes than those who do not.
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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Months After Tkr Surgery
Its been four months since I had my total knee replacement. Once again time is flying by. Immediately after TKR, time seemed to drag and the healing progress was slow.
Now that the real hard work is over I feel much better and Im able to do everything that I could do prior to TKR, only now its without pain. I still feel soreness and stiffness along with occasional swelling around my knee after activity.
However, I continue to work at my rehab and an exercise routine is still an important part of my day.
In this article, Ill share my experience during the last month and I hope it encourages you to work extra hard in the months after knee surgery. Those first few weeks after TKR surgery with the physical therapists are so important.
Range Of Motion 4 Months After Tkr
As Ive mentioned in other articles, your range of motion will increase the most in the few weeks after knee replacement .
However, you can still achieve some improvements in the 3rd and 4th months.
I would encourage you to continue to do the range-of-motion exercises that were prescribed by your physical therapist. I use a fitness center to continue my workouts Use your Silver Sneakers free pass if you are over 65.
Ive developed a routine with the physical therapy exercises, the stationary bike, and regular bicycle rides 6 to 10 miles. I believe they continue to help me maintain flexibility and help me to increase my range of motion, slowly, by a few degrees.
I am not seeing the huge gains as I did early on, but I am increasing my range of motion little by little.
I continue to massage my knee with Free Up before and sometimes after workouts. It helps to loosen the knee before activity and feels better when I begin my exercise.
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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.
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
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Recovery Time After Knee Replacement
Therecovery timeline after knee replacement surgery varies significantly from patient to patient, but the rehabilitation process typically takes 10-14 weeks. During this time, youll work with your physical therapist to reach goals in range of motion, strength, and functional activities without difficulty or pain.
With help from your doctor, physical therapist and care team, you can regain comfortable use of your knee and return the activities you enjoy.
Possible Benefits Of Total Knee Replacement Surgery
Regardless of whether a traditional total knee replacement or a minimally-invasive partial knee replacement is performed the goals and possible benefits are the same: relief of pain and restoration of function.
The large majority of total knee replacement patients experience substantial or complete relief of pain once they have recovered from the procedure. The large majority walk without a limp and most dont require a cane, even if they used one before the surgery. It is quite likely that you know someone with a knee replacement who walks so well that you dont know he even had surgery!
Frequently the stiffness from arthritis is also relieved by the surgery. Very often the distance one can walk will improve as well because of diminished pain and stiffness. The enjoyment of reasonable recreational activities such as golf, dancing, traveling, and swimming almost always improves following total knee replacement.
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How Long Is It Before I Can Walk After A Knee Replacement
Most patients progress to a straight cane, walker or crutches within two or three days after surgery. As the days progress, the distance and frequency of walking will increase.
Patients are usually able to drive a car within three to six weeks after surgery and resume all other normal activities by or before six weeks. Complete recuperation and return to full strength and mobility may take up to four months. However, in many cases, patients are significantly more mobile one month after surgery than they were before they had their knee replacement
When Can I Get Back To My Usual Activities
Typically, patients can return to their usual activities such as work and exercise after six months. However, you mustnt push yourself too hard during this period because your body needs time to heal.
This expected recovery time is obviously variable and depends on several factors such as the skills and experience of your surgeon, how well you follow medical advice, and whether or not there were any complications during surgery.
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Mobility And Home Life
Youll have reduced mobility for several weeks following knee surgery. At home, youll have an assistive device like a walker or cane to help you get around. You may need supervision and assistance with activities like bathing, dressing, toileting, and performing other daily tasks for the first few weeks. As the weeks go on, youll get stronger and be able to do more independently.
There are ways to prepare your home that reduce your risk of accidents and make it easier to get around.
- Move everything you need to the ground floor. If your home has stairs, create a living and sleeping space on the bottom floor so that you dont need to climb the stairs every day during recovery.
- Clear your living areas of potential tripping hazards like rugs and loose cords.
- Install safety devices like a grab bar, shower seat and toilet raiser in the bathroom.
- Enlist the help of neighbors, family and friends to help you run errands, pick up prescriptions, do yard work, perform chores and laundry, cook, and provide transportation while you regain full mobility.