The First 24 Hours After Knee Replacement Surgery
After surgery, the patient will wake up from anesthesia and begin to regain feeling in his or her legs. Doctors will pre-emptively treat pain using a combination of pain-relief methods that complement each other and minimize side effects, an approach that is called multimodal analgesia.
Read more about multi-modal analgesia and Managing the Pain of Joint Replacement.
Within 24 hours, if pain is under control, the patient may be asked to stand up and take a few steps with the aid of a physical therapist and/or a walker. Patients who get up and bear some weight on their new knees soon after surgery tend to recover more quickly than patients who do not.
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.
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.
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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.
Preparation For Total Knee Replacement Surgery
Patients undergoing total knee replacement surgery usually will undergo a pre-operative surgical risk assessment. When necessary, further evaluation will be performed by an internal medicine physician who specializes in pre-operative evaluation and risk-factor modification. Some patients will also be evaluated by an anesthesiologist in advance of the surgery.
Routine blood tests are performed on all pre-operative patients. Chest X-rays and electrocardiograms are obtained in patients who meet certain age and health criteria as well.
Surgeons will often spend time with the patient in advance of the surgery, making certain that all the patient’s questions and concerns, as well as those of the family, are answered.
Costs
The surgeon’s office should provide a reasonable estimate of:
- the surgeon’s fee
- the degree to which these should be covered by the patient’s insurance.
Total Knee Replacement Surgical Team
The total knee requires an experienced orthopedic surgeon and the resources of a large medical center. Some patients have complex medical needs and around surgery often require immediate access to multiple medical and surgical specialties and in-house medical, physical therapy, and social support services.
Finding an experienced surgeon to perform your total knee replacement
Some questions to consider asking your knee surgeon:
- Are you board certified in orthopedic surgery?
- Have you done a fellowship in joint replacement surgery?
- How many knee replacements do you do each year?
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What Does Knee Replacement Surgery Involve
The team at Tri-State Orthopaedics provide the latest advancements in treating chronic knee problems. When conservative options arent enough, your provider may recommend knee replacement surgery. Also called arthroplasty, this procedure involves replacing the structure of the damaged knee joint with metal and plastic parts to restore the normal function of the knee and relieve chronic pain.
Knee replacement is an incredibly common and successful procedure. Over 90% of people who have knee replacement experience significant improvement in pain and their ability to get around. For most people, knee replacement restores a good quality of life, giving back independence and allowing you to engage in activities you used to enjoy. However, recovery is often a long road. If youre scheduled for or considering knee surgery, here are some helpful dos and donts in your path to recovery.
Knee Replacement Recovery At Home And Outpatient Therapy
It would be nice if a knee replacement was like getting a new car part installed and away you go. The surgery is just the beginning of the knee rehabilitation process.
Swelling, stiffness, and strength are necessary to improve in order to decrease pain and progress therapy to higher level activities. They will be the primary focus of therapy early on to set up the patient for successful rehabilitation. It will take time for the knee tissues to heal and gradual loading to improve strength and flexibility.
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What To Expect Before Knee Replacement Surgery
Knee replacement surgery requires some form of anasthesia where youll either be unconscious or awake but unable to feel the procedure. Your doctor will inform you of your options to make the best decision for your particular circumstances.
During knee replacement surgery , damaged bone and cartilage from your thigh bone, shinbone and knee bone are replaced with a prosthetic joint made of metal alloys, plastic and polymers.
The goal of knee replacement surgery is to resurface the parts of the knee joint that have been damaged and to relieve knee pain that cannot be controlled by other treatments. – Hopkins Medicine
How Do I Manage Pain And Discomfort After Joint Replacement Surgery
Try to take your pain medication as soon as you begin to feel pain. Don’t wait until the pain becomes severe. Follow the instructions on the prescription label. Remember to take your pain medication before activity and bedtime.
If you need to have stitches or staples removed and you’re still taking pain medications, be sure to have a friend or family member drive you to your appointment.
Pain medication may cause nausea. If this happens, decrease the amount you are taking or stop and contact your surgeons office.
If you need additional pain medication, please contact your surgeons office. Give at least a few days advance notice before you run out of the medication. Please plan ahead, especially for holiday weekends.
Also remember:
- You aren’t permitted to drive a car while taking narcotic pain medication.
- It may take several days to have a bowel movement. Anesthesia and pain medication often cause constipation. Drink plenty of fluids and eat whole grains, fruits, and vegetables. A stool softener or laxative can help bowel function return to normal.
- Don’t hesitate to call your surgeons office with any questions or concerns.
Incision care
Walker, crutches, cane
Use your assistive devices for balance as instructed by your surgeon or therapist. By your first post-op visit with your surgeon, you may have already improved and changed from using a walker or crutches to a cane .
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What Does Recovery Look Like After A Knee Replacement
If arthritis has caused damage or chronic pain in your knee joint, you would likely benefit from a total knee replacement. This treatment can help to relieve the pain and improve your mobility.
The recovery process after knee replacement surgery is a bit lengthy, but most patients say that it is well worth it. Lets talk about what you can expect during recovery after having a knee replacement operation, and where you can go for an evaluation and treatment of your knee pain.
What To Expect With Knee Joint Replacement
The first and most important thing you can expect with knee joint replacement is a drastic reduction in knee pain. Studies show that 90% of people who undergo knee replacement therapy report feeling significantly less pain.
You can also count on your new joint to last 15-25 years, according to the American Academy of Orthopedic Surgeons.
A knee joint replacement, also known as arthroplasty, is a surgery that removes damaged knee bone and cartilage and replaces it with an artificial knee joint, usually made of metal, plastic, or ceramic.
We typically recommend this surgery for those with severe knee pain, most often caused by osteoarthritis.
At Douglas J. Abeles MD & Associates in Castro Valley, California, our skilled medical team has extensive experience treating knee pain and performing knee joint replacement surgery. Here, we share what to expect during and after surgery.
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Physical Therapy Continues At Home
After your hospital stay, the CPM machine continues to keep your knee moving, even when youre sitting down. This motion helps prevent stiffness, immobility, and scar tissue buildup. For roughly the next three weeks, either at home or in a rehab facility, you continue to gain strength and mobility, with less dependence on a walker, crutches, or cane.
As you continue your daily routine of gentle, strength-building exercises, the pain gradually decreases. Dr. Woodson and your physical therapist give you personal goals to achieve each day and each week, until you can move around more comfortably.
Similar Conditions That Affect The Knee
Meniscus tear
Sometimes patients with knee pain don’t have arthritis at all. Each knee has two rings of cartilage called “menisci” . The menisci work similarly to shock absorbers in a car.
Menisci may be torn acutely in a fall or as the result of other trauma or they may develop degenerative tears from wear-and-tear over many years. Patients with meniscus tears experience pain along the inside or outside of the knee. Sometimes the pain is worse with deep squatting or twisting. Popping and locking of the knee are also occasional symptoms of meniscus tears.
Since some of these symptoms may be present with arthritis and the treatment of arthritis is different from that of meniscus tears, it is important to make the correct diagnosis. A good orthopedic surgeon can distinguish the two conditions by taking a thorough history, performing a careful physical examination, and by obtaining imaging tests. X-rays and Magnetic Resonance Imaging scans may be helpful in distinguishing these two conditions.
Knee Joint Infections
Also called infectious arthritis or septic arthritis, a joint infection is a severe problem that requires emergent medical attention. If not treated promptly knee infections can cause rapid destruction of the joint. In the worst cases they can become life-threatening.Symptoms of a knee joint infection include:
- severe pain
- fevers and
Again, a joint infection is a serious condition that requires immediate medical attention.
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When Do You Need To Call Your Orthopedic Surgeon After Knee Replacement
Signs of infection, such as-
Increased pain, warmth, swelling or redness.
Pus draining or unusual discharge from the incision.
High fever.
Signs of a blood clot, such as-
Pain in the calf, back of the knee, thigh, or groin area.
Redness or swelling in the legs or groin.
Incision opens up and begins to bleed
Severe pain that does not get better even after taking painkillers.
Shortness of breath
Follow up care after knee replacement surgery
In the first year after your knee replacement surgery, you will have regular follow up consultations with your orthopedic surgeon. During these visits, the doctor will note about your progress, discuss your comfort level, mobility, how the new knee is working for you and may take X-rays for better evaluation. The doctor will address any of the concerns you might have and will make sure you are healing well.
Physical Therapy After Knee Replacement Surgery
Mobility is also another important factor to consider when it comes to physical therapy. This is because there are certain activities that you will need help with during the first few weeks. This includes showering, getting in and out of bed or chairs, as well as climbing stairs.
The first key milestone is reaching 90 degrees of knee flexion. This will allow you to sit comfortably on chairs/couches and walk up and downstairs. The next priority is to fully extend your leg as if one cannot do this it makes walking very difficult.
The normal amount of knee bend should be roughly 135 degrees, but achieving this goal takes a long time. The other option would be using an assisted-living home. You can also use a nursing facility for assistance with daily tasks such as bathing and toileting.
After you receive knee replacement surgery, it will take time for your range of motion to return. This is partly due to the swelling that can persist up until several months after receiving this procedure. You should expect a combination of movement and static stretches while incorporating these exercises into your routine.
Your rehab program will also include strengthening exercises. The reason for this is that after knee replacement, its common to see patients minimize how much they use their new knees due to pain. This can cause weakness in the leg muscles and those around the hip.
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Here Are Some Of The Reasons You Might Need Knee Surgery:
- Stiffness in the joint and pain makes it difficult to walk, stand up, or climb stairs
- You often have swelling in the knee area
- Chronic pain bothers you when resting
- The pain is disrupting your sleep
- The knee has defects or is bowed
- Medication and physical therapy havent been effective in managing the pain
If you can relate to any of these symptoms, then its time to talk to a sports medicine doctor about your treatment options.
What Should I Expect During Weeks 6 Through 12
This period after joint replacement is a time of continued improvement. You will probably notice an increase in energy, a desire to do more activities, and a noticeable improvement in your new joint. Please keep in mind that every patient is different and will improve at different pace. If you are not happy with the pace of your recovery, please contact your surgeons office to discuss your concerns.
Walking
After your six-week follow-up visit, you will likely start using a cane to walk and move about. Use the cane until you return for your 12-week follow-up visit. Walk with the cane as much as you want as long as you are comfortable.
Back to work
Many patients return to work after the six-week follow-up visit. Tips to remember for returning to work include:
- Avoid heavy lifting after you return to work.
- Avoid standing or sitting for long periods of time.
- Avoid activities such as frequently climbing stairs or climbing ladders.
- Avoid kneeling, stooping, bending forward or any position that puts the new joint under extreme strain.
- Expect a period of adjustment. Most people return to work with few problems. However, you may find the first several days very tiring. Give yourself time to adjust to work again and gradually this should improve.
Continue exercise program
Comply with all Restrictions
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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.
Who Performs Knee Replacement Surgery
If you need knee replacement surgery, then an orthopedic surgeon is the type of doctor you must see. Here at Orthopedic Associates, we offer a range of doctors, physical therapists, and sports medicine specialists to help you manage the pain and recover as effectively as possible.
Our team offers three knee replacement surgeries:
- Total Knee Replacement Surgery
- Partial Knee Replacement Surgery
- Revision Knee Replacement Surgery
Additionally, we have other joint replacement procedures for different types of sports medicine injuries and other orthopedic concerns:
- Reverse Shoulder Joint Replacement Surgery
- Shoulder Joint Replacement Surgery
- Direct Anterior Hip Replacement Surgery
- Partial Hip Replacement Surgery
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Preparing Yourself For Knee Replacement Surgery
Dr. Tiberi offers a surgery preparation app called Peerwell. Patients can use the application on their mobile devices and tablets to prepare for knee replacement surgery, step by step. Dr. Tiberi is able to customize the information for each patient so that they receive tailored instructions on preparing for surgery and recovery.
Peerwell helps Dr. Tiberis patients prepare by providing daily modules to complete in the weeks leading up to surgery. Dr. Tiberi has found that this step-by-step preparation method helps his patients feel less overwhelmed by the pre-op materials, because the information is broken down into segments. When patients are well-prepared before knee replacement surgery, they tend to have better outcomes after surgery.
Preparation modules in Peerwell cover information on the following topics:
Dr. Tiberi and his team will also be available to answer any questions you may have during the preparation process.