If you’ve been suffering with knee pain from arthritis and you’ve tried physical therapy, exercise, medications and even losing weight to help, but without success, you may have been given the option of a total knee replacement. In fact, this could be your best bet to begin living a pain-free life again. If this is the case, your orthopedic surgeon has already told you that this procedure is one of the most common bone or joint surgeries performed today. After surgery, most will enjoy a normal lifestyle within a matter of months and can then expect a full recovery. If you’ve already scheduled your surgery, or even if you are just considering it as an option, you probably have questions about recovery. Let’s take a look at what you can expect after your total knee replacement surgery.
What to Expect
The knee joint is like a hinge joint between the upper and lower leg bone. If you are experiencing consistent and significant pain, you are well aware of how important this joint is in living a normal and active life. Osteoarthritis, also known as degenerative arthritis, causes the surfaces of the bone in the joint to wear down, resulting in pain and swelling and stiffness. Since the most common reason to have total knee replacement surgery is to relieve the pain that other treatments could not alleviate, your biggest goal after surgery should be relief of pain, improved function and a better quality of life.
Although there is an increasing trend to have total knee replacement surgery in the outpatient setting, the majority of these procedures are still done during a short hospital stay. Generally speaking, you can expect to spend 1 night in the hospital where the goal will be to control your pain, prevent complications, and get you moving again. After discharge from the hospital, you should expect to follow up in the office within 2 weeks so that your surgical team can check your incision and knee range of motion and make sure your recovery is proceeding as planned. You should be seen again in the office around 6 weeks after surgery, where you will have an x-ray done of your new knee. After that, your orthopedic surgeon will see you again around 3 or 4 months after surgery to recheck your progress again. It is recommended that once you’ve completely recovered, you should follow up with your orthopedic surgeon every year or two, to check up on how your new joint is doing, and monitor the health of the joint replacement with an xray.
While you are still in the hospital, you will receive the same oral medications that will be used at home after your hospital discharge, to be sure you tolerate these medications well and that they are helpful with any post-operative discomfort. Using your post-operative medications as prescribed will help to prevent blood clots and also provide the pain relief needed to work hard on your physical therapy exercises. Appropriate pain control will help you after surgery to progress well with physical therapy, which is very important in preventing pain in the long-term, and improving your knee function.
Serious complications are not common after total knee replacement surgery, but with all surgery there are always potential risks. Potential post-operative complications include blood clots and infection. Because of this, you will notice some things to prevent these potential problems as soon as you wake up from surgery. You will have compression boots on while you are in bed, which help keep the blood flowing in your legs and prevent clots. Once you get up and start moving, which is the best prevention for blood clots, you can improve the blood flow in your legs and minimize the risks of immobility. You will also be given a blood thinner medication for 4 to 6 weeks after surgery to lower your risk of blood clots. To prevent infection, you will receive strong intravenous antibiotics right before and after surgery. In addition, a special sterile dressing will be placed over your knee at the end of surgery to keep bacteria away. Be sure to follow your orthopedic surgeon’s instructions for incision care to prevent complications at home.
The sooner you get moving, the better it will be for you in the long run, so expect to start rehabilitation the same day as your surgery, even within a few hours. You’ll be asked to start moving your feet and ankles as soon as you wake up, and you’ll be taught how to do range of motion exercises. You will have some pain and swelling, so you’ll want to find a balance between moving but not overdoing it. Walking within moderation throughout the day is important. When at rest, it is best to keep your leg elevated to decrease swelling. Physical therapists will teach you how to get out of bed and walk with a walker initially, and occupational therapists will be there to help you learn to care for yourself.
By the day after surgery you should expect to be taking short walks down the hall and you will be able to shower. At this point you will be walking short distances, taking care of all your own personal needs and even managing steps after instructions from your nurses and physical therapists, meaning you are ready to return home. It’s time now to get to work with outpatient physical therapy to work on getting back to living an active and pain-free lifestyle.
It is very important that you follow your rehabilitation schedule, work with your physical therapist, and do your exercises at home. Research shows that people who consistently follow the advice of their orthopedic surgeon and physical therapist have the best results from total knee replacement surgery. Because each person’s recovery is unique, your rehab program will be tailored to your needs, but there are some generalities that everyone can expect. The most important exercises are focused on regaining the flexibility or range of motion in your knee, before stiffness and scar tissue can set in. You will also progress in the first several weeks from using a walker to a cane, and then ultimately no assist devices once you are cleared to do so by your physical therapist. By 6 weeks out, you will be continuing with your range of motion exercises, but will also be focused more on strengthening your muscles as you return to your normal routines of working, driving and household activities. The focus on strength and endurance, as well as continuing to improve your range of motion, will help you to return to normal activities. Low impact activities like swimming and bicycling may be added to your regimen once your incision has completely healed as well.
While most people are ready to get back to their usual activities within a matter of months, your body will continue to heal and your knee will continue to strengthen, particularly if you follow your exercise plan, over the next year. You may be able to progress to more rigorous activities, but it is very important that you seek the advice and guidance of your orthopedic surgeon and your physical therapist before you do so. Generally speaking, low impact exercise promotes health for your new joint, but even participating in some sports is not out of the question, as long as your surgeon approves your activity.
Making the decision to have a total knee replacement is a big step in improving your quality of life. If you have any questions about knee replacement surgery, or if you are bothered by any other problems with your bones or joints, don’t hesitate to call us. Please contact our friendly team today at the offices of Dr. Brett Gilbert in Raleigh, Durham, Cary and Apex, by calling us at (919) 788-8797 or you can request an appointment with Dr. Gilbert using our appointment request form, or you can self-schedule your appointment here.