Sometimes the only solution to chronic knee problems, like severe pain and loss of mobility, is surgical intervention in the form of a total knee replacement. It sounds scary, but if you know what to expect it can help put your mind at ease.
What to Expect from the Procedure
Before any surgery is performed on you, you’ll undergo an evaluation to determine the extent of the damage to your knee, including x-rays. You’ll also get a general medical evaluation including a look at your medical history in order to make sure that you’re a good candidate for surgery.
The procedure itself generally takes 1-2 hours and is performed under anesthesia. Some surgeons prefer to use a spinal block anesthetic instead of or as a compliment to general anesthesia. The reason for this is that the effects of spinal anesthesia wear gradually, helping to minimize pain immediately after the surgery. The procedure involves several steps including the resurfacing of bones and removal of damaged cartilage, and placing metal and plastic implants to restore smooth knee motion.
You may be admitted to the hospital for a few days following your procedure to monitor your condition immediately following the surgery, but it’s very common these days for patients to be discharged after a single night or even the very same day.
Precautions Prior to Surgery
Another component of preparing for the surgery is preparing for life after the procedure. For the first few weeks after the surgery you will very likely need assistance with the activities of everyday life such as bathing and getting dressed, so arranging for help is an important step prior to surgery. For bathing purposes a shower bench or chair is recommended. Other home modifications such as toilet seat risers and safety bars will make it easier to complete everyday tasks safely. A chair of sufficient height (18 to 20 inches) with a firm cushion and arms will be easier to get in and out of than your normal chairs and sofas and should be considered.
You’ll also want to remove anything that can pose a falling hazard such as loose cords, rugs, or other objects on your floors. A fall after your surgery could cause severe damage to your knee and require new surgery. In addition, if you live in a multi-story home, consider temporarily arranging to reside on only one floor to eliminate the need to go up and down stairs.
What Post-Op Recovery Looks Like
Within a few hours of the surgery, you’ll be able to start lightly exercising your knee. A continuous passive motion (CPM) machine might be used to slowly move your knee while you’re in bed, and a physical therapist will teach you specific exercises to strengthen your leg and restore your knee’s mobility so that you can resume walking and normal daily activities as soon as possible. Your doctor will assist you with pain management, possibly prescribing stronger pain medications if necessary for short-term pain relief after your surgery.
A few weeks after your procedure, any stitches or staples you have will be removed. Your surgical wound should be kept away from water until it has thoroughly sealed. Bandaging the wound to prevent irritation from your clothing is also a smart idea.
A possible complication of knee surgery is the potential for blood clots to form, which can be dangerous. In order to minimize this risk, compression garments and exercise are recommended to help restore and maintain good circulation in your legs. Blood thinning medication may also be prescribed. If you experience any tenderness or redness above or below your knee or any new swelling in your feet, ankles or calves this may be a sign of a blood clot and you should notify your doctor.
Long Term Recovery, Physical Therapy, and Long Term Outlook
Part of your long term recovery plan is gradually increasing the amount of walking you do in order to increase your mobility, and slowly resuming household activities. If you work with a physical therapist, they can help you with specific mobility exercises to aid in your recovery, including:
Straight leg raises
Stationary bike riding
Your physical therapist will guide you through implementing these exercises based on your specific needs and recovery timeline. These exercises can help you achieve a more complete recovery more quickly so that you can get back to your daily activities. It’s important to exercise in order to help your knee recover and restore your full range of motion. Listen to your body – some pain is to be expected when doing exercise during your recovery period, but anything excessive may be a sign you’re pushing yourself too hard. That said, there are no particular restrictions placed on knee replacement patients after the procedure and resumption of activity is greatly encouraged. Follow the advice of your physical therapist to get the best short term and long term results!
After your recovery is complete you will be able to resume normal daily activities, including recreational activities like sports. This includes high-impact activities like running, but it’s important to note that these can make your implants wear out a little sooner. If you're a dedicated athlete, you may want to try lower-impact sports such as cycling and swimming. Treated well, you can expect your implants to last for 15 to 20 years, and you’ll be able to enjoy a return to mobility and activity.