Knee replacement surgery is one of the most traumatic orthopedic surgeries that can be performed. It involves the removal of the entire kneecap and surrounding bone and the insertion of a prosthetic replacement. Although the surgery is a shock to the body, the outcome is almost always worth the risk and initial discomfort.
Post-Op and the First 2 Weeks
When you awaken from the surgery, you will be in a lot of discomfort and will likely be on a constant motion machine to keep the knee joint from stiffening. Pain medication will be provided, and constant monitoring, as well as nursing will occur. Despite the pain and the size of the incision, patients will be up and weight bearing within the first 24 hours, under the guidance of professional staff. Home therapy will be needed, and physical therapy is a must from day one. The patient usually goes home from the hospital within three to five days, and the remainder of the recovery will be on an outpatient basis. Physical therapy will start at twice a week, either at home or in-office, and move up to three times a week by the end of the first month. This first stage in PT will mainly focus on re-engaging your quadriceps muscles and learning how your replaced joint feels and functions. Pain medication will be necessary throughout this stage, as PT sessions are very likely to be extremely painful. Working through the pain and focusing on the goals is a critical step in this time frame. PT will mainly focus on regaining range of motion at this stage.
First 6 Months
Physical therapy is hugely important to recover from total knee replacement surgery. A skilled PT can do more for your recovery than any medication or any doctor's consult. The process involves the rehabilitation of the knee muscles, as well as the surrounding leg muscles and the core strength of the body. Balance, movement, motion and stability are all concentrated on at various stages of rehab, and by the end of physical therapy, which is usually around six months for a total knee replacement, the knee should be better than new, and the patient ready to resume a far more active and pain free lifestyle. Once the initial two weeks of general PT are done, the focus will shift to strength-building exercises such as legs lifts, resistance exercises, moderate weight training and continued range-of-motion exercises. Every week will see new goals set, and again, your focus on achieving these goals will make all the difference in the overall speed and totality of your recovery. There will be times when you dread going to physical therapy and think the pain is not worth the effort, but keep in mind the goal of an active, healthy lifestyle, and you can work through the challenges set in front of you. Pain medication will gradually be decreased and finally stopped, and reliance shifted to over-the-counter drugs such as Ibuprofen and Tylenol.
Although you may be released from a doctor's care and from regular physical therapy after six months, there will be bi-annual follow ups to make sure that your knee is functioning as it should. In addition, it is critical to make sure that you continue some of the rehab techniques you learned while in physical therapy. Daily exercises should include: leg lifts, quad sets, stretching, and walking. These exercises are meant to be continued, and will help you maintain the strength and ease the wear on your new knee. Once you have a total knee replacement, it is important to remember that recovery is actually a lifelong process. The better you take care of the replaced knee, the longer it will last, and the better your life will be. If at anytime after your knee surgery, you should experience swelling or pain in the joint that does not clear up with icing, rest, elevation and compression, it is important that you see your doctor for a checkup. Remember, knee replacements can only be done twice in a lifetime, so taking care of your new knee is vital to its longevity.