Medically known as arthroplasty, a knee replacement is a surgical procedure that replaces a damaged knee with an artificial one made of plastic, metal, or polymer. The procedure helps alleviate pain and restore knee function and mobility for patients with osteoarthritis and other conditions. The first knee replacement surgery was performed in 1968, and over 600,000 of these surgeries are now performed each year. A knee replacement may be appropriate for patients who struggle with walking and getting out of chairs. It is also appropriate for individuals with knee deformities and severe knee pain. When considering surgery, orthopedic specialists will do x-rays and imaging studies to visualize the specific damage to the knee and formulate a plan for which type of knee replacement may be most effective for the patient. The orthopedist will also physically examine the patient's knee, feeling for tenderness and evaluating range of motion. Doctors may ask overweight patients to lose weight before the operation so they can have a smoother recovery. Knee replacements are typically performed with general anesthesia, and they may also be done using spinal anesthesia.
Recovery from knee replacement can be a lengthy process. It is often done in stages, and some patients may need a full year before they feel completely recovered. The steps discussed below are general parts of the recovery process for all knee replacement patients.
Physical therapy is a crucial portion of the recovery process and is arguably the most important component of recovery. Physical therapy enables the new knee and the muscles around it to gain the strength, flexibility, and range of motion necessary for daily tasks such as standing, walking, and driving. Patient's adherence to the therapy recommendations often determines the quality of life they have following this procedure. While patients who engage in rigorous and regular therapy sessions often have no difficulty walking on their own, individuals who are not as diligent with their therapy sessions may still need to use a cane or walker following the operation.
Typically, initial therapy may begin as early as the day of the surgery and may involve the patient simply standing up after the procedure. After patients are discharged from the hospital, they usually continue their therapy at an inpatient rehabilitation facility. Patients can also choose to have therapy at home with a licensed physical therapist who makes home visits. Exercises usually include a combination of standing, walking, riding a stationary bike, stretching using an elastic band, and passive motion. During passive motion exercises, the physical therapist will move the knee in various directions to increase range of motion. Patients will be shown a series of daily exercises to complete at home outside of their therapy sessions.
While most patients who have a knee replacement will begin walking on the same day or within a few days after surgery, they will still be spending longer than usual in bed or resting, which may cause blood to pool in the lower legs, increasing the risk of a blood clot. Doctors will likely recommend patients wear compression socks to prevent blood clots from forming. During the patient's stay at the hospital, these are provided by hospital staff, and nurses may put them on patients while the patients rest in their beds after the procedure. Once a patient returns home, they may need to continue wearing compression socks. Patients should purchase compression socks for this before surgery. They are available at pharmacies and through specialist stores and catalogs. Compression socks improve blood circulation in the lower limbs. Patients should ask their orthopedic surgeon about what level of compression is appropriate for their body. It is important for compression socks to provide adequate compression, but they should not be too tight.
Pain Relief Medication
Pain relief medication will be provided for patients immediately following surgery, and additional medicines for pain relief will be recommended once patients return home. At the hospital, opioid medications such as morphine and oxycodone may be used after the procedure, though they are generally only used for a day or two. If patients experience severe pain once they are at home, doctors may recommend other strong pain relievers. Within the first week after a knee replacement, most patients can switch to using prescription-strength anti-inflammatory medicines like ibuprofen and naproxen. Eventually, patients usually move to just using regular-strength over-the-counter pain relievers. They gradually reduce these until they are no longer needed. Some pain relievers can cause stomach bleeding, confusion, constipation, and other side effects. Patients should use the lowest dose that alleviates their pain, and doctors should be informed of any concerns or increasing pain.
Maintain Recommended Exercise Schedule
Patients need to maintain the recommended exercise schedule set by their physical therapists and doctors to have a full and speedy recovery. Patients should comply with all the exercise instructions from their medical team and avoid doing too much too soon. They should try to walk whenever they feel able, making sure to use a walker or cane as instructed by healthcare staff. For the first few weeks after surgery, exercise should be limited to walking and the physical activities suggested by the therapists. Patients may need support with cooking, doing laundry, and other basic tasks at home during this period. After the first month following surgery, patients will likely be able to take on more complex exercise regimes, and they should check with their doctor before beginning these.
Get Support Handles Around The Home
Doctors often recommend patients get support handles around the home before surgery. This is especially important as strength in their legs is reduced during the initial recovery period, placing patients at a greater risk of falling and injuring the knee. Any fall could be a serious setback in the patient's recovery, and it could potentially mean a patient would need additional surgery. Patients will need to use walkers and canes at first, and they should have support bars installed in their bathroom. These are particularly useful in showers and by toilets. Handrails should also be placed at all staircases, and patients may also benefit from the use of shower benches, dressing sticks, and reaching sticks to help them grab objects without having to bend the knee.