What to Expect After Total Knee Replacement Surgery

Arthroplasty, or total knee replacement surgery, is a major surgical procedure and to ensure proper healing it is important to follow the directions given by your orthopedic surgeon. The knee bears a great deal of weight and a well designed physical therapy plan should be followed after knee surgery to ensure restoration of movement and mobility to the knee joint.

Very basically, arthroplasty involves replacement of the knee joint cartilage with a prosthesis made up of special metals and plastics and involves a hospital stay of 3 to 7 days after the knee replacement surgery. Most hospitals will not discharge a patient who has had replacement knee surgery unless they can walk with the aid of crutches. Knee rehabilitation therapy commences almost immediately after the surgery and can continue for several months. This is a crucial key to good recovery.

Since it can take up to 3 weeks after surgery before the repaired knee joint can be expected to bear any weight, it may be necessary for patients to receive in-home assistance. If in-home care is not available then there are rehabilitation centers that can provide that service. This would mean staying at the center for 2 or 3 weeks after the operation. During this time the leg should be kept elevated as much as possible and use ice packs to help minimise swelling.

Since we are all different with different health, fitness and motivation levels and the complexity of knee surgery varies with each operation, the recovery procedure and recovery time can vary. The following are guidelines only and can vary from case to case.

For the first three to four weeks after the knee replacement, walking with aid of crutches or a walker is necessary.

After that period the use of a cane is recommended for two to three weeks.

Usually, after around 8 weeks, most people can walk unaided.

It generally takes from 6 to 12 months for the knee joint to heal completely. This time frame is dependent on the knee exercises and rehabilitation program being followed and on the knee not being damaged by trying to pursue some activities too soon.

The level of mobility of the knee following the surgery varies from person to person, however, most people should be able to bend the repaired knee joint to 90 degrees with two to three weeks after their knee replacement surgery. Eventually, many will get over 110 degrees of motion in the repaired knee.

It should be possible to return to jobs that are sedentary by 6 weeks after surgery. More physical jobs should be looked at on an individual basis in conjunction with your health care professional.

After about 12 weeks, most people are back to their normal activities and the pain experienced before the knee replacement has usually disappeared by this time.

It is important to remember that the components used in the knee joint prosthesis are not able to heal if the knee is damaged and so common sense must prevail when considering undertaking leisure, sporting and employment activities to lessen the risk of injury. Here is a list of recommended activities, activities that are allowed in moderation and ones that should be avoided altogether.

Recommended activities

* Swimming and water aerobics
* Cross-country skiing
* Golf
* Dancing
* Cycling
* Using training machines like cross trainers and exercise bikes
* Desk work

Permitted: Allowable in moderation:

* Hiking
* Sports like gentle tennis or gentle downhill skiing
* Jobs that do not require heavy lifting (driving, walking, standing etc).

These activities should be avoided at all costs:

* Jogging or running
* Impact exercises
* Contact sports and those sports that put a lot of stress son the knee through pivoting or twisting e.g. basketball, squash, football etc.
* Heavy labor and lifting.

With the advances made in total knee replacement surgery procedures and prosthetics, almost full use of the knee can be expected for many years.