Author: Dr. Oscar Paredes Ottalengo, about this author…
Are you getting ready for a Total Knee Replacement? here is some information about its recovery time.
Everyone wants to be able to walk freely, get out of the clutches of crutches. Osteoarthritis is defined as one of the main reasons of age and disease-related dependence on crutches.
In preparation for a total knee replacement Knee replacement Recovery time is Everyone wants to be able to walk freely, get out of the clutches of crutches. Osteoarthritis is defined as one of the main reasons of age and disease-related dependence on crutches.
It affects more than 10% of men and women above the age of 60, usually affecting women more often than men.
The number of people suffering from joint disorders increases according to age, with knee and hip joints most commonly affected by the osteoarthritis (Zhang & Jordan, 2010).
Other common reasons of disorders of larger joints are traumatic events and rheumatoid diseases.
In my own experience I suffered from traumatic sports injuries since I was a teenager; after two ACL surgeries, I had a knee replacement at the age of 44 years old.
Since then, my life has been different in many ways, but with therapeutic exercise and skilled care of my right knee, I have been able to cope with my daily living activities without pain and with a plenitude of life experiences.
Knee arthroplasty has emerged as one of the most effective treatments for joint-diseases related disability.
It is especially useful in the cases of osteoarthritis with a high level of physical disability due to joint deformation, not benefiting from the pharmacological treatment.
With the improvement in surgical techniques and quality of artificial joints, knee replacement surgery has seen an increase in numbers in the last decade.
It is reported that more than half-a-million people in the US have knee-joint replacement surgery each year. There are now approximately five million people living the artificial knee joints in the US.
While people live longer and younger people get joint problems more often, this number is presumed to increase(Maradit Kremers et al., 2015).
How well the person recovers and feels after the knee replacement surgery depends on the various factors, like how much damage was done to the adjoining structure before going for a knee surgery.
Most of the knee replacement surgeries also require the repair work of ligaments (connective tissues that connect the bones and keep the joints at the place).
Rehabilitation After Knee Replacement
Knee replacement surgery is a major procedure, requiring few days in the hospital (usually 3-5 days), but it all depends on each individual.
In order to be discharged home, you should be able to demonstrate the following:
In order to be discharged home, you should be able to demonstrate the following:
- Get dress and bathe independently or with minimal help
- You should bend your knee well enough to allow you to get in/out of a car.
- To be able to ambulate safely with or without an assistive device for about 25 ft or more.
- Get in/out of bed with minimal help.
If discharge home is not deemed appropriate due to the patient is showing a significant decrease in functional mobility or safety, the surgeon may recommend temporary placement in a Skilled Nursing Facility for rehabilitation prior to going home.
Home Health Care including a Nurse, a Physical Therapist, and an Occupational Therapist, is also a very common indication by Drs, upon discharging patients home.
The last part of the rehabilitation process would differ from place to place and person to person, patients may often go to outpatient physical therapy, while in other conditions some people may carry out the process more independently.
Usually, with the right kind of medications and physical therapy interventions, patients can expect pain and inflammation to gradually subside between six weeks and three months (again, this would vary from case to case), and be able to walk without crutches or other assistive devices, though full healing may take up to one year.
Exercise is very important in the recovery phase for better movement, and less feeling of the artificial joint, thus the intensity of exercise would have to be increased slowly.
With the adequate kind of physical therapy, one can expect to perform most of the activities, like brisk jogging, swimming, or even playing in certain sports, though some of the very strenuous physical activities like jumping from height are not allowed.
During the recovery process, you may have to take analgesics for pain and medications to prevent blood clotting, along with other therapeutic modalities as cold therapy and pressure therapy.
Though most people can get close to normal movement, some may continue to feel the difference between the joints (artificial and natural), and this is quite common.
Few people may feel little discomfort during the knee movements; others may feel joint being stiffer.
Some may feel clicking of metal and plastic, and metal while walking or bending. But with time most people can get used to the feeling.
Physical Therapy Guide After Knee Arthroplasty
Because every case of knee replacement is different, there is no single agreed protocol for physical therapy after the surgery.
Physical therapy plan has to be individualized for each case by the professional physiatrist.
The physiatrist will decide about the intensity of exercise program. Some physiatrist would prefer land-based procedures, while other aquatic therapy.
Usually, physical therapy done under the supervision of trained physiatrist would result in better and quicker recovery as compared to remotely supervised therapy, but it may not be practicable in many cases (Pozzi, Snyder-Mackler, & Zeni, 2013).
Below are some of the exercises recommended by the American Academy of Orthopedic Surgeons (AAOS) for recovery after knee replacement surgery.
Two to three sessions of 20-30 minutes of exercise each day and at least 30 minutes of walking every day must be done for optimal results (Foran, 2017).
Early postoperative exercises
While lying in bed, straighten the legs by tightening the thigh muscles, and hold it for 5-10 seconds. Repeat it ten times.
Lying down, straighten the legs by tightening the thigh muscles as above, then lift the leg as high as you can, still keeping the leg straight. Do it periodically during the day.
Move foot up and down by using the calf muscles. Perform this exercise for 2-3 minutes, repeat 3 times an hour.
Place something under your heel, so that it is a bit elevated. Then try to straighten the knee joint as much as you can by tightening the thigh muscles. Repeat several times.
While lying in bed, bend your knees as much as you can by trying to touch your buttocks with the heel of your foot. Hold knee bent for 5-10 seconds. Repeat it several times.
Sitting Knee Bends
While sitting on a chair or your bed, bend the knees as much as you can, or until your foot is touching the floor.
Hold for 5-10 seconds and then straighten your leg. You can help to bend your knee by pulling with the opposite leg crossing it over the operated leg.
Supine Knee Bends
While lying face up on the bed, elevate your legs up on a wall. Glide your operated leg’s heel down the wall as tolerated and repeat several times.
Initially, walk with the help of either walkers or crutches. Keep the leg straight while walking, and slowly increasing the distance.
Ascending and Descending the Stairs
It is better to start with the help of someone, and by holding onto the rails. While going up good knee should lead, while coming down it is the operated leg that should lead.
Standing Knee Bend
While standing erect with the help of walker or crutches, bend the operated knee as much as you tolerate and hold it in that position for 5-10 seconds. Repeat it several times.
Assisted Knee Bend
Lying on the back, bend your knee as much as you can, then with the help of towel try to force the bending to the maximum.
Upright or Recumbent bike
Do either for 10-15 minutes, twice a day. Slowly increase the tension level. Do it 3-4 times a week.
If done regularly these exercises would increase the strength and mobility.
Foran, J. R. (2017, February). Total Knee Replacement Exercise Guide-OrthoInfo – AAOS. Retrieved September 25, 2017, from http://orthoinfo.aaos.org/topic.cfm?topic=a00301
Maradit Kremers, H., Larson, D. R., Crowson, C. S., Kremers, W. K., Washington, R. E., Steiner, C. A., … Berry, D. J. (2015). Prevalence of Total Hip and Knee Replacement in the United States. The Journal of Bone and Joint Surgery. American Volume, 97(17), 1386–1397. https://doi.org/10.2106/JBJS.N.01141
Pozzi, F., Snyder-Mackler, L., & Zeni, J. (2013). PHYSICAL EXERCISE AFTER KNEE ARTHROPLASTY: A SYSTEMATIC REVIEW OF CONTROLLED TRIALS. European Journal of Physical and Rehabilitation Medicine, 49(6), 877–892.
Zhang, Y., & Jordan, J. M. (2010). Epidemiology of Osteoarthritis. Clinics in Geriatric Medicine, 26(3), 355–369. https://doi.org/10.1016/j.cger.2010.03.001