Osteoarthritis is the most common form of arthritis of the knee. It can cause pain, difficulty walking, going up and down stairs, swelling and inflammation, sleep disturbances and even knee deformities.
There is no cure for the degeneration caused by osteoarthritis, but knee replacement surgery (arthroplasty) is a solution with a success rate for more than 90 percent of patients. That means that 90 percent of people who have a knee replaced experience improved knee function and a reduction in knee pain. Knee replacements can last 20 years or more with proper care.
Knee replacement may seem like a major operation, but recovery from it is getting easier every year. With a skilled surgeon, you can be fully independent in four to six weeks. Summit Medical Group Orthopedics surgeons have trained at some of the most competitive residency and fellowship programs in the country and have collectively performed thousands of knee replacements.
Here is your guide to understanding and preparing for your surgery and learning what to expect from recovery, as well as tips to help your recovery go quickly and smoothly.
Partial Knee Replacement vs. Total Knee Replacement
Relief of pain and improved knee function due to osteoarthritis are the goals of knee replacement surgery. Depending on your specific condition, your physician will recommend either a partial or total knee replacement.
The knee is comprised of three parts:
- Medial (inside)
- Lateral (outside)
- Patellofemoral (front)
In patients with osteoarthritis, often only one part of the knee is affected. In this case, a partial knee replacement may be suggested, as only the affected compartment of the knee needs replacement.
There are specific candidates for a partial knee replacement. Your physician will determine which surgery is indicated for your specific case. Patients with certain types of knee arthritis, such as rheumatoid and inflammatory arthritis, are not considered good candidates for partial knee replacement.
In contrast to partial knee replacement, all three compartments of the knee are replaced in a total knee replacement surgery. The bones that meet at the knee joint are resurfaced. Your surgeon removes the damaged portions of the bones at the thigh bone (femur) and the top of the shin bone (tibia) and replaces them with prosthetics – an artificial joint – made of plastics, metal and polymers. In most cases, the back of the kneecap is resurfaced.
Preparing for Knee Replacement Surgery
Prior to your knee replacement surgery, your surgeon might suggest and require some preparations to help ease and speed recovery. Things you can do include:
- Participate in physical therapy to strengthen the muscle around the knee (you may benefit from less pain and better knee function post-surgery).
- Decrease or eliminate medications two weeks before surgery:
- Aspirin, NSAIDs and any other medication that inhibits blood clotting
- Opioid pain medications
- Steroids and any other medications that suppress your immune system
- Homeopathic medications and supplements – provide your physician with a list for review as some may need to be discontinued before or after surgery
- Eliminate smoking or tobacco use or nicotine from vaping (vaping is not a safe alternative), as nicotine impedes healing and increases the risk of post-surgical infection and deep vein thrombosis (potentially deadly blood clot).
- Decrease or eliminate alcohol use, as heavy alcohol use influences the effects of anesthesia and should be reported to your physician for surgical safety (one to two drinks per day or more).
- Start a weight loss program approved by your physician, if recommended.
- Report to your doctor any illnesses that occur in the days before your surgery.
What to Expect After Surgery
Most people can expect to stay in the hospital for no more than three days, with many going home in as little as one. At Summit Medical Group Orthopedics, the average length of a hospital stay for our knee replacement patients is one to two days. For some patients, knee surgery can even be an outpatient procedure: no hospital stay necessary.
Expect to be up and moving the same day as surgery. Our patients can begin walking immediately. Light activity is recommended as it helps cut down on swelling and shortens recovery time.
Your surgeon will order a regimen of physical therapy. Your physical therapist may come to your house for the first one to two weeks after surgery. After that, you will visit a physical therapy facility two to three times a week (or more) for a number of weeks after surgery.
- Keep your wound site clean and dry and change the dressing as recommended by your doctor.
- Do not bathe or shower until you are allowed to do so per your doctor’s instructions.
- Contact your doctor immediately if you notice any draining from the wound site, as this may be a sign of infection.
Preemptive pain management is crucial to speed healing time, earlier hospital discharge and decreased infection risk. The less pain you experience, the faster you are able to perform the exercises key to building strength and returning to normal activities. Speak to your doctor before surgery about what pain management program should be employed post-surgery.
- Expect swelling immediately after surgery. Ice your knee at regular intervals for 20 minutes at a time, and keep your knee elevated above your heart as much as you can in the first hours and days after surgery to reduce swelling.
- Take prescribed painkillers or anti-inflammatory medications to help with any pain and swelling.
- Limit or eliminate opioid painkillers as soon as possible, as they are highly addictive.
You may have a pain relief program that includes a peripheral nerve block, local anesthetic or steroid injections. Not all surgeons administer peripheral nerve blocks, so discuss this option first with your surgeon.
Tips to Speed Recovery
Preparation at home encourages a faster and easier recovery period. There are many steps you can take. Some are listed here, but you may find other preparations tailored to your own home and recovery.
- Remove all rugs – these can cause you to trip.
- Secure electrical cords to the walls to avoid tripping.
- Clear obstacles from walkways and move any furniture that may cause tripping or falls.
- Arrange for meals with a spouse, family or friends and stock up on pre-made meals and snacks. Place them in easy-to-access areas.
- Arrange for transportation services, as you may be unable to drive in the first few weeks after surgery.
- Arrange for others to clean and run errands. You may be able to perform light cleaning, such as dusting. Clear all activities with your physician first.
- Adjust the bed height, if possible, to help ease the transition in and out of bed – it may need to be raised or lowered.
- Move your bed, if possible and needed, so that sleeping arrangements are on the same floor as daily activities to avoid stairs.
- Be sure a comfortable chair with good support is available with an ottoman or reclining feature to keep the leg elevated.
- Install a higher or modified toilet seat to avoid stress on the knees and enable easier rising and sitting.
- Install a shower seat or place a small stool in the shower to avoid standing and slipping.
- Install rails by the toilet and in the shower, if possible.
- Use cold packs to help with pain and swelling.
- Practice walking with a cane, walker, or other assistive device.
- Check all house railings to be sure they are sturdy; fix any loose ones.
Lifestyle changes can include:
- Quit smoking (smoking impedes healing).
- Lose weight, if necessary.
- Perform all physical therapy exercises diligently.
- Eat a healthy diet.
Getting Back to Daily Activities
You must stay active once you return home after surgery; however, you need to find a balance where you do not do too much and damage your new knee. A comprehensive recovery program, such as those given after surgery with Summit Medical Group Orthopedics, can have you fully independent in as little as four to six weeks.
Driving. You may drive once your strength and reflexes have improved and as long as you are not taking any opioid pain medication. Driving usually resumes within three to six weeks after surgery.
Exercise and sports. Physical therapy will be your main source of activity after surgery for up to two months. You may also be asked to ride a stationary bicycle to improve muscle tone and maintain flexibility in the knee. Your doctor will let you know when it is okay to return to regular exercises and sports.
In the meantime, you may walk as much as you’d like, swim after your wound is healed, and perform low impact activities such as light tennis, bicycling or golfing. High-impact activities will decrease the longevity of your knee replacement. You should also avoid deep bending.
Returning to work. The return to your job is dependent upon multiple factors, including the type of work duties you perform, the extensiveness of your surgery and your recovery rate. You may only be out of work for a matter of days after surgery and usually no more than six weeks. Your doctor will approve when you are able to resume working.
Sexual activity. Your doctor will determine when it is safe to resume sexual activity.
Travel. Though travel is not restricted, air travel may affect your knee, especially during early healing. Pressure changes and the immobility for extended periods may cause swelling. You should check with your doctor before any planned air travel. Also, metal detectors may be sensitive to your artificial joint. You should inform the security screeners of your joint replacement before going through the metal detector.
Weight loss. With the approval and supervision of your physician, start a weight loss program or continue with the one you started prior to surgery. A healthy weight will extend the life of your knee replacement as well as speed the recovery process and lessen pain on the knee.
If you have questions about knee replacement surgery or are interested in learning more, contact us today to schedule a consultation. We look forward to helping you with any questions or concerns.