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Stages of Recovery from Knee Replacement

16th February 2018

The knee is a vital joint that enables movement and stability in the leg. If the health of the knee is affected and other treatments have not given relief, the entire joint may be replaced with surgery. It can take months to recover after this type of surgery, and it may even be a year before the knee has full strength and endurance, so it is not an operation to undergo lightly. However for those whose knees are worn, damaged or causing great pain, a knee replacement can give great relief.

There are a number of factors that cause knees to become diseased or damaged. The knee could be smashed or torn in an accident, but it is more likely that a condition such as osteoarthrtis or rheumatoid arthritis has lead to the cartilage being worn down, causing erosion of bone and painful inflammation and swelling. Any adult can be considered for a knee replacement, but most operations are performed on those over 60 and under 80.

The impact of osteoarthritis

Osteoarthritis is the number one type of arthritis that affects joints in the UK, and the most common condition leading to knee replacement. It can cause to stiffness and pain in the knee, swelling and a feeling that the leg bones are grinding past each other when you bend and straighten your leg.

Crystals can develop in the cartilage, and the knee may be damaged to the point where it is deformed. When rheumatoid arthritis occurs, the capsule surrounding the knee and helping to keep everything in place can become swollen and stretched, leading to a painful and unstable joint. In severe cases of these conditions, the knee may be so painful and deformed that replacing it is the best option. Gout, haemophilia and knee disorders where problems with the blood supply cause bone to die can also lead to knee replacement. The good news is that when the knee is replaced, it should last for at least 20 years.

Initial recovery

Recovering from a knee replacement operation varies from individual to individual, depending on factors such as general health, and any complications that may arise. This type of surgery is considered quite straightforward, but there is always a small risk of infection. Other risks could include bleeding, artery damage, persistent pain, or stiffness. However for most people knee surgery goes smoothly.

There will generally be a stay in hospital of up to five days. When a patient is discharged, they will be issued with instructions about how to care for the new knee at home. A physiotherapist will assist with recovery by giving patients exercises to do to help with mobility and strengthen the muscles supporting the knee. Following surgery of this type it is also a good idea to eat well, rest and not undertake any reckless activity that could stress the new joint unnecessarily. Recovery will be gradual and patients will need to tend to their knee each day, and follow the regimen of exercises that the physio has assigned.

Getting back on your feet

It is important to start using the new knee almost immediately. While resting it completely may seem sensible, it may also mean that joint becomes very stiff and hard to bend. To prevent this happening, hospital staff will probably have you on your feet and moving around within hours of having the operation. During your stay in hospital a physiotherapist can help you with strategies for getting out of bed on your own and performing tasks around the home. At first it will not be possible to walk unaided, and a walking frame or crutches will be needed for moving about. Again, the physio can provide help and advice with selecting an appropriate aid and using it efficiently.

The physio will probably set patients tasks such as sitting on the bed, going to the bathroom and using the facilities in preparation for the patient's return to their own environment. If your home has stairs, the physio will probably want to make sure you can go up and down these. The amount of activity will increase each day.

Just after the surgery a patient is probably on high strength painkillers, but these will be reduced on leaving the hospital. When a patient leaves hospital they should understand the exercises they need to do to help with recovery, and they should also be able bend their knee easily. Additionally, patients going home should be able to bathe and dress themselves, sit down, stand up, get in and out of bed with minimal use of supportive aids and be able to walk at least 20 feet and manage stairs.

Getting back to normal

Around the six week mark, patients should be able to discard walking aids and ease into normal movement and activities. If the patient has faithfully carried out the exercises set, the knee should exhibit significant improvement in strength and flexibility. The pain and swelling should decrease also, although it could be several months before the pain disappears completely, and swelling can persist for a year afterwards. Some patients are even back behind the wheel of a car by four to six weeks after surgery.

The patient's doctor and physio should be able to advise when a patient can return to work, and daily activities should be carried out without problems by the seventh week following surgery. By the two to three month mark, patients should be able to walk some distance unassisted, and carry out tasks such as shopping and driving. The physio may assign more demanding exercises to push the flexibility of the knee further. Dedication to an exercise regimen in this section of recovery can really pay off in the long run with a new knee that is strong, flexible and eventually fit for any activity the patient desires, from aerobics to skiing. By 12 weeks after surgery, the knee should be flexible, largely pain free, with continuing, gradual improvement in the next few months.

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