Continuing Your Recovery - Knee Surgery
How long does it take to recover?
Most patients will take up to 3 months to return to most activities and likely 6 months to one year to fully recover to maximal strength and endurance following a total knee replacement. Again this is highly dependent on preoperative conditioning, additional medical problems, and patient expectations.
What restrictions will I have?
Restrictions following knee replacement are generally few and should be discussed with your surgeon.
- Kneeling: Many patients following knee replacement will have some difficulty kneeling on the operative knee. Most patients become less aware of this with time but will always have a general perception that the knee is artificial and doesn't really feel like a normal knee.
- Return to Work: Most patients are able to return to preoperative activities and work but may have some difficulty performing heavy labor.
- Travel: You may travel as soon as you feel comfortable. During the first 6-12 weeks after surgery, it is recommended to stretch or walk at least once an hour when taking long trips. This is important to help prevent blood clots in the lower extremities.
- Exercise/Activities/Sports: On a long term basis, after physical therapy is completed, you may return to most exercise and sports, including walking, gardening, and golf. Swimming or stationary bike is highly recommended. Avoid high-impact sports such as running, singles tennis or squash.
When can I walk after surgery?
Rapid rehab protocols which emphasize increasing mobility and activity, aids a quicker recovery. You will be out of bed, sitting in a chair and walking beginning the day of, or the day after the surgery. You will attend physical therapy sessions two times a day starting the morning after your surgery.
You will use a walker at first and, depending on your progress, may practice walking with a cane before you are discharged from the hospital. There are exercises to achieve mobility and strengthen the muscles around the knee replacement, but initially these are relatively easy. You will wean to a cane or no assistive device by 2-3 weeks postoperatively.
When can I shower?
Most surgeons do not like the wound to be exposed to water for 5-7 days. However, becoming more popular with surgeons are waterproof dressings that allow patients to shower the day after surgery. Patients then remove the dressing at 7-10 days after surgery. Once dressings are removed you still shouldn't soak the wound for 3-4 weeks until the incision is completely healed
When can I drive?
If you had surgery on your LEFT knee, you may return to driving as you feel comfortable, if you have an automatic transmission. If surgery was on your RIGHT knee, you should not drive for 1 month (4 weeks) after surgery. However, some surgeons do not allow their patients to drive until after they have been seen in the office at 4-6 weeks after surgery. Check with your surgeon for more specific direction.
When can I return to work?
Returning to work is highly dependent on the patient's general health, activity level and demands of the job. Depending on the type of job, you may resume work whenever you feel able. More demanding jobs requiring more lifting, walking, or travel may need up to 3 months for full recovery. Always discuss your plan with your surgeon to obtain the proper clearance to resume work.
Do I need physical therapy after surgery, if so for how long?
Physical therapy is important to your recovery and progress. A skilled therapist can accelerate the rehabilitation as well as make the process more efficient with the use of dedicated machines and therapeutic modalities. The amount of therapy needed depends upon a patient's pre-op conditioning, motivation, and general health.
If you go directly home from the hospital, you will have in-home physical therapy about 3 times a week, for 2 weeks. It is advisable to continue physical therapy on an outpatient basis after you are discharged from in-home physical therapy. You should call the outpatient physical therapy facility soon after arriving home to schedule your first appointment (for the third week after surgery). This is to prevent a lag in your progress. You can call Towson Sports Medicine in Towson at 410-337-8847, in Bel Air at 410-569-8587, UM SJMC's Outpatient Physical Therapy/Rehab at 410-337-1336 (press 2), or a facility of your choice that is within your insurance network to make an appointment.
If you go to an inpatient rehab facility or transitional care unit from the hospital, you should contact the Outpatient Physical Therapy Facility as soon as you arrive home to set up appointment to continue your physical therapy.
You will also be taught a series of exercises that you can perform on your own without supervision. For the first 6-12 weeks after surgery you should spend some time each day working on both flexion and extension of your knee. It is a good idea to change positions every 15-30 minutes. Avoid a pillow or roll under your knee. A roll under the ankle helps improve extension, prevent a contracture, and relieve pressure on the heel. Aquatic exercising, swimming, and exercise bike are good.
What are the major complications?
Total knee replacement is primarily a pain relieving procedure however may not relieve all pain with possible residual stiffness and swelling.
Although severe complications are relatively rare (1-5% of patients), patients may experience a complication in the postoperative period. These include very serious and possibly life threatening complications such as heart attack, stroke, pulmonary embolism (a blood clot to the lungs) and kidney failure. Blood clot in the leg is also a complication requiring some type of blood thinner following surgery to reduce the incidence.
Stiffness or loss of motion can also occur. Infection (1%) is one of the most debilitating complications and often requires prolonged antibiotics with several additional surgeries to rid the infection. The implants can also fail over time due to wear or loosening of the components. But this generally occurs many years after surgery.
How long do I have to follow up?
It is important to follow up with your surgeon after your joint replacement. In most cases, joint replacements last for many years. You need to meet with your treating doctor after surgery to ensure that your replacement is continuing to function well. In some cases, the replaced parts can start to wear out or loosen. The frequency of required follow up visits is dependent on many factors including the age of the patient, the demand levels placed on the joint, and the type of replacement. Your surgeon will consider all these factors and tailor a follow-up schedule to meet your needs. In general seeing your surgeon every 1-2 years is recommended.