Knee replacement, also known as knee arthroplasty, is a surgical procedure to replace the weight bearing surfaces of the knee joint to relieve pain and disability. It is usually performed on patients suffering from osteoarthritis, rheumatoid arthritis and psoriatic arthritis. In patients suffering from severe deformity due to advanced rheumatoid arthritis, the surgery may be more complicated and carries high risk.
The surgery can be performed as a partial or total knee replacement surgery, and typically includes replacing the damaged joint surfaces of the knee with metal or plastic components.
The recovery and rehabilitation process after the surgery is the most important part for the successful completion of the surgery. For a successful knee replacement surgery, you need to invest a considerable amount of time and energy towards rehabilitation programs. Rehabilitation begins in the hospital, most probably the very next day after surgery. You have to follow a strict timetable for diet, exercise and medication and are very crucial for the success of the surgery. It helps you in healing faster and ensures long term success of the operation. The timeline of rehabilitation process is as follows:
Within the first 24 hours after waking up from surgery, you will begin by standing up and walking with an assistive device with the help of a physical therapist (PT). It is very essential to use your artificial knees as early as possible after surgery. A continuous passive motion (CPM) machine will be provided to keep your knee in motion and prevent immobility.
The PT will ask you to walk using assistive devices and encourage you to use regular toilet. They will also ask you to climb a few steps at a time. Your activity level should increase and they may also ask you to use CPM.
The PT will ask you to go on longer walks and shift your medication to lower dose of pain killers. By discharge, you will very well be able to walk with minimal usage of assistive devices and also be able to bend your knee to a minimum of 90-degree angle.
You should be able to move much more freely during this time. Very minimal usage of walking assistance is required and the pain would also have considerably reduced. The exercises prescribed by the PT should be followed strictly. It is also advisable to use CPM during this stage.
If you have performed all the prescribed exercises and taken correct medication, you will observe considerable amount of improvement in your condition. There should be improved flexion and strength. Longer walks of half a mile or more will be possible. Your daily chores will become easier to perform. Some recipients may be able to drive within this time but before attempting such a feat, it is necessary to consult your PT and get his advice. It is advised to wait more if you are under narcotic medication or don’t feel confident to drive. You should also be able to gain at least 90-degrees of flexion to climb stairs and for normal walking.
This is the most important time in your rehabilitation process and determines how quickly you will be able to return to your normal lifestyle. During this period you may be able to walk a couple of block without any assistive devices and can perform all the day to day activities like driving, shopping etc. The PT will monitor your improvements and suggest exercises like:
By this week, you would be well advanced in the path of recovery and be able to perform activities like swimming, driving, golfing etc. The exercises prescribed by the PT should be followed. Also care should be taken not to indulge in high impact physical activities like running, aerobics, football etc. They may cause damage to implant or its surrounding tissue. You might experience pain during this time and consult your medical team as soon as possible.
You will be almost entirely pain-free and would return to your normal life. There would be a significant increase in flexion to about 115 degrees which enables you to engage in a wide range of activities. If at any point you feel pain, consult your medical team immediately.