The decision to have a knee replacement performed is not an easy one. Many times people are shocked to find out that their knee needs to be replaced. Your doctor will let you know when your knee is ready to be replaced and likewise, you will let him know when you are ready to have your knee replaced based on your degree of pain and the limitations that pain is placing on your lifestyle.
Physical therapy will be a very important part of your recovery from a knee replacement beginning the day after surgery at the inpatient level. A therapist will come to your room the first day after surgery and help you get out of bed and start to put some weight through the affected leg. You will then work up to walking with a walker or crutches as well as learn how to use the stairs and be given some exercises to start getting the muscles in your legs working.
Once out of the hospital you will begin outpatient physical therapy. On the first day you will be evaluated by a physical therapist. The evaluation will consist of a review of your medical history, changing the dressing that is covering your incision, as well as assessment of the range of motion in your knee. You will then be instructed with some exercises which will become a part of your home exercise program. You will perform these exercises several times a day at home as well as when you come in for follow up therapy sessions. Your therapy appointments will typically be three times per week for an hour to an hour and a half at a time. Total rehabilitation time following surgery ranges greatly but is typically 3-5 months.
Your therapy team will work to accomplish a few goals during your therapy including improving range of motion to a functional level for both bending and straightening. You will also work with them to improve your walking and progress from your walker or crutches to a cane and eventually progress to walking without an assistive device if able. Your goals may also include returning to work or to a specific sport or activity that you enjoyed prior to your surgery. Be sure to mention any of these goals to your therapist. Remember, we work for you and together we will work to ensure that you have the outcomes from your surgery that you hope for.
The following are some of the things that you may find helpful as you consider knee surgery. You will not be able to drive for a while after your surgery. Your surgeon will ultimately be the one to release you to return to driving. The amount of time will depend on which leg you have surgery on as well as what medications you are taking for your pain. The doctor will also take into consideration the available motion and strength in your knee and how easily you are able to move your leg.
Many people are curious about sleeping positions following a knee replacement. In the beginning you will most likely be sleeping on your back and may be more comfortable with pillows under your feet and lower legs. If you want to use pillows for elevation be sure to avoid putting pillows under the back of your knee to encourage your knee to stay bent. You should try to rest, whether sleeping or just sitting throughout the day, with your knee straight as much as possible. You will be able to try sleeping on your side shortly after surgery. It will help to have a pillow between your knees because the inside of your knee may be tender when it touches your other leg. Your therapist and your doctor will help you determine when you are ready to try sleeping on your side.
You will have staples in your incision for about two weeks after surgery. You will be instructed in the hospital on how to care for your incision and your therapist will change your dressing during your sessions until your staples have been removed. You will also have compression stockings on both legs as soon as you wake up from surgery. These are to assist with circulation in your legs following surgery because you will not be as active as normal. These will help to keep the swelling down as well as help in preventing blood clots. Most doctors would like you to continue wearing these for six weeks following surgery.
Many patients report noticing clicking in their knee following surgery. This is very common and can be for a number of reasons. You will have a moderate amount of swelling in your knee following surgery and this can cause the structures in your joint including your knee cap to move differently and sometimes this will produce a clicking sound. You may continue to feel a click in your knee with movement even well after recovery as a result of the artificial components in your knee articulating with each other. The click should not be painful and will likely become less noticeable over time.
Ultimately, please remember during the course of your surgery, from deciding when you are ready to proceed with surgery to your hospital stay to your rehabilitation, we would like you to feel comfortable with asking any questions you have as well as sharing with us any concerns that you have about your symptoms or your care at any time throughout this process. Coordinated Health provides a comprehensive approach to your care. We are a team who have been arranged with the purpose of making your experience the best possible and you are the leader of that team.