Your doctor may recommend knee replacement surgery if you experience severe pain, stiffness and limited mobility due to arthritis or other degenerative conditions in your knee or knees. A knee replacement is recommended as a last resort after other, less invasive, more conservative treatments have been tried. These might include medications, injections and arthroscopic surgery. If these treatments have failed and mobility is significantly limited, your doctor may suggest a knee replacement. The surgery is performed by an orthopedic surgeon under general anesthesia. During the surgery, the damaged part of the joint is removed and replaced with an artificial material that is attached to the femur (thigh bone) and the tibia (lower leg bone). Newer, minimally invasive knee replacement surgery, which requires a smaller incision and a less invasive approach, may be an option for you and may shorten recovery time and lead to less pain during healing. Talk to your doctor about different approaches and what is best for you.
When both knees are involved, some people choose to have both replaced at the same time. Talk to your doctor to determine if this is an option for you. When both knees are replaced at the same time, initial recovery is usually longer as mobility is more difficult right after surgery.
After a hospital stay of about three to four days, you may be discharged to another setting for continued rehabilitation, or you may be discharged home with outpatient or home health care. Your doctor will help determine the best discharge plan for you with input from your therapists and case manager regarding the criteria for each level of care. At a skilled nursing facility (SNF) or an inpatient rehabilitation facility (IRF), patients work with therapists on an inpatient basis. Therapy time in a SNF can vary according to your needs. In an IRF, the minimum therapy requirement is three hours daily.
Whether you are at a SNF or an IRF, you will work with your physical therapists to learn exercises to strengthen the muscles around your knee, and you’ll do general strengthening exercises. Range of motion (ROM) exercises that bend and straighten the knee joint will be especially important. You must begin working on increasing the flexibility of the knee and gaining full extension of the knee immediately to help prevent scar tissue from forming internally. Your therapist will also teach you mobility techniques to help you return to independence; these include bed mobility, sit-to-stand and walking.
Initially, you will probably walk with a walker. As your strength, balance, and endurance improve, you may be able to progress to crutches or a cane. Your therapist will help you know when you are ready to safely move on to another device. Your therapist will also teach you to walk on uneven surfaces such as ramps, curbs and stairs. Occupational therapists will assist you with activities of daily living (ADLs), which may include how to safely get in and out of a shower or tub and how to dress within your initial limitations through the use of adaptive equipment, if needed. They will teach you how to adapt your activities at home to accommodate your walking device when you are doing things like cooking, cleaning and doing laundry. Both occupational and physical therapists will discuss any appropriate home safety instructions or home modifications that might be needed. Some of the most frequently advised instructions include:
Once you leave an inpatient setting, you will likely continue therapy on an outpatient basis. It is very important to continue so the therapists can monitor your strength and ROM and you can have the best possible recovery. Driving can normally be resumed about four to six weeks after surgery. You will need to avoid all sports including jogging until cleared by your physician. If you complete your rehabilitation program and follow all post-surgery instructions from your physician and therapists, you should be able to resume most of your favorite activities with little to no discomfort.
This article is informational only and does not constitute medical advice, and is not a substitute for medical or professional care.
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