What to Know if You're Considering Knee Replacement Surgery

What to Know if You're Considering Knee Replacement Surgery

A knee replacement is a surgical option for those who suffer from arthritis or other conditions that significantly damage the knee joint and cause pain. It consists of removing parts of the damaged knee joint and replacing them with metal prosthetics. And, thanks to technology, you can expect your new joint to last about 15-20 years. 



The decision to get a knee replacement is not always straightforward and requires careful consideration of several factors. However, those who decide to proceed with surgery typically do so because their pain has affected their ability to walk, climb stairs, or work, and more conservative treatments have failed.

You should expect to stay in the hospital for one to three days following surgery. During that time, you will be monitored for any complications and undergo physical therapy as soon as you are cleared to get out of bed. For some, that may be as early as the night after surgery. You will be able to return home once the orthopedic team agrees that you are medically stable and safe to leave the hospital. Your surgeon will decide when you can work or perform strenuous activity, such as intense exercise or physical labor. 

For most people, it takes six months to a year after surgery to see a full return of strength and endurance. Recovery will largely depend upon your physical conditioning before surgery, any pre-existing medical conditions, and your participation during rehab.  If you’re curious about the factors that may affect your outcome, you will find your answers below. 

Factors that are associated with worse outcomes after knee replacement surgery
Prior to surgery, many surgeons will recommend physical therapy and weight management because studies have shown higher body mass index and/or poor physical conditioning to be associated with worse post-surgical outcomes. 

Having certain pre-existing medical conditions may also affect your recovery time. Individuals who use tobacco products or those who have been diagnosed with depression are at risk for worse outcomes. Luckily, researchers have not found a correlation between diabetes and recovery after knee replacement surgery, but most physicians will ask you to closely monitor your glucose levels before and after leaving the hospital.

Family support is also crucial to your recovery. Those with limited support systems and/or resources are more likely to report poor outcomes after knee replacement surgery than individuals with strong support systems in place.

How you can optimize your recovery after knee replacement surgery
Thankfully, there are ways to increase your chances of a less complicated recovery following a total knee replacement. Research has found that patients who are knowledgeable about the surgery and expectations for recovery have a decreased risk of post-surgical complications and a shorter hospital stay. Without further ado, here are the ways in which you can enhance your recovery:

1. Read about your surgery from trustworthy sources
Learning about your neighbor’s daughter’s friend’s knee replacement does not count. Instead, read about your upcoming surgery from the American Academy of Orthopedic Surgeons

2. Take a specialized, pre-operative exercise class
You should participate in a pre-operative exercise class prior to undergoing surgery. These classes are offered by physical therapists to improve strength in the muscles surrounding the knee joint and can improve your outcomes after surgery. 

3. Make a plan for returning home after the surgery
Who will drive you to follow-up appointments and to the grocery store? How will you prepare meals or do laundry? Asking yourself these questions will ensure that you are prepared for your return home from the hospital. Expect to be limited in your mobility for the next three months, so plan accordingly and establish a solid support system. 

You will most likely use a walker for the first few weeks and will need enough space to maneuver without tripping over throw rugs or furniture. Also, plan to stay on the first level of your home and limit stair climbing as much as possible, at least for the first few days upon returning home. 

4. Mentally prepare for the road to recovery
While knee replacements have come a long way, it is reasonable to expect some pain, swelling, and stiffness during your recovery. Typically, a total knee replacement is considered to be more painful than other joint replacements, however, early rehab protocols will help to reduce stiffness and pain related to the surgery. Also, some surgeons may choose to use nerve blocks or other modalities to help with pain management. 

It is imperative that you follow the recommendations of your surgeon and physical therapist in order to regain as much motion and strength as possible within the first few weeks of recovery. The amount of therapy needed will depend upon your condition before surgery, motivation and progress with your exercises, and overall health. 

If you have questions about the procedure or recovery process, then take comfort in knowing that you are not alone. Carefully weigh your options, discuss questions with your surgeon, and establish a solid support system before you agree to proceed. Take a pre-operative exercise class to optimize your outcomes, and be mindful of how your overall health can affect recovery. Once you are cleared to begin working out on your own, we will be waiting for you on the other side, with exercises like this Lower Body Pilates Workout or Glute Activation Workout - Knee Friendly Butt and Thigh Workout.

If you have undergone knee replacement surgery in the past, please share your top recommendations for a speedy recovery in the comment section below. What worked well for you, and what would you have done differently? 

Written for Fitness Blender by Kayla C, PT, DPT
Board-Certified Neurological Clinical Specialist

References

1. Jette, D. U., Hunter, S. J., Burkett, L., Langham, B., Logerstedt, D. S., Piuzzi, N. S., Poirier, N. M., Radach, L., Ritter, J. E., Scalzitti, D. A., Stevens-Lapsley, J. E., Tompkins, J., Zeni, J., Jr, & American Physical Therapy Association (2020). Physical Therapist Management of Total Knee Arthroplasty. Physical therapy, 100(9), 1603–1631.  

2. Mistry, J. B., Elmallah, R. D., Bhave, A., Chughtai, M., Cherian, J. J., McGinn, T., Harwin, S. F., & Mont, M. A. (2016). Rehabilitative Guidelines after Total Knee Arthroplasty: A Review. The journal of knee surgery, 29(3), 201–217. 

3. AAHKS Patient and Public Relations Committee. (2017) Total Knee Replacement