Total Knee Replacement

If you put off knee replacement the joint will continue to degrade, and your pain will worsen. This will mean your quality of life will worsen along with your knee. One way people look at the value in this is by reducing it to a mathematical formula. This is a method orthopedic surgeons use to detail the potential improvement total knee replacement can provide for a patient. Here’s how it works.

• A normal adult scores 50 on a “function scale.”
• A person with a problem knee, on average, scores 32.
• Typically, a total knee replacement patient gains a fixed amount of improvement — about 12 points on this function scale.
• If done at the appropriate time, total knee replacement can bring a person’s “function” score up to 44. That’s not the 50 of normal, but pretty close. Life returns with that kind of mobility.
• If a patient waits until they are in so much pain they can’t sleep or their mobility is limited, their score drops, and their post-surgery score may only rise to 32. That’s far below what they could achieve with earlier intervention.

Waiting is only pushing your quality of life down for a longer period of your life. Isn’t life too short to roll the dice that way? There’s a reason over 600,000 people in the U.S. opt to have total knee replacement every year, rather than “toughing” it out and missing out on life.

How much work you’ll need to miss with total knee replacement is variable, depending upon the patient and the type of work. If you work in an office environment, you can return to work when you can safely travel to and from the site. This can be anywhere from 2-6 weeks after surgery. If at a desk job, you should try to elevate the leg as much as possible and take walks at appropriate intervals.

If your job involves more standing and walking, you can return to it when you can walk without a limp, generally between 6 to 12 weeks.

If your job involves more physical stress, it will be 10-12 weeks before you can return. This will depend on when you can safely perform your job duties.

Motion is important for your recovery. You want as much flexion (bending) and extension (straightening) as possible. It can take weeks to establish the range you need. It’s important to obtain full extension because this allows the knee to “lockout.” This reduces fatigue of the quadriceps muscles were standing for a long period of time. It also will allow the knee to function more normally when walking.

The goal with bending is to surpass 90 degrees. This can be difficult due to stiffness. Riding a stationary bike is excellent for increasing flexion. At some point, patients may need manipulation under anesthesia. Your orthopedic surgeon will do this at Summit Healthcare. This is necessary in about 2 percent of patients to release the adhesions that have formed and are preventing motion.

Sleep positions are important for at least 6 weeks. The best position is on your back with your surgical leg propped up with 2-3 pillows. Don’t put them behind your knee. You want to keep the leg above your heart. You can sleep on the opposite side of your replacement, but you cannot sleep on the repaired knee side. With your new knee up toward the ceiling, you need to keep two pillows between your legs. Keep your legs even, and don’t cross your legs ever. It is not safe to sleep on your stomach for at least 6 weeks.

You will experience pain after this surgery and during recovery, but it helps to think back to the daily, ongoing pain your degraded knee was causing you before your surgery. After your anesthesia wears off, you’ll still have a nerve block that has lasting anesthetic qualities. That will cover the first day. From there, you’ll be on narcotic pain medication taken orally or in IV form. This will likely be morphine, fentanyl, or oxycodone. They are addictive, but you’ll only be on them for a short while. Your pain should diminish relatively quickly, within 4 or 5 days at the most.

Future lingering pain is somewhat dependent upon you. If you follow your physical therapy diligently and make some lifestyle modifications to eliminate areas of impact, your future pain should be minimal, especially compared to your pre-surgery levels of pain.

Our knee replacement patients from Show Low and the surrounding areas are excited by the feeling of freedom after having this surgery. That’s because their knee pain was causing them to have to miss out on more and more activities such as hiking or even walking around the block.

You’ll be walking at just 1 to 3 weeks, but you’ll use a walker. From there you’ll move to crutches, and then a cane. In 4-8 weeks, you should be walking without support.

Many people equate “activities” with sports. Here are some dos and don’ts moving forward.

• Swimming, cycling, and golf can resume after the surgical wound is healed.
• Jogging, basketball, and volleyball are likely out, as they put pressure on your new knee and will cause it to wear out more quickly.
• Tennis should probably change to doubles only, and at a relaxed pace. Or consider switching to pickleball.
• Downhill skiing, skating, and sports where there is a risk of falling can be resumed, but the patient should have been proficient prior to their surgery, and you need to understand the risks.