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RECOVERY AND REHAB
Now that your surgery is over, it’s time to focus on your recovery and rehabilitation, and getting back to enjoying your days with family and friends — with relief from your knee pain. Find out about post-op care, what to expect when leaving the hospital and heading home, important exercises and living your life with a knee replacement.
WHAT SHOULD I KNOW ABOUT POST-OP CARE?
Even before you leave the hospital, you’ll start your rehabilitation therapy, and it will continue for three months or longer. The goal is to improve your muscle strength, increase the movement in your knee joint, protect your new knee joint, and return to the activities you did before surgery.
During your first week post surgery, you may experience some pain, along with discomfort while exercising, but you should see noticeable improvements each and every day. After 2-4 weeks, you’ll start to feel like you’re getting back to normal, but since everyone recovers differently, it’s best to listen to your body and keep in close touch with your doctor along the way. Watch the video to learn more about what to expect during your post-op care.
WHAT HAPPENS WHEN I LEAVE THE HOSPITAL?
Before your surgery, you and your doctor will have decided where the best place for you to continue recovering is, which could be at a rehabilitation center or at home. And like any operation, there is risk for complications, such as the risk of infection and Deep Venous Thrombosis (DVT), which is when blood in the large veins in the leg form blood clots, so it’s important to learn more about what happens when you leave the hospital so you can do all that you can to help make your recovery as safe and speedy as possible.
WHAT ARRANGEMENTS FOR HOME CARE SHOULD I MAKE?
Having a close friend or family member by your side to assist you through your recovery can make a huge difference in preventing a range of potential complications, from wound care to falls.
Your other option would be to arrange for a professional home care worker to come to your residence. What is covered will depend on your insurance:
- Commercial Health Insurance: These policies typically cover some home care services, but benefits for long-term services vary from plan to plan.
- Medicare: Home care is covered if you’re homebound, under a physician’s care and require medically necessary skilled nursing or therapy services. To determine coverage under the Medicare program, go to http://www.medicare.gov.
- Medicaid: This is a joint federal-state medical assistance program for low-income individuals administered by the states. While each has its own set of eligibility requirements, they’re only mandated to provide home health services to individuals who receive federally assisted income maintenance payments, such as SSI and Aid to Families with Dependent Children (AFDC), and individuals who are “categorically needy.” To find out if you’re eligible, call your state’s Medicaid office or go to http://www.benefits.gov.
HOW WILL MY PAIN BE MANAGED?
In the first 24-48 hours after surgery, you will likely experience substantial discomfort, varying from mild pain to pressure to significant pain, which will be managed by your doctor with medications such as:
- Nonsteroidal anti-inflammatory medications (NSAIDS): These are typically used to relieve arthritis, reduce inflammation and treat other causes of pain.
- Opioids: These are typically prescribed for moderate to severe pain.
They’ll be taken prior to getting out of bed, walking or doing exercises. All of them have side effects, but not everyone gets them. The most common side effects are constipation, nausea and vomiting, sleepiness, dizziness, rash, itching and slowed breathing, and you should let your doctor know if you start to experience any of these.
To help with the pain during your rehabilitative exercises, it’s important to prepare your muscles by applying a heating pad to your knee for five minutes before you begin. Then after, you should apply an ice pack for up to 15 minutes.
Besides your knee, you may also experience pain in other parts of your body, such as in your throat if a breathing tube was used, or in your back, chest and/or shoulder muscles because you were lying down during and after surgery. However, these symptoms should ease with time.
After 10-14 days, you will usually be able to stop taking strong pain medications as you’re getting back to normal.
HOW CAN I HELP MY WOUND HEAL?
As your incision heals, it’s perfectly normal to feel some discomfort and numbness in the area. This means new nerves and tissue are growing as your body accepts your knee implant.
It’s also normal to have temporary swelling, pressure and/or bruising in your ankles and feet, and these may last for a few months. However, always discuss your symptoms with your doctor to make sure nothing disrupts your recovery.
Here are a couple things you can do to help:
- Ice your knee (always cover ice packs in a towel to avoid frostbite)
- Wear compression stockings
- Elevate your leg with a pillow
- Ankle exercises
HOW DO I AVOID BLOOD CLOTS?
Once you’re at home recovering, one of the risks is blood clots. Because you aren’t moving around as much, blood collects in the veins of your legs and feet, which can lead to the formation of clots. These can move from your legs to your lungs and cause pulmonary embolism, so it’s important to do everything you can to prevent them.
Your doctor will prescribe you blood thinners that act as an anticoagulant, and you may take these for up to 35 days after surgery.
Here are some ways to prevent blood clots:
- Wear compression stockings: These are very tight-fitting knee-high socks that help your blood flow better, and your doctor may ask you to wear these for several weeks.
- Use an intermittent compression pump device: This is similar to a blood pressure cuff that repeatedly inflates and deflates to help blood flow better in your legs.
- Avoid wearing tight clothing for the first few weeks.
- Keep your legs elevated: A few times a day, for the first few weeks, elevate your legs six inches above your heart.
- Change your position often.
- Avoid standing or sitting for more than an hour at a time.
- Reduce the amount of salt in your diet, as it causes fluid retention.
- Avoid bumping or injuring your legs.
- Avoid crossing your legs when sitting.
You should also keep an eye out and contact your doctor if you see any symptoms of blood clots, such as redness, swelling or discoloration of the skin at the site of the clot, tenderness or pain at the site of the clot, or a warm feeling at the site of the clot (but not everyone experiences these).
WHAT ARE THE DO’S AND DON’TS OF RECOVERY?
While it’s essential to follow your surgeon’s and physical therapist’s instructions while you recover, there are a few do’s and don’ts to make your journey to recovery as fast as possible.
- Keep up with your exercises: Be sure to follow the rules of your physical therapist.
- Engage in lower-stress activities, such as golfing, hiking, walking, biking, stationary skiing and swimming. Ask your doctor before doing any rowing, table tennis, cross-country skiing or bowling.
- Take care of your lungs: Since your body needs plenty of oxygen to heal properly, make sure to do breathing exercises.
- Manage your pain: Be sure to take medications as prescribed by your doctor, and let him/her know if they aren’t doing enough to relieve the pain.
- Control swelling: Along with icing your knee, you should elevate it above your heart with pillows while in bed. This will help to control swelling which reduces pain and improves your circulation and range of motion.
- Rest: Get plenty of rest to help your knee heal. If you’re having problems sleeping, ask your doctor to recommend an over-the-counter sleep aid or prescribe medication to help you.
- Avoid activities such as competitive racquet sports, high-impact aerobics, high-intensity jogging/running, mogul skiing, martial arts, rope jumping and rough contact sports.
- Don’t twist your knee: You want to avoid any jarring forces on your knee, so instead, turn your entire body to avoid stress on your knee.
- Avoid scheduling dental work or surgical procedures on your bladder or colon: These can cause bacteria to enter your bloodstream and may lead to infection in your new joint. Discuss any of these with your surgeon before having them done.
- Don’t lift heavy objects: This can cause damage to your new knee.
- Don’t push yourself too hard: While you want to get back to your life, it’s important you give your body the time to recover.
WHAT ARE SOME POST-OP EXERCISES?
Exercising daily is key on your journey to recovery, as the muscles of the thigh and leg help to keep your knee joint stable.
Your doctor and physical therapist will typically outline a program for you, but below are some videos that show you how to perform each exercise.
Just a few tips:
- You should always warm up your knee with a heating pad before you begin and then ice immediately after.
- It’s okay to feel discomfort while you’re exercising, but the pain should go away soon after.
- Keep a daily log, so you, your doctor and physical therapist can track your progress.
- Consult your doctor and physical therapist before you begin.
HOW IS LIFE DIFFERENT AFTER A KNEE REPLACEMENT?
After having a knee replacement, you can expect your life to be a lot like it was before the surgery, just with relief from the pain. However, there are a few changes you can make to help your knee work properly and avoid any future pain and damage.
Now that you’ve had your surgery, making smart and healthy choices can help keep your new knee in good shape.
- Manage your weight: Every extra pound you weigh adds four pounds of pressure on your knee joint, so by staying healthy you can avoid unnecessary stress on your joints.1
- Wear the right footwear: Avoid high heels, but if you do choose to go with one, go with a heel that’s one-half to three-quarters of an inch high.
- Exercise: Your doctor and physical therapist will recommend certain exercises for you to help strengthen the muscles that support your knee, but be sure to perform them correctly so as to not strain any muscles.
- Be careful on stairs: Always hold the railing as you go up and down stairs to help alleviate some of the pressure on your knee.
Taking nutritional supplements can help keep your knees healthy — helping you to live the life you want to. Talk to your doctor to see if any are recommended.
- Glucosamine: Derived from shellfish, it’s an amino sugar that aids in repair of cartilage and other body tissues, and is often combined with chondroitin for arthritis treatment.
- Chondroitin: A naturally occurring sugar, that joins with protein to help the body’s cartilage maintain its stability, that’s obtained from animals such as cattle, pigs and sharks.
- MSM (methylsulfonylmethane): A natural sulfur thought to have anti-inflammatory effects that’s found in some plants, foods and beverages.
- https://www.arthritis.org/living-with-arthritis/comorbidities/obesity-arthritis/fat-and-arthritis.php. Accessed May 23, 2019.
Important Safety Information
As with any medical treatment, individual results may vary. The performance of knee replacements depends on your age, weight, activity level, and other factors. There are potential risks, and recovery takes time. People with conditions limiting rehabilitation should not have this surgery. Only an orthopaedic surgeon can determine if knee replacement is right for you.