A total knee replacement is a surgical procedure whereby the diseased knee joint is replaced with artificial material. During a total knee replacement, the end of the femur bone is removed and replaced with a metal shell. The end of the lower leg bone (tibia) is also removed and replaced with a channeled plastic piece with a metal stem. These artificial components of a total knee replacement are referred to as the prosthesis.
Total knee replacement (TKR) surgery is considered for patients whose knee joints have been damaged by progressive arthritis, trauma, or other destructive joint diseases. The most common reason for total knee replacement in the United States is osteoarthritis.
Total Knee Replacement Recovery Time
Total knee replacement recovery generally requires between one and a half to three hours of operative time. After surgery, patients are taken to a recovery room, where their vital organs are monitored. When stabilized, patients are returned to their hospital room to begin the healing process.
After TKR surgery, proper recovery and rehabilitation are crucial for the restorative process. Recovery and rehabilitation greatly improve your chances of healing and ensure long-term success.
Within 24 hours to 48 hours after surgery, patients are encouraged to walk with an orthopedic device or walker; and a patient may stay in the hospital for 3-7 days after the surgery to begin their recovery regimen. Typically, the doctor decides to release the patient based on their ability to reach certain milestones such as:
· Standing
· Walking with assistance
· Flexing and extending the knee
Physical therapy begins immediately after surgery to ensure swift and efficient healing and increased mobility. Physical therapy is an extremely important part of rehabilitation and requires full participation by the patient for optimal outcome. Some pain, discomfort, and stiffness can be expected at the start of any physical therapy regimen.
One unique device that can help speed recovery is the continuous passive motion (CPM) machine. The CPM machine is attached to the operated leg and moves the knee through various degrees of range of motion while the patient relaxes. This can help to improve circulation and minimize the risk of scarring and contracture of the tissues surrounding the knee.
Outpatient Physical Therapy
After a patient is discharged from the hospital, the doctor will prescribe outpatient physical therapy, which will include knee strengthening exercises and knee stretches. Physical therapy will help the patient build strength and flexibility—which consequently protects the knee and other surrounding joints and muscles—and promote sufficient healing by increasing blood flow.
Within 6 weeks of a total knee replacement surgery, most patients are able to care for themselves and continue normal daily activities, including driving and walking. However, it may take anywhere between 3 months to one year to fully recover and experience all the benefits of the knee replacement surgery.
Total knee replacement may significantly improve your overall mobility, function, and flexibility. Total knee replacement patients are advised, however, to refrain from engaging in high impact sports such as running or skiing, as these activities can cause the replacement to deteriorate more quickly. Swimming, however, is an ideal form of exercise, since the sport improves muscle strength and endurance without exerting any pressure or stress on the replaced joint.
For an optimal outcome after total knee replacement surgery, it is important for patients to continue an outpatient physical therapy program along with home exercises during the healing process. Patients will be asked to continue exercising the muscles around the replaced joint to prevent scarring and contracture and to maintain muscle strength for joint stability. These exercises after surgery can reduce recovery time and lead to optimal strength and stability.
Future Operations
Though infrequent, patients with total knee replacements can require a second operation years later. The second operation may be necessary because of loosening of the prosthesis, fractures, or any other complications involving the replaced joint. Reoperations are generally not as successful as original operations, and they carry higher risks of complications.
Before making any decisions, it is important to consult your physician about your health and knee replacement options.