If you have been dealing with debilitating knee pain and stiffness for some time, you are likely looking forward to your knee replacement surgery. This routine procedure leads to dramatic pain relief and improved mobility in 90% of patients, and most patients can expect to enjoy their new knees for up to 20 years, if not longer.
While you may be ready and excited for your surgery, are you prepared for the recovery and rehabilitation involved? Recovery following this procedure takes quite some time, and what you do during your recovery and rehabilitation plays a big part in the success of your treatment. Keep reading to learn about knee replacement recovery times and what they involve.
Recovery time after knee replacement varies significantly depending on the type of knee replacement surgery, the patient’s age and the patient’s general health. But according to the American Association of Hip and Knee Surgeons (AAHKS), it can take up to three months to return to most activities and six to twelve months to fully recover.
Knee replacement surgery involves making long incisions, cutting away damaged bone and cartilage, and attaching implants that make up the new knee. For the incision to heal and the body to adjust to your new knee, time and rehabilitation are needed.
In the first 24 hours, as the anesthesia begins to wear off, you will slowly regain feeling in your legs. You may be asked to take a few steps with assistive devices, like walkers, crutches and canes, with the assistance of a physical therapist.
Most patients stay in the hospital for one to three days. Your team will manage your post-operative pain and change the compression dressings on your knee(s). You will need to keep your leg(s) elevated to reduce swelling and may be prescribed a continuous passive motion (CPM) machine. A CPM machine moves your leg while you are in bed.
After your hospital stay, you will continue your recovery at home. Your orthopedic team will create a recovery program for you upon your discharge.
While the recovery timeline after knee replacement differs from one person to the next, it generally looks something like this:
Your recovery starts as soon as you wake from surgery. Your physiotherapist will encourage you to get on your feet with assistive devices within the first 24 hours. This is to reduce swelling, prevent blood clots and maintain strength. Walking a few steps from your bedside is enough initially. Using a CPM machine during this time prevents excessive scar tissue and joint stiffness. Pain, swelling and even minor bruising are normal following surgery.
You will be discharged when you can get out of bed, climb stairs and walk a short distance (150 feet) with an assistive device. Being able to bend the knee at a 90-degree angle is another criterion for discharge.
You will be prescribed lower-dose pain medication and exercises from the physiotherapist. You will also need to use the CPM machine at home.
Most patients are able to bend their knee with minor pain and fully extend their leg after about 10 days. With time, you will rely less on your assistive device and gradually place more weight on your knees. By the end of week three, most patients can walk with a cane.
By this time, inflammation and swelling will be completely gone, although you still may feel mild soreness and pain. You will also notice significant improvements in knee strength and mobility. You will no longer need to use the CPM machine at this point.
Many patients can return to work and daily activities by week six, including driving. Patients with physically demanding jobs that involve long hours of walking, standing or lifting may need at least three months before returning to work.
Physical therapy typically lasts 12 weeks. If you follow your doctor’s and physiotherapist’s advice every day, you can expect to see your knee bend at a 120-degree angle by the end of this period and to walk without an assistive device a couple of blocks.
As your knee improves, your physiotherapist may change your program to include more challenging exercises, like mini squats, step-ups, toe rises and leg balances.
You can now begin to relax and include a wide range of activities into your routine, including walking, bicycling and swimming. However, patients are discouraged from running, jumping, and strenuous exercises in order to keep their new knees for longer.
Patients who get a partial knee replacement and who receive treatment on only one knee typically recover sooner than patients getting total knee replacement on both knees at once.
But other factors, like your age, health and adherence to your recovery program, can affect the speed of your recovery. When recovery takes longer than anticipated, it is usually for the following reasons:
Not following physical therapy. The goal of physical therapy after knee replacement is to help you regain mobility by strengthening leg muscles and establishing the new knee’s range of motion. Not following your post-surgery guidelines will delay your recovery.
Risky behavior. Not using assistive devices, drinking alcohol, and abusing pain medication can prevent you from participating in physical therapy and increase your risk of falling, which may lead to additional surgery. Overexertion and lifting heavy objects can put undue strain on your knees, slowing down recovery.
Smoking. Studies show that smoking significantly increases the risk of infection, wound complications and the need for revision surgery in patients who get a knee replacement. That is because the nicotine in cigarettes constricts blood vessels, which reduces oxygen and nutrient flow to the tissues.
Unmanaged diabetes. A large 2013 study in The Journal of Bone & Joint Surgery found that well-controlled diabetes does not slow down recovery or put you at risk of complications after knee replacement. However, unmanaged type I or II diabetes can lead to poor blood flow and low immunity, which makes recovery difficult and the risk of infections high.
The team at the Orthopaedic Institute of Ohio performs hundreds of partial and total knee replacement surgeries each year. Our occupational therapists are here to assist you in your recovery and to help answer any questions you might have.
Contact the Orthopaedic Institute of Ohio today if you want to learn more about what you can expect during knee replacement recovery.