What to Expect After Knee Replacement Surgery

At the advice of your physician, after much consideration and a struggle through stiffness, swelling, and knee pain, it’s time to schedule your total knee replacement surgery. While surgery isn’t always the first solution to knee discomfort, it’s often the ultimate intervention in the case of knee osteoarthritis.

But facing surgery is often anxiety invoking. After all, what should you expect after knee replacement surgery? Will you have a quick recovery? What does the post-surgical recovery look like for knee replacement?

Your physician has probably explained the increased mobility you’ll experience after knee surgery. They’ve also told you how much better you’ll feel after the procedure. However, you also know post-surgical recovery is no easy feat and will require significant work.

At the Orthopaedic Hospital of Wisconsin, we’re here to help you throughout your knee replacement surgery—before, during, and after. We want to reduce your concerns and reassure you of a bright future. Recovery from knee replacement takes time, but with the proper preparations, you will be back to doing the things you enjoy very soon. OHOW’s Stephanie Patek, PT, DPT explains what to expect after knee replacement surgery.

IMMEDIATELY FOLLOWING KNEE REPLACEMENT SURGERY

After knee replacement surgery, you can expect to stay overnight in the hospital for no more than three nights. Most patients commonly remain with us only one night post-surgery. The length of your stay usually depends on your doctor’s protocol and your overall health.

Factors that may affect your stay after knee replacement surgery:

• Is the replacement and incision healing routinely?
• Are your pain levels manageable?
• Can you perform “bed mobility” and walking with only the assistance of a device, not another individual?

After knee replacement surgery, we will carefully monitor your recovery. During your stay in the hospital, you will be evaluated by a physical therapist that will assess your situation and teach you how to move about safely. The therapist will review getting in and out of bed, negotiating stairs, and necessary maneuvering about your home. Your physical therapist will also help determine what aspects to focus on based on your living situation outside of the hospital. The physical therapist will also recommend additional supplies you may need after your return home; these may include a walker, grabber, shower chair, and other assistive devices.

The physical therapist you work with after knee replacement surgery will also provide you with a specific set of exercises to begin your post-surgical recovery right away. These knee exercises focus on gaining range of motion and strengthening the muscles in your leg.

A small group of patients that experience delayed healing or have limited support at home experience a better outcome after knee replacement surgery if they spend time in a skilled nursing facility or rehabilitation hospital for a few weeks for further recovery. Your care team will work with you to determine the best setting and situation for optimal recovery following your knee replacement.

WHAT TO EXPECT FROM KNEE REPLACEMENT RECOVERY AT HOME

After you’re discharged from the hospital, you’ll likely experience some swelling in your surgical leg. The swelling may not only be in your knee but above and below the surgical area, possibly even your feet. You may notice bruising around your knee and lower leg as well after knee replacement surgery.

While swelling is normal, it can be uncomfortable. Your care team will review treatments with you and may suggest some strategies to assist you in the management of your swelling, such as:

• Keeping your knee elevated above the level of your heart for at least 20 minutes every hour.
• Icing your knee for 20 minutes every hour.
• Performing your physical therapy exercises, such as ankle pumps, knee range of motion, and hip mobility multiple times per day to prevent fluid from settling in the lower leg.
• Avoiding keeping your knee in a bent or gravity-dependent position, such as standing or sitting still for prolonged periods.
• Wearing the appropriate fitting compression stockings provided by your post-surgical team.

Infrequently, swelling can stem from something more serious, such as a blood clot or an infection in the lower leg. Swelling, warmth, and redness in areas AWAY from the incision site are typical symptoms that require medical attention. Your care team will review these concerns with you after your knee replacement surgery, but it’s important to be aware of them. Notify your surgeon right away if you experience any concerning symptoms.

OUTPATIENT PHYSICAL THERAPY AFTER KNEE REPLACEMENT SURGERY

Depending on your surgeon’s protocol and your current healing status, you will begin outpatient physical therapy between 2-7 days after knee replacement surgery. You can expect to see your physical therapist 2-3 days per week for 10-14 weeks, depending on your recovery time.

As stated above, knee swelling will limit your flexibility after knee replacement surgery, but the normal healing process, along with tissue scarring, will also prevent the knee from bending and straightening.  Your outpatient physical therapist will help you slowly improve this mobility and decrease stiffness while also making sure not to aggravate the knee, potentially causing more trauma and swelling.

Stephanie Patek, PT, DPT explains, “As physical therapists, we are highly trained to provide movement progressions and graded exercises to help you achieve the best outcome from your knee replacement.”

Other than swelling and limited motion in your knee, you may also notice that your leg feels weaker and unsteady. This is most likely due to the quadriceps muscles, which are the thigh muscles that straighten your knee, having difficulty “turning on.” This sensation of weakness is typical post-knee replacement. Your physical therapist will help you regain this muscle strength that will allow you to become more functional, including walking without a device and negotiating stairs.

The weeks following knee replacement are crucial for recovery and, ultimately, the outcome of your experience. Committing to a knee replacement recovery plan and pushing yourself in physical therapy will decrease your healing time while also improving your chances for long-term success.

RECOVERY TIME AFTER KNEE REPLACEMENT

The recovery timeline after knee replacement surgery varies significantly from patient to patient, but the rehabilitation process typically takes 10-14 weeks. During this time, you’ll work with your physical therapist to reach goals in range of motion, strength, and functional activities (sit to stand, walking, and ascending/descending stairs) without difficulty or pain.

With help from your doctor, physical therapist and care team, you can regain comfortable use of your knee and return the activities you enjoy.

KNEE REPLACEMENT RECOVERY TIPS

During your initial knee replacement recovery stages, make sure you get plenty of rest and fuel yourself with healthy foods and water.

Patek says, “Your body is working hard to heal, and this, along with your physical therapy exercises, should be your primary focus during the initial recovery phase.”

Before your surgery, you can help set yourself up for success by completing these knee injury prevention measures:

• Remove throw rugs and other tripping hazards around your home.
• Secure electrical cords to also prevent tripping.
• Make clear, wide paths to frequently traveled areas of your home; aim to make them wide enough for a walker.
• Talk with family and friends to help with meals during your first few days at home.
• Arrange for transportation to and from physical therapy and doctor check-ups as you will be unable to drive until your surgeon clears you.
• Determine a comfortable, accessible sleeping situation, preferably on the first level of your home.
• Set up a couch or chair with positions to appropriately elevate your knee above your heart.
• Place a small stool or shower chair in the shower to avoid slipping.

A return to regular physical activities post total knee replacement is usually encouraged. Whatever you enjoy—walking, golfing, bowling, swimming, dancing, or even tennis—should eventually be comfortable on your new knee. Remember that your body was made to move, so listen to your physical therapist’s instructions and do what feels good to you.

Knee replacement technology has made great leaps in the past 15+ years, and it continues to advance. There’s no reason to fear knee replacement surgery. With the help of your care team at the Orthopaedic Hospital of Wisconsin, you’ll return to the activities you enjoy. Here’s to a more mobile, more enjoyable, comfortable life after your total knee replacement surgery!