Written by: Gina Breit, PT with Agnesian Bone & Joint Health
Your physician has told you that you would benefit from a getting your knee replaced and you have decided that it is finally time - now what? You have likely heard horror stories about the pain and rehab following a knee replacement and are apprehensive about this part. While the recovery is no walk in the park, most patients find it to be worth it. Let’s go through what to expect from a rehab perspective following a knee replacement.
Depending on what time of the day you have surgery, you may have your physical and occupational therapy evaluations on the same day. While many people are concerned that they are unable to walk on their knee at this point, it is safe to do so with assistance of a walker and a therapist or nurse. After the first day you will have therapies twice a day working on range of motion exercises, walking, stairs and car transfers to get you home safely. While the typical length of stay in the hospital is three days, it may be longer if you have issues with medication, pain management or mobility to safely go home. Before you leave the hospital, a waterproof bandage will be applied to your incision, which will allow you to shower at home as soon as you feel safe doing so. The bandage, along with the staples (if your doctor uses staples), will be removed about two weeks following surgery at your follow-up doctor visit.
After going home, in the week following surgery, you will be scheduled for outpatient physical therapy. On the first visit, your therapist will perform an evaluation where they will measure your range of motion, swelling, strength and ability to get around. They will give you exercises to work on and discuss your individual therapy plan. You will return to therapy two to three times per week to work on stretching, strengthening and walking. While typical duration of therapy is six to eight weeks, it can vary for each individual.
The first phase of therapy will focus on your motion and basic strength. This phase is often the most painful due to acute healing of the surgical site and swelling, which can make exercises and even sleep challenging. Try to rest as much as you can between exercises to help with your recovery during this phase. The second phase of therapy will work on more challenging strength exercises to get you back to walking without a cane or walker, as well as get you back to the activities that you enjoy. Most people can expect to get back to all daily activities and most recreational activities including biking, hiking, gardening and golfing. If you have a particular activity that you would like to get back to doing make sure your therapist is aware so that they can address this with you. Prolonged kneeling is not advised following knee replacement, but frequently kneeling cannot be avoided. Most people can expect to be able to start kneeling for short periods with a kneeling pad or cushion three months after surgery. A positive outlook and dedication to rehab are things that get people through total knee replacement recovery the fastest.