Knee replacement surgery recovery- What to expect?

A knee replacement surgery is a major operation, but the recovery from this surgery is now easier due to less invasive surgical techniques and procedures. With a successful knee replacement performed by a skilled surgeon, you can become fully independent in 4 to 6 weeks. Recovery after a knee replacement is not much painful or uncomfortable. Most people recover just fine, and return to regular life and sports in a couple of months. It is normal to have some swelling or discomfort after the surgery, which will be managed by medications prescribed by the surgeon. As long as you take your medications on time, follow the recovery tips, take necessary precautions and follow your physiotherapy plan, no complications should arise. But if any side effects or complications arise, call your doctor right away. 

After surgery, most people experience significant improvements in the quality of their life. But, it will not happen all at once. It usually takes around 4 to 6 weeks to return to most activities, and it can take up to 6 to 8 months to make a full recovery and regain full strength.

Recovery Timeline for Knee Replacement

The first 12 weeks after your knee replacement surgery is the most critical period for therapy, rehabilitation and recovery. During this period, you need to remain committed to following your doctor’s and physiotherapist’s recommendations to help improve your long-term prognosis.

Here is a recovery timeline from Day 1 to Week 12 after a knee replacement-

●    Discharge from the hospital- Most patients are discharged from the hospital 3 to 5 days after a knee replacement. Your orthopedist will prescribe you medications to manage pain, promote recovery and prevent infection. You will also be given specific instructions for physiotherapy, exercises and taking care of yourself during the recovery period. 

●    Day 1 to 3- You will be able to walk the same day after the surgery. Some patients may feel the need to use walking aids like a walker, cane or crutches for a while, which is okay.  In the hospital, you will work with your orthopedic surgeon to work on straightening the knee joint and bending the knee.

●    Week 3- About 3 weeks after your hip replacement, you should be able to walk for more than 10 minutes at a time (without a walking aid or assistance). Your physiotherapist may recommend you to go on longer walks if your progress is good. 

●    Week 4 to 6- You should notice significant improvements in your knee around this time if you have been consistent with your physiotherapy and exercises till now.  Between week 4 to 6, your doctor may allow you to start driving, if your recovery is going fine.  

●    Weeks 7 to 11- Physiotherapy and rehabilitation should be continued without absence. Around these weeks, you will be working on your knee’s range of motion, mobility, and strengthening the leg muscles that support the knee joint. 

●    Week 12- You might be able to return to most regular, daily activities but you would still be advised to avoid high-impact activities, sports and exercise (such as aerobics, running, basketball, hinking, trekking, mountain climbing, etc). 

●    One year after surgery- With physiotherapy and exercises, you will continue to make progress throughout the year after your knee replacement surgery. By this time, your “new” knee should reach its full mobility and strength. You should be able to return to almost all activities by this time.

What to Expect From Knee Replacement Recovery

Most patients are discharged from the hospital 3 to 5 days after knee replacement, with many patients going home in as little as 2 days. The average length of a hospital stay after a knee replacement surgery is 2 to 3 days.  Read ahead to find out what to expect, in various aspects such as activity levels, pain management, incision care, etc when you get home after your knee replacement. 

Activity level- You can expect to be up and moving the same day after your knee surgery. Most patients begin walking without support immediately after the surgery. After discharge from the hospital, light activity is recommended as it will help cut down swelling and will shorten the recovery time. Your orthopedic surgeon will recommend a regimen of exercises and recommend you to a good physiotherapist for your post-surgery rehabilitation and physiotherapy. Your orthopedist and physiotherapist will work closely with you for the coming weeks to monitor your progress and ensure you are recovering as well as possible.  Physiotherapy will play an important role in gaining strength and increasing mobility with the new knee joint. This will also prove notably beneficial in the long run. 

Incision Care- Keep your incision site clean and dry and change the dressing as recommended by the surgeon. Do not bathe or shower until your surgeon says you can, to prevent infection. Contact your orthopedic doctor immediately if you notice discharge, draining or bleeding from the incision site, as it may be a sign of infection.

Pain management- You will be prescribed painkillers before your discharge from the hospital. Pain medications will allow you to get through the post-operative pain without much discomfort. Managing the pain will allow you to remain as mobile as possible and would enable you to do knee exercises without much discomfort. You will also get a good night’s sleep, which is very important for a successful recovery.

Sleep- After your knee surgery, it is quite common to face trouble sleeping. These tips below might help you sleep better after a knee replacement-

●    Try sleeping with a pillow between your knees- Finding a restful sleeping position after your knee replacement surgery can be tricky. If you are used to sleeping on the side, you can try sleeping by placing a pillow between your knees. This will provide some additional protection and padding for the knee and might give you comfort. If you are used to sleeping on your back, do not place  a pillow under your knee to sleep as this will hinder the recovery and may prevent the knee from fully extending.

●    Take your pain medications just before you go to bed and during the night- Try to take your pain medications some time before you go to bed. This should hopefully give you a good night’s sleep. You may wake up in pain in the early hours of the morning. If that happens, keep your dose of painkillers next to your bed or handy anywhere else and take them when the pain kicks in. If pain increases or if you are having trouble sleeping even after taking medication, speak to your doctor, who would be able to help you.

Diet- By the time you are discharged from the hospital, you would be allowed to eat your normal diet. You may also notice irregular bowel movements after your surgery, which is common. Try to prevent constipation and avoid straining during bowel movements. Drinking enough water and fluids, eating fiber rich foods and taking stool softeners (if necessary) can help avoid constipation.  

If your stomach is uneasy, try bland, easily digestible, low-fat foods such as plain rice, boiled chicken, toast, or yogurt. Your orthopedic doctor may recommend you to take iron and vitamin supplements to boost recovery. In general, make sure to eat a healthy diet and watch eating small portion sizes for better digestion. Remain hydrated and drink plenty of fluids (unless your doctor has told you not to). Try to maintain your ideal body weight as gaining much weight will put more stress on the new knee.  

Exercises- After your knee replacement surgery, it is important to follow your  recommended physiotherapy and exercise plan and continue progressing without overexerting the new knee, which is still healing. Sticking to an exercise regime will help  reduce swelling, increase your knee’s range of motion and strengthen the leg muscles supporting the knee joint. Your physiotherapist or orthopaedic surgeon might recommend exercises such as  walking, muscle pumping, stretching, bending the knees and other exercises to focus on the quadriceps. Walking regularly, even for short periods throughout the day will help you regain strength.  

When do you need to call your orthopedic surgeon after knee replacement?

Call your orthopedic surgeon right away if you think you have signs of infection or other complications such as-  

●    Signs of infection, such as-

○    Increased pain, warmth, swelling or redness.

○    Pus draining or unusual discharge from the incision.

○    High  fever.

●    Signs of a blood clot, such as-

○    Pain in the calf, back of the knee, thigh, or groin area.

○    Redness or swelling in the legs or groin.

●    Incision opens up and begins to bleed 

●    Severe pain that does not get better even after taking painkillers.

●    Shortness of breath

Follow up care after knee replacement surgery

In the first year after your knee replacement surgery, you will have regular follow up consultations with your orthopedic surgeon. During these visits, the doctor will note about your progress, discuss your comfort level, mobility, how the new knee is working for you and may take X-rays for better evaluation. The doctor will address any of the concerns you might have and will make sure you are healing well.

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