Knee Replacement Rehab and Recovery

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Knee replacement surgery is among the most common surgical procedures performed by orthopedists. People with severe knee arthritis can find relief from pain and improvement in function by having this surgical procedure. While most people understand that the surgery takes 1-2 hours, and the hospitalization is short, there is a lot of confusion about the expected recovery timeline. When can I walk? When can I drive? How long will I be out of work? These are some of the common questions I hear from people facing knee replacement. The answer to each of these questions may depend on the individual, but there are some guidelines that you can use to help understand the expected recovery following a knee replacement surgery.

Day of Surgery

The day of knee replacement surgery is mostly a day to recover from your procedure. But it is not just about rest. Depending on the time of day of your surgery, you may be asked to sit in a chair or on the side of the bed.

Patients will begin simple activities including ankle pumps, leg lifts, and heel slides. It is important for patients to take sufficient pain medication to allow them to participate in their rehabilitation exercises. As more patients are pushing to get out of the hospital sooner, physicians are becoming more aggressive with activities having the patient walk short distances even on the day of their surgery. In some situations, patients may return home on the day of knee replacement surgery, although this is a new development that is relatively rarely performed.

Some doctors will place you into a motion machine, called a CPM. The benefit of a CPM has not been clearly proven, and most surgeons these days choose not to use the device unless there is a specific concern for scar tissue formation after your knee replacement surgery.

Hospitalization

During your hospitalization, you will meet with physical and occupational therapists. The physical therapist will work on mobility, strengthening, and walking. The occupational therapist will work with you on preparing for tasks such as washing, dressing, and other daily activities.

Therapy progresses at a different pace for each patient. Factors that will affect the rate of your progression include your strength before surgery, body weight, and ability to manage painful symptoms. The type and extent of surgery can also affect your ability to participate in physical therapy.

Discharge/Rehabilitation

Patients are usually discharged 1-3 days after knee replacement surgery, although some patients may go home sooner or later. It is important that discharged patients be able to safely get in their homes and perform regular activities, such as getting to the bathroom and preparing food.

If patients are not progressing to the point that they can safely return to their home environment, inpatient rehabilitation may be recommended. This allows for further work with the therapists and 24-hour support services. While there are advantages to in-patient rehabilitation, there are also advantages to going directly home. First, patients are out of the healthcare setting, and therefore at lower risk for developing a hospital-acquired infection. Second, being at home requires patients to do many basic activities that are effective rehabilitation. Patients who return home may have home services arranged as necessary. This may include a visiting therapist and/or nurse.

Some surgeons are starting to perform outpatient joint replacement surgery. This means that people go home on the day of their joint replacement. This is still a new process, and the majority of people will spend at least one night, if not more, in the hospital after a knee replacement. However, you can discuss with your doctor if you are interested in outpatient joint replacement. The key to doing outpatient knee replacement is being prepared ahead of time--this means planning all of the rehab and home services you may need before the surgery. Typically, much of this planning is done in the hospital after your surgery, but if this can be done ahead of time, outpatient joint replacement may be an option for you.

Walking

Most patients take their first steps after surgery with the aid of a walker. Patients with good balance and a strong upper body may opt to use crutches. Transitioning to a cane depends on two factors. First, restrictions from your surgeon—not all surgeons allow full weight to be placed on the leg in the early weeks after surgery. Second, your ability to regain strength.

  • Usual time to return: 2 to 4 weeks with a cane; 4 to 6 weeks unassisted

Stairs

Many patients have to navigate stairs in order to enter or get through their homes. Therefore, your therapist will work with you to get up and down steps using crutches or a walker.

  • Usual time to return: 1 week with crutch/walker; 4 to 6 weeks unassisted

Driving

Return to driving depends on a number of factors, including the side of your operation and the type of vehicle you have (standard or automatic). Patients need to be able to safely and quickly operate the gas and brake pedals. Under no circumstances should patients drive when taking narcotic pain medications.

  • Usual time to return: 4 to 6 weeks

Work

Return to work depends on the activity that you have to do with your job. Patients who work in a seated position, with limited walking, can plan on returning about 4-6 weeks from the time of surgery.

Patients who are more active at work may need more time until they can return to full duties. Laborers should consider their work obligations before undergoing knee replacement. For example, patients may not be able to return to activities such as heavy lifting after knee replacement.

  • Usual time to return: 4 to 10 weeks, depending on work obligations

A Word From Verywell

While not everyone recovers from total knee replacement surgery at exactly the same pace, there are some milestones that you can use to plan for recovery and measure your progress. Talk with your doctor to understand if there is anything about your situation that may alter your progression through the recovery process, and let him or her know if you don't think you're on track for recovery. Keep in mind that the early phases of recovery move quickly with significant improvements each day; the later stages may take weeks or longer to show progress, but with time and effort, you will get there!

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