Knee Replacement Surgery: Long-Term Care

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Knee replacement surgery involves removing damaged portions of the joint and replacing them with prosthetic components. Depending on your case, it can take three to six weeks before you’re clear to return to normal, day-to-day activities.

However, complete rehabilitation can take three months to a year. This is a critical period, and successful outcomes depend on a clear understanding of how to care for the post-surgical knee over the long term.

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Benefits of Surgery

The conditions treated with knee replacement surgery (including osteoarthritis, rheumatoid arthritis, and post-traumatic osteoarthritis) are characterized by inflammation, pain, and loss of mobility. Knee replacement surgery can reduce or eliminate the pain and restore mobility of the knee, though a complete return to pre-arthritic levels of motion isn’t expected.

During this procedure, a thin layer of bone is removed from the femur (thigh bone), the tibia (shin bone), and the patella (knee cap), and an implant made of stainless steel, titanium, cobalt chrome, and/or polyethylene is used to replace the bone that was removed.

With proper care, knee implants are durable; in fact, over 90% of contemporary implants are still functioning well after 15 years.

Maintaining the benefits and the integrity of the artificial knee depends on proper healing during the recovery period following surgery and beyond. What can you do to preserve the positive outcomes of knee replacement surgery over the long-term? Here are some quick tips:

Keep Follow-Up Appointments

Typically, following surgery, you’ll have several follow-up appointments to monitor for complications and to ensure the implant is working well. These follow-ups occur around six weeks following surgery (when initial recovery is expected), and then at three months and six months, with annual check-ups after that.

In addition, you’ll participate in regular physical therapy sessions.

Set up Your Home

Accidents in the home can cause problems during recovery.

As you look towards your recovery period, set up your home to:

  • Prevent trip hazards
  • Keep important items within reach
  • Arrange furniture so you can navigate around with crutches, a walker, or other assistive devices

It’s also a good idea to install a chair, grab bar, and raised toilet seat in the bathroom. Since you’ll want to avoid deep bending or straining, consider acquiring grabbing tools, long shoehorns, or long-handled sponges.

Balance Fitness and Safety

At discharge and subsequent appointments, you’ll be given specific instructions about activities you can and can’t do. Ensuring that you’re still getting some exercise while recovering, while also making sure not to hurt yourself is key.

Your surgeon and physical therapist will provide you with instructions about activity limitations and exercises. It's important that you keep up with the exercises they recommend—that said, if anything feels off or becomes painful, let your healthcare provider know as soon as possible.

Medications and Supplements

Following surgery, you may be prescribed medication to help manage pain and swelling and to prevent infection. Make sure you have a complete understanding of prescribing information.

Unless directed otherwise, take the full course of any pills, and safely dispose of any leftovers by bringing them back to the pharmacy. In addition, your healthcare provider and/or physical therapist may recommend you take other supplements to boost your bone and joint strength.

Communicate and Get Clearance

As tough and durable as artificial knee joints are, they have limitations. In general, you may want to avoid activities that would put the knee in danger, such as high contact sports.

On the road of rehabilitation, make sure to get medical clearance before starting up new physical activities, or re-starting things you’d done in the past.

Possible Future Surgeries

While knee replacement surgeries are highly successful, revision knee replacement is sometimes necessary. During this procedure, all or part of your knee implant is replaced, and the procedure is usually more complex than the original surgery.

What circumstances prompt consideration for this surgery? Here’s a breakdown.

Worn or Loosened Implant

For a variety of reasons, knee implants may come loose or become worn out over time. This is especially the case if you engage in high-impact activities, are overweight, or if you’ve had your knee replacement for a longer period of time.

This leads to pain and discomfort and can lead to an immune response that attacks the supporting thigh or knee bone.

Infection

While the risk of infection is highest when the incision is healing, infections can also occur during recovery or even years after the operation. Infection around the implant leads to pain, swelling, and drainage from the knee, while also loosening the implant.

  • If your knee replacement has only been in place for a few weeks, an infection can be treated by debridement, in which the components are left in place, but are disinfected.
  • If your knee replacement has been in place for a few months or more, it is typically treated with a staged surgery, or, two-part procedure. In the first part, the implant is taken out and replaced with a cement spacer that has been treated with antibiotics. In the second, this spacer is removed and the prosthetic knee joint is replaced.

Instability

This condition occurs when ligaments and tendons around the prosthetic knee are damaged or imbalanced, leading to swelling and weakness in the knee. Physical therapy and bracing the knee is the first line of treatment, but if these steps don’t yield results, revision surgery may be the best option.

Stiffness

Scar tissue build-up around the knee can impair mobility after knee replacement surgery. The initial treatment is manipulation under anesthesia, in which the healthcare provider strategically bends the knee to break down the scar tissue. If this intervention doesn’t work, then the implant may need to be partially or totally replaced.

Fracture

The bone around a knee implant can break due to an accident or a fall. this often calls for revision surgery. Before treatment, your surgeon will need to assess the health and stability of the bone structures and may need to widen the scope of the implant. In some cases, parts of the broken bone may also need to be replaced with a prosthetic.

Lifestyle Adjustments

You’ll need to make some changes and adjustments as you navigate life after knee replacement surgery. The key is maintaining activity without excessively straining the area or causing injury.

Lifestyle adjustments may include:

  • Eating healthy: Alongside the usual benefits, maintaining a healthy diet rich in proteins, vitamins, and minerals can aid in knee replacement because it promotes weight loss. Excessive weight can put undue stress on your implant, so talk to your healthcare provider about what you can do to manage it.
  • Avoid vitamin K: If you’ve been prescribed blood-thinning medication, like warfarin, following your surgery, you’ll be advised against eating too much of the foods that are rich in this vitamin. These include broccoli, cauliflower, Brussels sprouts, onions, as well as many greens, such as kale, spinach, and turnip greens.
  • Driving: Typically, people can drive after recovering from a total knee replacement. Don’t start driving until after you get your practitioner’s OK; in most cases, you’ll be able to get back behind the wheel at about three to four weeks. Before driving, your healthcare provider will want to ensure that you have discontinued taking any drowsiness-inducing pain medications (if you took any after your surgery) and that you have adequate strength and mobility of your knee.
  • Physical therapy: Following total knee replacement, you’ll undergo physical therapy sessions, in which you’ll be educated on exercises you can do to promote positive results. For instance, riding a stationary bike can be a good way to help build muscle without stressing your knee.
  • Lower-impact exercise: Once you’re cleared for physical activities, keep in mind that some sports or exercises are safer than others. Swimming, walking, golfing, and light tennis are all considered relatively safe, while more intense sports, such as racquetball, jogging, or skiing, might need to be skipped.
  • Air travel: When going through security at an airport, be sure to let the security staff know that you have a knee implant, as it may set off their sensors. In addition, sometimes flying leads to swelling or pain in the knee, even years after a knee replacement has healed. As such, be sure to get your healthcare provider’s OK before making plans.

The rule of thumb is to make sure you completely understand your practitioner and physical therapist’s orders. Never hesitate to ask questions or to contact your providers if anything seems off.

A Word From Verywell

While having a knee replacement surgery is far from a walk in the park, it’s important to remember that this treatment is well-tolerated and highly successful. It’s helped countless people get back on their feet, letting them enjoy life free of pain, swelling, and discomfort.

Today’s techniques and technologies have made this procedure even more successful, with reduced chances of complications. Successful outcomes, however, require more than healthcare providers, physical therapists, support staff, and top-of-the-line equipment. They require you, the patient, to be proactive, engaged, and committed to doing what it takes to get better.

With the help of your medical care staff, as well as the support of your loved ones, you can pave the way towards better days ahead.

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Article Sources
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  2. Cleveland Clinic. A patient's guide to total joint replacement and complete care. 2016. 

  3. Foran J. Activities after knee replacement. American Academy of Orthopaedic Surgeons. Updated December, 2018. 

  4. Cross M. Revision total knee replacement. American Academy of Orthopaedic Surgeons. Updated 2015.