Knee Replacement – What to Expect
- Posted on: Nov 15 2018
A Knee replacement is a surgery that should be considered when daily tasks like walking, standing, and transferring from sitting to standing become painful. It is usually recommended to individuals who have severe arthritis or other significant injury. A knee replacement is classified under the heading of a total knee replacement or partial knee replacement. The type of surgery is based on the surfaces of the bones that come together to make up the knee joint. These bones are the femur and tibia. If only one surface is affected, a partial replacement may be performed. Whether it is a total or partial knee replacement, the surgery usually takes 1-2 hours to complete.
The person will then be on bed rest for 4 hours to allow the anesthesia to wear off. Urination may be difficult immediately after the surgery and a catheter may be used. If all vital signs are adequate after 4 hours, a physical therapist will be in the room to assess strength, tolerance with changing positions, ability to stand, and ability to walk. The person will be pushed as far they can tolerate. Most knee replacement patients will spend 1 to 3 days in the hospital. The decision on whether to be discharged to the home or to a rehabilitation hospital is made by the surgeon and physical therapist. A person with stairs in the home must be able to traverse a full flight before being sent home.
The rehabilitation continues whether it is performed by the hospital physical therapist or the home physical therapist. 1-2 weeks after the surgery, the patient is usually sent to outpatient physical therapy. Initial focus is placed on improving motion, decreasing swelling and allowing the surgical site to heal. Scar mobility techniques will be used when the surgical site is completely healed. Range of motion continues to be the chief focus until the knee can be fully straightened to 0 degrees and bent to 110 degrees. A healthy knee usually bends between 130-140 degrees but 110 degrees is the number that is required for almost all actives of daily life. After the motion has been achieved, full focus is placed on strengthening. The goal is to return a person to all activities they were able to participate in before the surgery. Knee replacements are a highly successful surgery.
About 95% of surgeries are successful over 10 years. The life expectancy of the hardware is 20 years but many variables can affect that time, including the strength of the muscles surrounding the knee, a person’s weight, and the activity level of which the person engages after the surgery. Kneeling, running, and jumping are not recommended after the surgery but can still be performed if needed. A person is usually able to walk without an assistive device in 1 month but will not fully return to all activities for 3-6 months. The length of time depends on the condition of the knee before the surgery, how successful the surgery was, how hard the person works, and the skill of the physical therapist. Advanced PMR uses a combination of manual stretching, soft tissue mobilization, and focused exercises to relieve pain and return knee replacement patients to their previous activities as fast as possible. When you are ready for outpatient physical therapy, come on down to Advanced PMR!
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