In traditional knee replacement surgery, the surgeon makes a long incision over the middle of the knee and cuts muscles, tendons and ligaments to get to the knee joint. When more tissues, muscles and tendons are cut during surgery, the recovery is more painful and the healing process takes longer.
Knee joint arthritis causes pain, decreased range of motion, and mobility limitation. Knee replacement reduces pain effectively. However, people with knee replacement have decreases in muscle strength (“force-generating capacity”) of the involved leg and difficulties with walking and other physical activities.
This surgery has a profound effect on muscle function and particularly affects quadriceps muscle strength. Deficits in quadriceps strength can persist for years after TKA.
The average recovery time from knee replacement surgery is approximately six months, but it can take roughly 12 months to fully return to physically demanding activities. Though the recovery process can be long, there are steps you can take to heal well and enhance your recovery speed.
In cadaveric studies, Mayo Clinic has found that the standard surgical incision used in total knee arthroplasty almost always severs the infrapatellar saphenous nerve. The severed nerve generally doesn't affect the knee's function.
Muscle atrophy happens for a number of reasons but the one that is most relevant following knee or hip surgery is called Disuse Muscle Atrophy (Powers, 2004). Disuse muscle atrophy occurs with bed rest, not moving a joint or leg, physical inactivity and space flight (Powers 2004).
This muscle atrophy is increased by the nervous system reducing the input signal to your leg muscles after surgery. Disuse muscle atrophy is initially why you lose muscle mass in your operated leg after ACL surgery, which is completely normal.
The first two to three weeks post-op is generally the time patients feel most discouraged due to the pain. It's hard to get up from a chair, it's difficult going up and down stairs, you're moving slowly and you have to use a walker because you have no strength or balance.
One of the most common problems people experience after knee replacement is a stiff knee joint. 1 This can cause difficulty with activities that require a lot of bending, including going down stairs, sitting in a chair, or getting out of a car.
How Long Does The Stiffness Last? Knee stiffness is the second most common complication after a total knee replacement surgery, after pain. It is common for 2 weeks to 3 months following the surgery. This stiffness reduces as your knee gets adjusted to the implants.
The biggest challenge in the early recovery of a TKR (up to 3 months postoperative) is the regaining of knee motion. We will send a physical therapist to your house to help you with the walking, knee exercises, and gentle manipulation of the knee.
Stiffness is one of the complications that can occur after a total knee replacement. Stiffness can be described as a feeling of tightness in the knee that limits range of motion (ROM). Knee range of motion is a measure of how well you can bend and extend your knee.
Your orthopaedic surgeon and physical therapist may recommend that you exercise for 20 to 30 minutes daily, or even 2 to 3 times daily; and walk for 30 minutes, 2 to 3 times daily during your early recovery.
The majority of patients expect to be able to kneel after TKR,2,4,5 however, these expectations are frequently not met,1,6 with between 50% and 80% of patients reporting that they have difficulty kneeling or do not kneel in the months and years after TKR.
A total knee replacement patient is typically looking at a one year recovery period for things to fully settle down. I should stress that doesn't mean you'll be living with constant pain for a year. But the occasional twinge or moment of discomfort could well last 12 months. Occasionally it could be two years.
Although exercise is the key to healing, you could be backpedaling progress by overworking your knee. Signs of over-exercising include swelling of the entire leg and lingering pain that stretches into the evening or into the next day.
You're not alone. Having an orthopedic surgery can leave you feeling tired for weeks or months after the procedure. Here's a list of 7 main causes of fatigue after surgery: surgical stress, blood loss, medications, pain after surgery, energy of healing, dietary changes, and sleep disturbance.
Nerve pain – The surgical incision that is made through the skin and underlying layers to get into the knee joint also cuts through small nerves that pass through these tissues. Commonly this leaves the outer aspect of the knee feeling a bit numb or tingly after surgery, or a feeling of a “tight band” around the knee.
Sleeping on the side can be painful because the leg is not straight enough. However, gradually, you can start sleeping on your side as the knee heals. But avoid sleeping on the operative side at all costs, as it puts a lot of pressure on the surgery site.
Knee replacement pain: The week following surgery
This is often considered the most painful stage of the recovery process. Your doctor will prescribe medications to help you manage your pain level.
You can't say how long you will feel exhausted after surgery, although it's normal to experience tiredness for 3-4 months following the procedure. Many factors can affect your recovery, like the environment at home, your sleep cycle, and emotional stress.
Four to six weeks after surgery
After about a month, your knee strength will improve. Plus, you'll feel more comfortable as your knee pain and swelling decreases. Depending on the type of knee replacement you had and how your recovery has been going, you may rely less or not at all on certain assistive devices.
After knee surgery, the knee swells up which leads to arthrogenic muscle inhibition, which is having the inability to contract your muscle despite no injury to the muscle or nerve.