The term total knee replacement sounds somewhat drastic. This operation would be better named a surface replacement of the knee. The remaining cartilage and approximately 5-10 mm of bone is removed from the ends of all of the bones: femur , tibia , and patella.
During the procedure
To perform the procedure, the surgeon: Makes an incision over the knee. Removes diseased and damaged bone and cartilage, leaving healthy bone intact. Implants the replacement parts into the thighbone, shinbone and kneecap.
The biggest challenge in the early recovery of a TKR (up to 3 months postoperative) is the regaining of knee motion.
New parts are fitted over the ends of both bones to create the new joint. The parts are usually made of metal and plastic. Some people may also have the back of the kneecap replaced with a new part. The kneecap is put back into place.
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.
While surgeons will take care not to cut or damage large nerves whenever possible, sometimes the peroneal nerve or a branch gets cut during the incision process. A study by the Mayo Clinic found that the saphenous nerve is sometimes inadvertently caught and closed in the incision sutures.
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.
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.
If you have had a knee replacement and your knee still feels unnatural, this is perfectly normal. It's normal for you to feel this way as recovery from a total knee replacement takes time. This doesn't mean that you can't reach full function or come to accept your knee as a normal part of your body.
After knee replacement surgery, you can gradually resume normal activities and there are no permanent restrictions, as long as you stay within your comfort level and follow the guidance of your healthcare team.
Recovery is slow
While it's different for everyone and depends on the type of knee surgery you've had, many people are surprised by how long it takes to recover. The time it takes to start doing simple tasks around the home, get back to work and importantly bending your new and improved knee may catch you by surprise.
Start with small, manageable steps over short distances and use an assistive device whenever needed. Gradually work your way up until you can walk longer distances without discomfort. Doing too much exercise can lead to pain and swelling, hindering your recovery.
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.
There is a range of accepted weight ranges, but the current standard is that anyone obese (greater than 100 pounds over ideal weight or a BMI of roughly 40-45) should not consider joint replacement.
TKA patients begin rehabilitation during the seven-day bedrest period, with the goals of decreasing swelling, increasing ROM, promoting normal leg control and promoting normal gait with an assistive device.
The pain after a knee replacement is typically no worse than one of your worst days before you had surgery. However, you can feel this way for the first two to three weeks after the day of surgery.
Crossing your legs
Shortly after your total knee replacement, it is not recommended that you cross your legs. This is most likely due to the lack of range in your knee to be able to cross your legs. If you have ever seen someone sitting cross legged, you know how much their knee needs to bend.
It is important to avoid crossing your legs after knee replacement surgery as this can put undue stress on the new joint and cause pain. Instead, keep your legs slightly apart and avoid any activities that require crossing them for at least six weeks.
The most common type of artificial knee prosthesis is a cemented prosthesis. Uncemented prostheses are not commonly used anymore. A cemented prosthesis attaches to the bone with surgical cement. An uncemented prosthesis attaches to the bone with a porous surface onto which the bone grows to attach to the prosthesis.
Patients undergoing total knee replacement are highly likely to experience fatigue before the surgery and six months following the procedure.
Spring and fall offer lots of daylight and fresh air. Your physical therapy is another reason to choose spring and fall for your knee surgery. Part of your therapy will be performing exercises indoors and outside, which will be more appealing when the temperature isn't too hot or cold.
Furthermore, with the advent of joint prostheses coated with hydroxyapatite, which work by promoting primary bone formation to fill the gap between the prosthesis and the host bone, the use of non-steroidal anti-inflammatory drugs may be counterproductive.