The do’s and don’ts of recovering from knee replacement surgery

After living with aching knees for far too long, you finally pulled the trigger, talked to an orthopedic specialist and explored your options to put a stop to your knee pain. You started with imaging, you tried strengthening your knees through physical therapy and alleviating your pain through injections — yet nothing provided longstanding relief.

While surgery wasn’t necessary immediately, it was the next treatment option recommended by your orthopedist.

So, here you are. You’ve scheduled your total knee replacement surgery. Here’s a breakdown of what to expect, from the moment you wake up with your new artificial joint through the next phases of your recovery.

What to expect after total knee replacement surgery

Discharge time

Generally, patients will spend the night at the surgical facility following total knee replacement procedure, but in some cases, you can be sent home following same-day knee replacement surgery. I prefer to keep my patients at the surgical facility overnight and discharge them the next day. Joint replacement surgery is a significant operation — even more invasive than an appendectomy. By spending the night, our team can address any medical needs, pain issues or problems with nausea.

Joint replacement surgery is a significant operation — even more invasive than an appendectomy. By spending the night, our team can address any medical needs, pain issues or problems with nausea.

Incision

You’ll likely be placed in a flexible postoperative dressing, but the outer dressing will be removed before you are discharged to go home. The incision site will be covered by what appears to be a very large band aid, which can be removed after seven days.

There are a few ways the surgeon can choose to close your incision. Rather than stapling the outer layer of the incision, I use an absorbable suture. Although this running stitch takes longer than stapling the incision, I feel it provides a superior closure. It also avoids the sometimes painful removal of staples at the 10-day mark.

Related: 4 exercises for aching knees

Mobility

The goal is for you to be up and moving as quickly as possible after surgery.

Every 90 minutes, I encourage you to be up and walking for 5-10 minutes. During the initial four weeks after surgery, you should avoid prolonged sitting. The act of sitting bends the leg at the ankle, knee and hip. This position restricts the drainage of the leg and can lead to swelling at the ankle. If you do notice swelling, lie down for 10-15 minutes and elevate your leg.

Every 90 minutes, I encourage you to be up and walking for 5-10 minutes.

Although the goal is to be mobile, I recommend using a walker for several weeks after surgery. The act of surgery involves dividing the muscles like curtains on a stage. The muscle will heal after surgery, but initially, your reaction time and strength are reduced. During this time, a walker helps to overcome this initial vulnerability. A fall in the post-op healing phase can be disastrous. My rule is always safety first. These first four weeks are an investment in the life of your implant.

Physical therapy

A physical therapist will instruct you on your post-op exercise program. You’ll start your exercises immediately after surgery through home therapy or therapy at an outpatient center. Although you may be hesitant to work your new artificial joint too hard too quickly, movement is an important part of your recovery process.

You will do your exercises three times a day, but keep in mind that you should guard against being overly active. The operative site needs time to heal. Think about rehab as your job and work only from 8 a.m. to 6 p.m. After 6 p.m., the patient needs to rest.

Long-term recovery

The goal is slow and steady progress. I routinely tell my patients that too much therapy can be as harmful to recovery as too little therapy. It’s all about finding the right balance. Trust your surgeon, therapist and the rest of your care team to help you heal at the right pace.

While the recovery process continues throughout the first year, the majority of improvement occurs in the first four weeks.

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Still have questions about knee surgery? Consult with an orthopedic surgeon today.