What to expect when you are expecting…a total knee replacement
A knee replacement, or Total Knee Arthroplasty, is one of the most common orthopaedic surgeries. A replacement can be either total, where the entire surface of the knee joint is replacement, or partial, where only a portion of the joint surface is replaced. In 50% of cases, the kneecap is also replaced. Preparing for the surgery is often a lengthy process. The entire journey, from initial consultation at the joint assessment clinic to surgery date, can take well over 6 months. During this time, patient often read up on the process to get an idea of what to expect from the actual surgery. But, it is also important to think of the rehabilitation process that takes place after, which brings your knee back to the optimal function that you had in your thirties that you have been dreaming about (ahhh, the glory days of the knee!). If you are expecting a knee replacement, use these tips to make the transition into rehabilitation a smooth one.
Get that knee moving
There is some evidence that suggests that better range of motion and strength before surgery can lead to faster and better outcomes after surgery. In fact, some studies suggest that one of the biggest indicators to range of motion after surgery is you range of motion before surgery. This does not mean that you are doomed if you have limited range before surgery. It simply means that it can be beneficial to try to get your knee moving beforehand. Heel slides and knee bends while sitting are a great way to accomplish this.
Ice ice baby
After surgery, it is normal to experience a certain amount of pain, stiffness, and swelling. There is evidence that cold therapy (i.e. icing ones knee) can help with this short term. The most valuable use of ice revolves around pain management. In the days after surgery, it is normal to experience a pain that is similar to that of a swollen joint: a dull throbbing sensation. Using ice wrapped in a damp towel for 20 minutes at a time is a great way to dull this pain. Some surgeons recommend the use of a Cryocuff. This is essentially an ice machine that circulates ice through a knee compress to cool down a joint while offering light compression. Cryocuffs can be rented, or purchase at certain physiotherapy clinics and online.
Set up your home
The rehabilitation process can take anywhere from 4-6 months. This certainly does not mean that you will be debilitated 6 months, but it does mean that you should expect a journey. It will be beneficial to plan out the few weeks after your surgery to accomidate a change in mobility. Here are a few things to consider:
- Usually, the goal is to get patients walking without an assisted device within 4-6 weeks. This means that you should plan to have limited mobility and be walking with a walker immediately after surgery. Plan to have room around your house for the use of a walker. Limit clutter on the floor and around corners.
- Consider the use of stairs. You may need to stay with a family member or friend until you are able to ascend and descend the stairs safely. Another option is to arrange to sleep on the first floor of your home if your bedroom is usually upstairs. Patient often opt for sleeping in the living room la-z-boy for the first few weeks.
- Tools such as a “grabber” can be beneficial around your living space.
- Your knee will be swollen and sensitive to touch for the first few weeks. Plan to wear shorts, very loose pants, or a skirt.
- You will not be able to drive after your surgery, so arrange for a family member or friend to run errands for you and to bring you to your physiotherapy appointments. Another option is to arrange for a physiotherapist to come to you in your home.
Start physiotherapy
Evidence indicates that physiotherapy is very beneficial to patients after a knee replacement. This evidence suggests that physiotherapy and mobilization of the knee should be started within 48 hours of the surgery. You should except to see a physiotherapist in the hospital the day of your surgery. Most surgeons will suggest starting physiotherapy as frequently as 3x a week after hospital discharge. The physiotherapist will assess you and make you an exercise program based on your goals. The first goals of rehabilitation usually revolve around managing pain, increasing range of motion, and returning to a normal walking pattern. Choosing a physiotherapist who will best help you to achieve your goals after surgery can be daunting. Consider our article; 5 tips for choose a physiotherapist after surgery.Do not forget that you will not be able to drive after knee surgery, and therefore it may be wise to consider home physiotherapy as a viable alternative. Home physiotherapy has been shown to be as effective, and in some cases more effectIve, at rehabilitating a knee after surgery.
If you are interested in experiencing physiotherapy after a knee replacement in your own home, call In-home Therapeutics. We are a team of expert physiotherapists who offer home physiotherapy to patients after surgery. Experience the convenience of in-home physiotherapy in your home. We offer home physiotherapy in Eastern Ontario including Cornwall, Brockville, Kingston, and Ottawa.
Email us at: information@in-hometherapeutics.com
