Oluwaseun Akinbo: The road to recovery after a knee replacement
What to expect when expecting a knee replacement can be an unknown. This is especially true for patients unfamiliar with anyone that has had a knee replacement. This series will paint a picture of the knee replacement experience. The first entry in this series was about the journey to a knee replacement. It discussed the pre-operative journey. The second entry discussed the process that starts on the day of surgery until discharge. This final entry discusses what happens after discharge, expectations, and timeline for recovery.
The impervious surgical dressing applied to the knee is removed at 7 days after surgery. The patient is then seen at 2 weeks after surgery (sooner if needed). The wound is examined. Staples/sutures are removed if used. Physical therapy is continued. The patient is seen again at 6 weeks from surgery. There is the expectation at this visit that a cane or walker is no longer being used. Of note, some patients will need their cane or walker for a long period of time. Range of motion is also assessed at this time. If limited, the decision is made for aggressive range of motion exercises with therapy versus a manipulation of the knee.
A manipulation is done under anesthesia. Most patients will benefit from a manipulation (bending the knee and breaking up scar tissue) before 3 months from surgery if unable to gain at least a 75-degree arc of. At 3 months post-op, patients are expected to be transitioning or have transitioned to their routine activities. Swelling and minor pain might still be present. Patients are expected to be about 75 to 80% recovered by 6 months. It can take a year or even longer to reach a point of maximum recovery from a knee replacement.
A knee replacement is not giving one back their normal knee from many years ago. It is giving one an internal prosthetic device that should function similar to a normal knee. This is an important distinction. Some patients might have minor 1-2/10 pain even after a year from surgery but not limiting pain. Numbness on the outside of the knee is common. Crepitus in the replaced knee is common. A sense of stiffness is common. Swelling after activities can also occur. These complaints largely fall into the category of nuisance symptoms as they do not typically affect the functioning of a knee replacement.
Satisfaction after knee replacement is high but it is not 100%. Carefully establishing expectations prior to knee replacement surgery is key to patient satisfaction. A 40-year-old that wants his normal knee back so he can play competitive basketball after knee replacement doesn’t have realistic expectations and might not be a good surgical candidate given expectations. Remember, satisfaction is a function of realistic expectations.
Dr. Oluwaseun Akinbo M.D. is an orthopedic surgeon at HaysMed. For more information, https://www.haysmed.com/oluwaseun-akinbo/.