by Jim Driggers
Does the sight of a broken-down escalator or the thought of having to make an extra trip across the room make you wince? Severe knee pain due to arthritis can affect most of your daily activities and limit mobility. If your knee hurts while climbing stairs, walking, or even sitting — and medicine, physical therapy, and walking aids no longer help — your doctor may recommend total knee replacement surgery, or total knee arthroplasty.
The prospect of having surgery may be unnerving, but know that if you and your doctor decide that surgery is right for you, you can handle it. If you have lived with the pain and loss of movement that arthritis can cause, you can work through the knee replacement recovery process.
As Brian Hill, PT, of Pleasanton Hill, California, points out, total knee replacement is major surgery. The procedure involves cutting into skin, blood vessels, and tendons to expose the knee joint, removing injured bone and cartilage from the knee, shin, and thigh, putting an artificial joint in their place and cementing or otherwise attaching it to bone, and then suturing together the cut tissues and skin. Although the recovery process can be long, Hill assures his physical therapy patients that bruising, swelling, and pain after the surgery are normal and should fully subside.
If your doctor has recommended knee replacement, you are not alone. According to the American Academy of Orthopaedic Surgeons, each year about 581,000 knee replacement procedures are performed in the United States, and most of them are total joint replacements. (Partial joint replacements, which typically replace one side of the knee joint, may be less invasive and require less recovery time.) More than 90% of people who have a total knee replacement find that their knee pain is greatly reduced and that they are better able to do daily tasks. Now that you’ve learned that the surgery may give you increased comfort and mobility, educating yourself about what to expect afterward — during recovery — can help you better prepare for it.
Ideally, preparing for your recovery begins weeks before surgery. Being prepared and ready to deal with the physical, mental, and emotional challenges inherent in recovery will largely determine how much benefit you get from your new knee. You should focus on three areas: your physical self, your mental self, and your environment.
Your physical self. Sometimes before and more often after surgery, your doctor or physical therapist will give you exercises to do to help your knee regain strength and mobility. If you’re able, try to “prehab” your knees and legs by doing the same exercises before surgery that you’ll be doing afterward. Ask your doctor about the routine ahead of time. The more familiar you are with the exercises, the easier they will be, and exercising your legs will help keep them strong.
Also try to increase your upper body strength before surgery. This will help when you’re using crutches or a walker, as you may need to do for several weeks during recovery.
Your mental self. Preparing yourself mentally for recovery is especially important. While factors such as body weight, pain tolerance, and level of physical fitness can all affect the speed and ease of recovery, the most important factor is how motivated you are to do what is necessary to recuperate. If you are a proactive participant in your own recovery, you should fare much better than if you don’t follow your doctor’s advice and don’t invest time and effort into regaining function.
Your environment. This includes not only the place where you will recover but also the people who will care for you. Many people underestimate how incapacitated they will be for the first few weeks after surgery. Depending on the type of knee replacement you have, you’ll leave the hospital two to five days after the surgery. When you do, you will definitely need help. Hospital staff will make sure you can get in and out of bed and walk with crutches or a walker before you are discharged, but you won’t be able to drive a car for several weeks, and it will be difficult to do many daily tasks at home. If you don’t have family or friends who are willing and able to help you after your surgery, or if you have special needs, then you may want to go to a specialized rehabilitation facility. Ask your surgeon about your options.
If your family or friends will be caring for you, have them read this article. You all are about to begin a journey that requires a lot of hard work and patience. As adults we’re generally not used to being so dependent on others. For their part, your caregivers may not expect to have to provide as much help as you will need during the first several weeks of your recovery. Preparing your meals, making sure you have ice packs for your knee, keeping track of when you should take pain medicine, and helping you with exercises, dressing, and undressing may seem like an exhausting full-time job for those not used to caregiving. That effort may strain relationships if your family and friends are unprepared. Talking about this upcoming challenge will help both you and your caregivers prepare.
Last Reviewed on April 20, 2011
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