What to expect from knee surgery rehabilitation
This article will look at the different types of knee surgery, the rehabilitation timelines, and what people can do to help speed up the recovery process.
Types of knee surgery
There are various types of knee surgery. The type that a person has will depend on the particular injury to the knee joint.
Total knee replacement
A person who has osteoarthritis or rheumatoid arthritis may require knee replacement surgery.
This is the most common kind of knee surgery for arthritis. The operation involves replacing the whole joint. Surgeons only undertake total knee replacement surgery as a last resort, often when the joint is irreparable, the damage interferes with everyday life, and other treatments do not alleviate the pain.
More than 600,000 knee replacements take place in the United States every year.
During the procedure, a surgeon will remove the joint and replace it with one made from metal, ceramic, or plastic.
Arthroscopy is a minimally invasive surgery that involves making a small cut in the skin over the knee, inserting a small light, and using small instruments to diagnose and treat knee problems, including:
- removing or repairing torn menisci, which are part of the cartilage in the knee joint
- repairing a torn cruciate ligament inside the knee
- trimming torn pieces of joint cartilage
- removing loose bodies, which are small fragments of cartilage or bone floating inside the knee
- removing an inflamed joint lining
This is an operation that involves the surgeon cutting, reshaping, and repositioning the bones to take some weight off the damaged part of the knee.
Sometimes, surgeons carry out this procedure to help correct a broken bone that has not healed properly.
Timelines and what to expect
Recovery and rehabilitation times will vary according to the type of surgery a person has.
Total knee replacement
After a total knee replacement, a person will need to stay in the hospital for several days. During this time, they will take medicines for pain management and to prevent blood clots.
A person may also use a continuous passive motion (CPM) machine, which is a knee support that slowly moves the knee while in bed. Some doctors believe this decreases the swelling by elevating the leg and improves blood circulation by moving the limb.
Someone undergoing a total knee replacement will usually be able to resume most of their activities within 3 to 6 weeks.
Most people will be able to drive within 4 to 6 weeks. However, people must wait until their knee bends enough to allow them to get into the car and sit comfortably. They will also need to develop enough muscle control to allow for safe braking and accelerating.
As this is a minimally invasive procedure, people will usually be able to go home a couple of hours after the surgery. They will usually be able to drive again within 1 to 3 weeks of the procedure.
Some people may need to take pain medication in the first few days following surgery. It is also best to keep the leg elevated as much as possible during this time. People may need to use crutches for a few weeks after surgery.
Most people will be able to return to most of their activities within 6 to 8 weeks, and sometimes much sooner.
People having an osteotomy have to remain in the hospital for 1 or 2 days. A medical team will provide pain relief.
The person will probably require crutches for several weeks, and the doctor may put the knee in a brace or cast while the bone heals.
A person can usually resume their regular activities within 3 to 6 months of surgery.
How to encourage healing
A doctor may suggest specific exercises to aid movement and strengthen the knee.
It is essential to keep the wound as dry as possible until it has thoroughly healed. Covering the wound with a bandage will help to prevent irritation from clothing or support stockings.
Eating a healthful, balanced diet with plenty of iron will help encourage healing. A person may have a poor appetite for the first few days following surgery, but eating nutritious foods will help them feel better sooner.
Aftercare will largely depend on the type of surgery the person has undergone.
The American Academy of Orthopedic Surgeons (AAOS) recommend exercise during the first few weeks after the operation.
A doctor may advise on specific exercises to do several times a day. These aim to restore movement and build strength in the knee.
Also, a doctor or physical therapist may design a personalized activity program. This may include a plan to gradually increase walking and a timetable for resuming everyday activities, such as sitting, standing, and climbing stairs.
Anyone who has had an arthroscopy should exercise regularly to encourage full recovery. A doctor or physical therapist will usually recommend 20 to 30 minutes of exercise two or three times a day.
A doctor will recommend rehabilitation exercises on an individual basis to people recovering from an osteotomy.
What to expect at the follow-up appointment
A person who has had an osteotomy will require an X-ray during their follow-up appointment.
If a doctor used stitches or staples during total knee replacement surgery, a nurse would remove them several weeks after the operation.
During the follow-up appointment, the doctor will assess how well the wound has healed. They will also set a personalized activity plan.
People recovering from an arthroscopy will also see the doctor a few days after the procedure. The doctor will review the surgical findings and make a post-operative treatment program.
People will need a follow-up appointment a few weeks after an osteotomy. During this appointment, a doctor will take X-rays to check on the healing process. The doctor will also advise the person when it is safe to put weight on the leg, and when they can start the rehabilitation process.
A total knee replacement aims to improve the function of a damaged joint, but many people will not regain a full range of motion.
However, more than 90 percent of total knee replacements are still functioning 15 years after surgery.
Some people may need to switch from high impact to low impact exercises after surgery or make other adjustments.
An osteotomy tends to relieve pain and delay the progression of arthritis in the knee. A person may require a total knee replacement later on, but the operation allows younger people with arthritis to lead a more active life for many years before that.