If you have recently had knee surgery, the surgery and rehabilitation process play as critical role in helping you recuperate in getting back up to your normal daily routine of having an active lifestyle. It can support your efforts to heal from surgery quicker and significantly improved your chances of long-term success. It is imperative that you commit to a plan and push yourself to do as much as possible each day. We have a timeline with goal setting guidelines to help learn what you can expect in the first critical 12 weeks or 3 months of recovering and rehabilitation.
Day 1 of Recovery
Rehabilitation will begin almost immediately after you wake up from surgery. Within the first 23 hours you will begin standing and walk use an assistive device with the help of a physical therapist (PT)l Its is critical to get up and use your artificial knee as soon as possible.
You can expect the PT to provide exercise that will help you strengthen your muscles and guide you through them every day. Your PT will also illustrate how you get in and out of your bed and move about with the aid of an assistive device, such as a walker, crutches or a cane. They mak ask you sit at the side of the bed, walk a few steps, as transfer yourself to a bedside commode. A nurse or occupational therapist will assist you with chores such as switching the bedsheets, dressing, bathing and using the toilet.
The PT will also review your home environment and help you get up with a continuous passive motion (CPM) machine fo use in the hospital room and possible at home. Some individuals leave the operating room with their leg already in a CPM machine. The machine holds your knee in motion to help limit the buildup of scar tissue and stiffness from the inability to move.
Your PT may ask you to walk for brief intervals of time using an assistive device. They may also inquire that you use a conventional toilet rather than a bedpan and ask you to try to escalate a few steps at a time. You may be asked to continue the CPM machine. As you recover from surgery, you actively should ultimately increase.
At the time of disaster, you nee should be getting stronger, and you should be able to increase your activity and erase level. You doctor will be shifting you from prescription -strength painkillers to lower does pain medication. Your PT may ask you to go on longer walks outside your hospital room, climb and down a staircase, move onto a chair or toilet without assistance and reduce the use of a walker, cane or crutches. At discharge, you should be able to do the following:
Dress and bathe on your own
Bend your knee well, and preferably to a minimum of a 90-degree angle
Minimally rely on an assistive device.
Goals by the Time you are Discaharged
You can get in and out of bed and perform transfers with the least amount of help possible using proper assistive tools and devices.
Walk at least 25 feet and go up and down stairs utilizing a walker or crutches.
Achieve a 90-dgree range of motion with your knee so you can perform sit -to stand transfers
Display an understanding of recommended exercise and activity.
Discharge Through Week 3
You should be able to move around more freely while exploring reducing pain by the time you are back home or in a rehab facility. You are likely to rely less and less on an assistive device. For example, if you required a walker at the hospital, you will reply be able to get by with crutches or a cane at this point. You should be engaged in a daily exercise regimen as determined by you PT. Bathing and dressing should be more comfortable activities, and you may be able to go outside fo longer walks. You will need fewer and less potent pain meds. You doctor may ask you to keep using a CPM machine during this period.
Weeks 4 Through 6
If you stayed consistent with your exercise and rehabilitation schedule, you should notice a significant improvement in your knee. It should exhibit improved flexion(bending) and strength You pt may ask you to go longer walks and wean yourself from using an assistive device. Towards the ned of this period, you may be able to go on longer walks – perhaps a half mile or father. Ideally, you will feel as though you are regaining your self-sufficiency. Pursuits such as cooking, cleaning, and other household chores should be much easier to achieve.
You should consult with your PT and surgeon to decide when you will be able to return to work and daily activities. Some TKR recipients resume driving four to six six weeks of surgery – but you should not just go for it. Talk about it with your surgeon prior you get behind the wheel. It is wise to wait a bit longer if you are taking narcotic medication or don’t just start driving.
Goals by week 6
Increase the strength of your knee by maintaining your exercise regiment and walking.
Return to everyday activities.
Experience decreased swelling and inflammation
Achieve an improved range of motion, preferably at least 90 degrees of flexion required of regular walking and climbing stairs.
Weeks 7 Through 11
At this point, you should be thoroughly on the road to recovery. You may be able to walk a couple of blocks without any assistive device and engage in other essential activities that require physical exertion, including driving housekeeping and shopping, Your PT will be monitoring your exercise and perhaps modifying them as your knee improves and you can move it more freely. This ay includes:
Hip abduction, which requires you to move your leg to one side while you are standing
Leg balances that involve standing on one foot at the time for as long as possible.
Step-ups include raising alternating feet up and down on a single step
Toe and heels rise, which involve alternating between raising up on your toes and heels while in standing position.
Partial knee bend that requires you to bend your knees and move upward and downward while standing
cycling on a stationary bike
This period is critical for long-term success. Your commitment to an excise and rehabilitation plan will perform a key role in deciding the timeframe you return to a normal lifestyle and how well your knee works in the future.
Goals by Week 11
Rapidly improving mobility and dramatically less stiffness and pain
Improved muscle usage in the knee and the surrounding area
Return to most everyday activities, comprising of recreational walking, bicycling and swimming
Improved range of motion, possible to 115 degrees.
If you have been diligent and committed to rehab, it is likely that you are up and about and starting to enjoy activities like swimming, walking, golf bicycling or dancing. It is essential to continue with these exercises prescribed by your pT and avoid the temptation to engage in high-impact activities that can cause damage to your imp[lant or cause damage to surrounding tissue. These include:\
- High-intensity cycling
At this point, you should be feeling a dramatic decrease in pain. It is critical to stay in touch with your medical team through this period and begins activities only after receiving clearance from them.
Goals by Week 12:
Ongoing contact with your medical team
Ongoing exercise regime such as walking, swimming, cycling, dancing
no loss of flexion or range of motion
Less pain or no pain at all with normal and recreational exercise.
Week 13 and beyond
You should notice gradual and continue improvement in your knee during this period. As time continues, pain should subside. IN most cases, you should feel near 100% after a year. However, it is imperative to stay in contact with your medical team and have periodical check-ups to help ensure that the knee is continuing to work properly. DO not wait to check with you surgeon if at any point you feel pain, swelling, unusual movement in the knee, and stiffness.
Of course, every person is different and rehabilitation periods can vary, depending on some factors. A standard full recovery from a total knee replacement is three to 12 months. However, remember that the harder you work rehabbing, the more likely you are to appreciate a faster and fuller recovery.