Total knee replacement - Please be a patient PATIENT
Total knee replacement has been proven to be one of the best reconstructive procedures offered to patients suffering with debilitating arthritis over the past 30 years. It is expected that close to 750,000 total knees will implanted in the United States in 2014 with millions having been implanted in the last decade. The operation is primarily performed for pain relief. Secondary benefits include improvement in ability to perform activities of daily living such as dressing oneself, return to physical activities, ability to socialize, and maintain one’s independent living. Surgery will increase mobility, stability, and safety.
Total knee replacement is a very different operation than a total hip. The knee joint is very superficial, covered only by skin and ligaments whereas the hip is deep in the groin and protected and covered by large muscle groups. We demand more from the knee than the hip. The knee must move through a greater arc or range of motion than the hip during some activities such as stair climbing. The expectations of a rapid recovery from a total hip and total knee are different. The post-operative course from a total knee can be long, frustrating and requires consistent rehab.
Though the ultimate excellent result for a knee replacement is achieved in most patients, the speed and duration of the recovery process is quite individualized. Most of the time, the FUNCTIONAL recovery is quite rapid. Patients will progress from a walker and/or crutches to a cane in about 2 weeks’ time. Many patients, depending on their age and severity of the arthritis and disability before surgery, will not need any ambulatory assistance by a month or so after surgery. However, the biggest impediment to recovery and patient satisfaction is the biological healing process called INFLAMMATION. This is persistent SWELLING, ACHINESS, STIFFNESS and WARMTH. Patients may not feel the operation to be a success and worthwhile, feel like the knee is their own, for even 1-3 years after surgery even though they are FUNCTIONING AT A HIGH LEVEL.
Often, patients considering a total knee replacement may know someone who had this operation and is walking around and active without pain 3 weeks after surgery. Of course, this is the exception and not the rule. The majority of individuals take 1-3 months to recover enough from surgery to get back to many of the their former living, work and recreational activities.
The INFLAMMATORY response takes a long time to recede. This process may be frustrating to the patient, therapist and surgeon…..but you can’t rush Mother Nature! In general the swelling-stiffness-achiness –warmth is only 50%(1/2) resolved by 6 weeks after surgery, 75% (3/4) resolved by 3 months, with complete resolution taking a year and sometimes even longer.
Despite the sometimes prolonged course to recovery for a Total Knee, it is a great life changing operation. You, as the patient have to be an active participant in the recovery and rehabilitation program! The final result is about 33% surgeon, 33% physical therapist and 33% patient effort.
If you are planning on having a total knee, please expect to work hard after the surgery to maximize your result and please be a patient PATIENT!