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How Long Will Pain Last After Knee Replacement

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What To Expect 3 Weeks After Knee Replacement Surgery

How Long Does the Pain Last After Knee Replacement Surgery?

Three weeks after knee replacement surgery, you might be either walking with a walker, with crutches or with a cane. You’ll likely experience mild pain and be low on energy. Hopefully by now you’ll be attending regular physiotherapy appointments to help rehabilitate your knee with your physiotherapists looking to implement more aggressive ROM exercises on your knee.

You won’t be able to drive at the 3-week mark, but you might start to be able to return to doing more around the house. You’ll probably be able to stand and walk around for about 10 minutes at a time and normal routines like getting dressed will become easier.

What Causes A Stiff Knee After Tka And How Can It Be Prevented

Dr. Jesse Otero answers ICJRs questions about the most common causes of knee stiffness after total knee arthroplasty, what to do if a patient presents with stiffness, and when to consider a revision procedure.

ICJR: What is the definition of a stiff knee after total knee arthroplasty?

Jesse E. Otero, MD, PhD: The goals of TKA are to relieve pain and restore function in patients with moderate to advanced osteoarthritis who have exhausted conservative treatments but still have knee pain that interferes with their activities of daily living. In most patients minds, the ideal result of TKA would be a knee that moves and feels the way it did in a more youthful time.

Before discussing stiffness after TKA, it is essential to first review normal native knee motion in relation to the activities patients routinely perform. Laubenthal et al presented a quantitative analysis of knee motion required to achieve normal activities of daily living. In this classic article, the authors used an electro-goniometer to show that on average:

  • 83° of flexion is required for climbing stairs
  • 93° of flexion is required for sitting
  • 106° of flexion is required for tying a shoe
  • 117° of flexion is required for squatting to lift an object

The widely accepted target after TKA, based on this study, is 120° of knee flexion. In objective terms, therefore, knees that fail to achieve 120° of flexion after surgery are commonly considered to be stiff.

ICJR: What are the most common causes of knee stiffness?

Returning To Activities / Sports

Here is some more guidance relating to specific activities and knee replacement recovery time:

  • You can resume many activities after 6-12 weeks, for example swimming
  • Some activities should be carried out with care e.g. golf dont wear shoes with spikes
  • Some activities are not advised following a total knee replacement as they put too much stress on the new knee joint. These include: jogging, contact sports e.g. basketball and football, squash, badminton, jumping activities and skiing. If you are unsure, discuss things with your doctor.

Pain and swelling can take up to 3 months to settle and knee replacement recovery time continues up to 2 years after your operation.

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Knee Replacement Recovery Tips

Here’s some top tips for four common questions about total knee replacement recovery time:

  • How Long Does The Pain Last? Many people find they have less pain after their knee replacement as the arthritis pain is no longer there. The post-op pain usually settles down within 6-12 weeks although their may be some residual pain and swelling for up to a year
  • How Do I Sleep After A Knee Replacement? Typically people find it most comfy to sleep on a firm mattress, either lying on their back or on their side with a pillow between their legs
  • Can I Kneel Down With My Knee Replacement? Yes you can although it may be uncomfortable in which case use a cushion or knee pad. Kneeling won’t cause any damage to the knee replacement
  • How Do I Make the Best Recovery? In order to make the best knee replacement recovery, follow all the advice from your doctor and physical therapist. Start exercises prior to surgery, get up and about as soon as possible, stick to your rehab programme, take medications reguarly when advised and keep going. There may be ups and downs along the way, but stay focused and positive
  • You can find the answers to loads more similar questions in the total knee replacement recovery questions section.

    Total Knee Replacement Surgery

    Knee Replacement Surgery  KneeReplacementHandbook.com

    Total knee replacement begins with removing the damaged parts of the femur and tibia. They are then shaped in such a way that will best accommodate the foreign objects that are used. The ends of both the tibia and femur are fitted with a piece of metal. The piece of metal that is on the tibia is attached to a piece of plastic. The patella is also sometimes fitted with a piece of plastic.

    These foreign objects allow for smooth motion in the knee, and by removing the damaged parts can prevent further degeneration or injury.

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    Get Plenty Of Rest And Limit Knee Movement

    You need plenty of rest, which is what you’re likely to do during the first 24 hours following your knee surgery. However, you can still take a few steps during the latter part of the first day. After all, you would still need to heed the “call of nature.”

    The most important thing here is to place as little force and weight on your operated knee. For this, your doctor will likely prescribe a knee brace, a cane, or crutches. After a few weeks, you may no longer need the cane or crutches, but your physician may still require you to use a brace.

    How Long Does A Knee Replacement Last

    About 90% of first-time knee replacements last at least 15 years,4 and many last at least 20 years.5

    Patients can extend the life of their knee replacements by complying with their physical therapy routines and avoiding high-impact activities, such as jumping or jogging. High impact activities cause friction between the man-made components of the replacement knee, causing wear and tear.

    Revision Knee Replacement SurgeryIf the initial knee replacement components need to be replaced for any reason, a second surgery called a revision total knee replacement may be needed. Wear-and-tear on components, component loosening, infection, and knee joint instability are the most common possible causes for needing revision surgery. Other reasons include knee stiffness and bone fractures.

    Patients should talk to their doctors about when is the best time to schedule knee replacement surgery.

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    How Long Will I Need Pain Medication After Total Knee Replacement

    Pain, swelling, and bruising are all normal after knee replacement surgery, both for partial and total knee replacements. Youll be sent home with oral pain medications after your surgery, which youll take for several weeks after your surgery.

    The most commonly prescribed pain medications after knee replacement surgery include prescription-strength naproxen sodium, ibuprofen, and acetaminophen. If those commonly used pain relievers dont provide enough relief, your doctor can prescribe something stronger, such as hydrocodone or an opioid pain killer. Narcotics are addictive pain relievers and can be taken safely after surgery but the duration of these drugs if chosen for use, should be limited as much as possible. Please speak with your physician prior to surgery in regards to the pain protocols that will be used postoperatively

    Your Role In Creating A Pain Plan

    How long does the pain last after a knee replacement?

    After surgery, it is common to have pain. A member of your health care team will monitor your pain level often and help you review treatment options.

    All of the following information will help your health care team prescribe the right medicine and therapy for your pain, and prevent problems . Tell a member of your health care team:

    • if you have allergies or reactions to pain medicine
    • what methods of pain control have worked or have not worked well in the past
    • where you feel pain and how much pain you have
    • what makes your pain better or worse
    • if your pain starts to get worse or you have new pain
    • what vitamins, herbal and natural products you are taking
    • if you drink more than two alcoholic drinks each day.

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    Flexion And Extension Contracture

    Contracture is a shortening of the muscle itself. So, fibrosis is something that sets up, like we talked about, as a spiderweb, and it connects bone to bone. Contracture is an actual shortening of the muscle, the tendon, because its been in a short position for so long. You know that whole use it or lose it? Thats real. That really happens. And so if you dont move that muscle, its going to contract, its going to stay short, because thats all it ever had to do. And thats why sometimes strengthening after a knee replacement takes longer, because you most likely didnt have that range of motion before surgery.

    If you had a knee, and that knee was only bending to 70 degrees, then the quadriceps knew that it had to work from 70 to zero, and thats all the quadriceps had to do. And the hamstrings only pulled the knee back to 70 degrees. They didnt pull it back any further, right? So, those muscle fibers that exist after 70 degrees on either side of the joint, theyre on vacation, and they like being on vacation.

    And when you ask them to start working again it takes a little bit of time for them to remember what their goal was, what their target was, what their job is.

    Scar tissue and swelling after knee replacement are the biggest challenges for most patients. Do your homework and make a plan for your recovery. With a good physical therapist and the right approach to recovery you will get back to your life in no time.

    Tight Calf Muscles After A Knee Replacement May Be Caused By New Alignment

    After a total knee replacement your new knee changes the alignment of the hip and ankle.

    Many clients have some form of bowing in their leg before surgery.

    Genu Varum also known as bow legged is when the knee curves outward.

    Genu Valgum also known as knock kneed is when the knee curves inward.

    Prior to surgery, your body has adapted to these mechanical changes over many years of your life. Now your new knee has changed decades of malalignment in 30-minutes. It is normal for your body to several weeks or months to adapt.

    * Recommendation: Talk to your physical therapist to learn which exercises you can do to normalize your alignment and the improve hip and ankle mobility in the process.

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    Nerve Damage From Surgery

    Nerve damage can happen during surgery, but it usually goes away within six months.

    Surgeons must cut and stretch skin and muscle during surgery. The American Academy of Orthopaedic Surgeons says pressure, stretching or cutting can damage nerves in the leg or around the joint.

    Knee surgery may involve special tourniquets to restrict blood flow in the leg. According to a 2013 study in the journal Acta Orthopaedica, these devices may put damaging pressure on nerves.

    Symptoms of nerve damage include radiating pain, tingling sensation in the leg, and numbness in the leg or foot.

    Should I Use Muscle Relaxers After Knee Surgery

    24 best X

    Many surgeons use muscle relaxants on patients who undergo surgeries. They do so to restrict muscle movement while patients are unconscious. However, researchers now associate them with increased risks of lung complications.

    As such, you may want to avoid over-the-counter muscle relaxants after your surgery. You should only use them if your doctor prescribes them.

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    Here Are Some Of The Reasons You Might Need Knee Surgery:

    • Stiffness in the joint and pain makes it difficult to walk, stand up, or climb stairs
    • You often have swelling in the knee area
    • Chronic pain bothers you when resting
    • The pain is disrupting your sleep
    • The knee has defects or is bowed
    • Medication and physical therapy havent been effective in managing the pain

    If you can relate to any of these symptoms, then its time to talk to a sports medicine doctor about your treatment options.

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    Anatomy Of The Knee And Associated Ailments

    The knee is comprised of three bones, the Tibia , the Femur , and the Patella . These bones align in such a way that allows them to bend. The muscles, tendons, and ligaments surrounding the knee serve as stabilizing agents. There is fleshy cartilage between the bones which acts as a cushion, preventing the bones from rubbing against one another called bursa.

    When someone experiences pain in the knee, there are several potential causes. The three most common are:

    • Osteoarthritis: soft tissues in the body degrade naturally over time. When the cushions between bones begin to deteriorate and the bones begin to rub against each other, this is called arthritis. This condition can cause a great deal of pain and occurs predominantly in people over the age of 50, but can occur to anyone at any time.
    • Injury: an injury can occur for many reasons, including a sports injury, falling, or a traumatic injury such as a car accident. When these occur, the bones not only experience trauma but may realign in such a way that causes pain. These can include torn cartilage, a torn ACL, or broken bones.
    • Overuse: repetitive motion in the knee can lead to more rapid degeneration of the soft tissue.

    Certain individuals may be more prone to knee pain than others due to their lifestyle. These people include:

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    What Should You Expect After Knee Revision Surgery

    Most patients who undergo revision procedures can expect to have good to excellent results. Although expected outcomes include pain relief with increased stability and function, complete pain relief and restoration of function is not always possible.

    Up to 20% of patients may still experience some pain following revision knee surgery. This can persist for several years after the procedure. Additionally recovery after revision total knee surgery is heavily dependent on the state and function of the knee prior to the revision surgery.

    Who Should Consider Total Knee Replacement Surgery

    Knee Replacement – How Long Does Swelling Last?

    It is usually reasonable to try a number of non-operative interventions before considering knee replacement surgery of any type. Prior to surgery an orthopedic surgeon may offer medications knee injections or exercises. A surgeon may talk to patients about activity modification weight loss or use of a cane.

    The decision to undergo the total knee replacement is a “quality of life” choice. Patients typically have the procedure when they find themselves avoiding activities that they used to enjoy because of knee pain. When basic activities of daily life–like walking shopping or reasonable recreational pastimes–are inhibited or prevented by the knee pain it may be reasonable to consider the surgery.

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    What Does Knee Replacement Surgery Involve

    The team at Tri-State Orthopaedics provide the latest advancements in treating chronic knee problems. When conservative options arent enough, your provider may recommend knee replacement surgery. Also called arthroplasty, this procedure involves replacing the structure of the damaged knee joint with metal and plastic parts to restore the normal function of the knee and relieve chronic pain.

    Knee replacement is an incredibly common and successful procedure. Over 90% of people who have knee replacement experience significant improvement in pain and their ability to get around. For most people, knee replacement restores a good quality of life, giving back independence and allowing you to engage in activities you used to enjoy. However, recovery is often a long road. If youre scheduled for or considering knee surgery, here are some helpful dos and donts in your path to recovery.

    What Happens During Surgery

    Prior to surgery, your physician and surgeon will consider things like weight, the condition of existing bone and cartilage, and other medical factors, and will have a plan in place post-surgery for optimal healing.

    During knee replacement surgery, your doctor will make an incision, moving your knee cap, and cutting away any damaged bone, cartilage, and joint surfaces. This is then followed by the attachment of artificial joints, which are tested by rotating and bending the new knee replacement, before the incision is closed up with stitches and/or surgical staples.

    Factors during the surgery, including blood loss, and unforeseen medical issues involving the condition of the bone, cartilage and underlying muscle can have an impact on recovery time and post-op pain following a knee replacement surgery.

    Pain after knee replacement surgery is sometimes caused by biological factors present before the surgery, while others may be caused by complications and conditions during the surgery itself.

    Arthritis is an example of a biological factor that may be present before the surgery, which can flare up after knee replacement surgery. Similarly, patients with pre-existing concerns about fibromyalgia may find their pain response heightened after knee replacement surgery for as much as six months.

    • Infection
    • Stiffness

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    Knee Replacement Recovery Continues Once Youre Home

    Even though hospital stays for knee replacement surgery are shorter than they used to be, getting back on your feet still takes time, says Dr. Parks.

    The next phase of recovery continues at home, as patients begin acclimating to normal activities, such as moving between rooms, getting up and sitting down in furniture, and using the bathroom. While everyone is different, many patients are likely to have similar experiences during the early weeks of recovery.

    For Barnes, stability was a big issue. I became very aware of where I was placing feet, for example, when stepping off a curb. I just felt a little clumsy early on after surgery so I was afraid of falling.

    In addition, she experienced a lot of swelling. The hospital gave me a special brace that circulates cold water around the knee, which was great and helped with swelling, she says.

    Whether your doctor has prescribed formal outpatient physical therapy or has entrusted you with an at-home regimen of walking and exercises, patients progressing through recovery achieve some big milestones along the way.

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