Dale Says

April 6, 2008

Now You Tell Me: Things I Wish I’d Known before Knee Replacement

Filed under: Knee Surgery — Dale @ 10:31 am

I am in the midst of recovering from total knee replacement. It’s been slow and painful, as everyone said it would be, but I’m gradually gaining strength and mobility and I now know it will be worth it in the end. My situation isn’t uncommon, as an increasing number of people are choosing knee replacement as a way to ease pain, increase mobility, and get back to a more active life.

What is surprising is how much I didn’t know before I had the surgery.

This article is meant to help readers who are considering knee replacement prepare for surgery, and for a successful recovery.

Make plans before surgery
There are a number of things that should be done before knee replacement surgery. Here’s a checklist:

 Have a physical examination to ensure that you are in good enough health to have the surgery.

 Check with your health insurance company to determine your coverage and responsibilities, and to complete required paperwork.

 Arrange for care after surgery (at home or in a rehab center) that includes meals, medicine, laundry, shopping, and transportation to and from the hospital and physical therapy.

 Re-arrange your home to allow you to get around on a walker or crutches without climbing steps or lifting or carrying things.

 Find and schedule an appointment with a qualified physical therapist that has experience with knee replacement patients.

 Lay in a supply of food, clean clothes, linen, medicine, and cash.

Mentally prepare for your hospital stay
Typically, knee replacement patients spend three nights in a hospital. During that time you will be in bed nearly full time (except for brief periods to do physical therapy). You will likely wear a catheter, have an IV attached to your arm, and be poked and prodded every couple of hours around the clock. There’s not much you can do about it – except to be mentally prepared for it. Take a couple of good books with you, ask friends to stop by with special treats, and pick out a few good TV programs or movies to watch.

Arrange for caregivers
Helping you through recovery is a big job and you should make sure you have arrangements with people to spend time each day with you for at least two weeks. You probably won’t be able to drive, cook, shop, do laundry, buy medicine, or clean house, and you will need someone to take care of those tasks for you.

Make sure your caregivers are well rewarded because helping you (at least at first) is probably going to be a pretty thankless task.

Pick a qualified and trusted physical therapist
A good physical therapist is crucial to recovery. Few of us have the discipline on our own to do the painful and tedious work required to recover from knee replacement and it helps to have a physical therapist as instructor, coach, disciplinarian, and cheer leader.

Find a physical therapist you trust who is experienced with knee replacement and willing to spend the time and energy to help you through recovery. Do everything your physical therapist tells you to do. If he or she doesn’t measure up change therapists until you find one that does.

Plan for pain
You will likely experience pain for several weeks and pain pills will only dull the pain, not eliminate it. Prepare to deal with two types of discomfort – pain during therapy and night pain.

The therapy of re-gaining flexion (bending the knee) hurts. After awhile you will get used to it, but the pain will still take your breath away. You can relieve the pain by taking pain pills before therapy sessions, and by massaging and icing your knee afterward.

You may also experience night pain – a sharp ache that wakes you in the middle of the night. You can ease night pain by taking anti-inflammatory pills (ibuprophen, for example) before you go to bed, and by gently massaging the knee, then icing it.

Get your knee back
Getting motion back in your knee involves increasing the flexion (bending) and extension (straightening). Immediately after surgery you will have difficulty with both functions and improving them will become your focus during recovery.

There are a variety of exercises to increase flexion, with the goal of gradually increasing the angle you can bend your knee to 110 – 120 degrees. Your physical therapist will teach you the exercises, and you should do them every day. At first, they will be painful, but your knee will gradually warm up and they will become easier and more rewarding. Two useful tools to improve flexion include a Continuous Passive Motion (CPM) machine, which slowly bends and straightens your leg, and a stationary bicycle, which helps increase mobility in your knee.

Be forewarned, there are no days off during recovery and you will have to do exercises every day for up to six months. Consider it your full time job to recover and push yourself, even on days when you don’t feel so good.

The payoff: a new start and a new knee
There are a lot of things I didn’t know about knee replacement. But looking back on it, I would have had the surgery even if I had known them. For me, it’s worth the pain and effort, because in the end I know I will have a new knee and a fresh start.

I hope you will feel the same way, and I wish you well in your recovery!

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