Knee Replacement

Knee Replacement

Painful knees are a common problem - often the result of wear-and-tear from sports injuries or obesity, which leads to a degenerative form of arthritis called osteoarthritis. Pain relievers and other treatments can help. When knee damage is severe, a total knee replacement can relieve the pain and allow you to be more active again.

Recently Answered

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    After total knee replacement surgery, you will have the following postoperative precautions:
    • Don't cross your legs.
    • Don't kneel and don't place anything behind your knee.
    • A pillow or any item for that matter should not be placed behind the knee.
    • If elevation and/or support is needed under the operative leg, it is to be placed under the heel.
    • You will be asked not to torque or twist on your new knee.
    • You will receive instructions for transportation to and from your home via your automobile.
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    You will start physical therapy on the same day as your knee replacement surgery. Your physical therapist will see you twice a day from that point on. Physical therapy will focus on such activities as bed mobility, transfer training, ambulation and stair training and range of motion exercises.

    You will also be visited by an occupational therapist during your stay at the hospital. Usually one visit by an occupational therapist is sufficient to cover such things as personal hygiene, self dressing, adaptive equipment needs and family training or education.
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    Before you have knee replacement surgery, your doctors will want to see you for physical therapy far enough in advance so that you will have an opportunity to build muscle strength around the joint. This will include six to eight weekly sessions of physical therapy. After total knee replacement surgery, you will absolutely need to participate in another six to eight weeks of sessions.

    There is a Medicare cap on therapy for each year that a person can get reimbursed for, so we do receive some questions about that when we encourage people to participate in preoperative therapy.
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    A Dr Scott Martin, MD, Orthopedic Surgery, answered
    Your rehabilitation begins immediately after joint replacement surgery. Grasp the overhead bar to shift around in bed and relieve pressure on your skin. Perform exercises as prescribed by your physical therapist. Before you actively bend a knee replacement, your knee is placed in a continuous passive motion (CPM) machine to bend and straighten it by a programmed (and gradually increasing) amount. Use of the CPM device supplements but can't replace your participation in physical therapy.

    By the day after surgery, a nurse or physical therapist helps you get out of bed and use crutches or a walker to move to a nearby chair. If you had hip replacement, an abduction pillow between your legs keeps your hips in a safe position while you sit; the first few nights, your leg may be returned to the sling. To prevent your hip from dislocating before the ligaments heal enough to stabilize the area, you must avoid specific movements in the hospital and for several weeks at home.

    Before you can safely go home, you are usually expected to be able to perform the following: get into and out of bed, walk with crutches or a walker, go up and down a curb and the number of steps you must negotiate at home, perform your rehab exercises, and show you can do necessary tasks with little or no assistance (and, after hip replacement, without violating your hip precautions). If you had knee replacement, you should be able to straighten your knee and bend it 90 degrees. Depending on individual circumstances, these requirements may be altered. If you are medically cleared for discharge but not able to do these things, or if you need extra nursing care or have no assistance at home, you are discharged to a rehabilitation center. Many people who live alone choose this option.
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    After knee replacement surgery, you may not feel like eating much, but your body still needs extra energy and protein to start healing. Try the tips below to help you eat enough to build your strength:
    • Eat 3 smaller meals every day, and add in 3 high-protein snacks.
    • Use ready-to-eat, easily prepared foods.
    • Keep nutritious snacks handy for nibbling.
    • If you still can't eat much, ask your doctor or nutritionist about whether you should drink a supplement such as Ensure, Boost, or Instant Breakfast.
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    Eating enough protein is essential to helping your body heal and fight infection after knee replacement surgery. Try to eat at least 2 to 3 servings per day.

    Excellent sources of protein include: beef, fish, poultry, eggs, cheese, milk, yogurt, cottage cheese, dried beans, nuts, seeds, peanut butter, and protein drinks.

    Add protein to your diet wherever you can: Mix dry milk powder into your regular milk, scrambled eggs, soups, or casseroles. Add ground meats to soups or casseroles. Nibble on nuts or cheese as a snack.
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    Once you have recovered from knee replacement surgery, a more active lifestyle can improve the lifespan of your replacement knee:
    • Keep active! Helpful activities include walking, hiking, cycling, swimming, low-impact aerobics, golfing, doubles tennis (without running for balls), and ballroom dancing.
    • But not too active! You still need to be careful, though. Avoid high-impact sports, including basketball, baseball, football, soccer, running, or rock climbing.
    • Stay at a healthy weight. Extra weight puts more pressure on your knees.
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    After knee replacement surgery, be safe with stairs. If you must climb stairs, there are a few things to keep in mind to be safe:
    • Avoid stairs if you are unsteady or dizzy.
    • Climb the stairs one at a time.
    • Do not switch feet for each new stair.
    • Use crutches if instructed by your therapist. Your therapist will have you practice stair climbing, if needed.
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    After knee replacement surgery, protect your new knee by avoiding certain positions and movements while your new joint is healing. Use care:
    • Not to kneel on your operated knee
    • Not to bend your knee forcefully
    • Not to cross your legs
    • Not to twist toward the side of your surgery
    • Not to put a pillow under your knee while you're in bed
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    After knee replacement surgery, getting pain relief will help you rest better and do important exercises so your new joint will heal properly. It's important to take your pain medication exactly as your doctor instructs. This will help you avoid complications and heal better faster. Also follow these tips:
    • Don't drink alcohol while you are on pain medication.
    • If your medication is running low, call for a refill at least 48 hours before you need more. You don't want to run out, especially after hours or over the weekend.