After the knee arthroplasty operation recovery is usually rapid. In the hospital right after surgery early knee movement, within the first 24 hours, is encouraged.
Recovery times can vary depending on the individual and the type of surgery carried out.
Antibiotics and pain relief following knee arthroplasty
The patient is provided with antibiotics to prevent infection and adequate pain relief with patient-controlled methods or by epidural analgesia.
Patient controlled methods include a pain medication delivery system or pump with medication like morphine. The patient can control himself or herself depending on the severity and self-perceived requirement of pain medications.
Epidural analgesia is provided using an anesthetic drug via a catheter threaded into the spinal cord. The drug numbs pain sensation below the waist.
Epidural analgesia is chosen for the first few hours or days. It is offered to patients with excessive pain. Cold compresses are provided for pain relief.
Physiotherapy following knee arthroplasty
Physiotherapy under expert guidance is begun as early as possible. Exercises are taught.
In most cases patients are allowed to walk with support and aids on the second day after surgery. Stitches are removed around 10 to 14 days after surgery.
Exercises include paddling or brisk up and down movement of the feet, deep breathing exercises and specific knee extension and strengthening exercises.
Follow up procedures to knee arthroplasty
If wound healing is good, mobility is to the satisfaction of the surgeon, at least 90 degrees of knee bending is achieved and no complications are seen patient may be discharged early.
First follow up after removal of stitches is at around 6 weeks in outpatients. On a follow up visit the surgeon enquires about pain relief, adequate wound care, identification of complications and adequate return to normal activities.
The next visits are annually for over five years or so. An X ray may be prescribed to ensure that the prosthesis is not beginning to loosen.
Walking aids and assistance
Climbing stairs and sitting or getting up a chair may require walking aids or assistance at least till wound is completely healed.
Kneeling should be avoided and activities like gardening that requiring should be avoided for the initial months after surgery.
Driving following knee arthroplasty
Driving may be resumed 1 week after surgery if the left knee has been replaced and the vehicle is automatic.
If the right knee has been replaced, driving may be resumed after 4 to 6 weeks.
Getting back to normal after knee arthroplasty
Returning to work or house work usually takes 6 to 8 weeks or more depending on the nature of work.
Sleeping positions after surgery on the side, back or stomach may be deemed safe.
Sexual intercourse may be resumed after adequate wound healing. This may take 6 to 8 weeks or more depending on the extent of surgery and general health of the patient.
Swimming can be resumed after around 6 weeks.
Other activities like cycling, golf, dancing etc. that do not produce strain on the knees may be started after complete wound healing. Exercises should be supervised initially.
The patient should avoid crossing his or her legs as this hampers blood circulation of the legs.
There may be an increased risk of deep vein thrombosis on long distance air travel. Adequate protection with stockings and blood thinners or anticoagulant medications must be taken before travel.
Patients are advised to prevent and avoid falls to prevent injury to the replaced knee. This includes removal of loose rugs and matting, making floors slip-resistant, stapling cables around the house, adequate railing and lighting within the house etc. (1-4)
Edited by April Cashin-Garbutt, BA Hons (Cantab)
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