What is the recovery like after a knee replacement?
Today we will answer another one of the most common questions I am asked from people considering knee replacement surgery. “How long is the recovery?” Although this is one of the most common questions we are asked, it is also one of the hardest to answer. At Hudson Valley Bone and Joint Surgeons we have replaced over 3,000 knees over the past several decades, and one thing that we know for sure is that each person recovers at their own pace. We recently performed a knee replacement on a high school gym teacher who was back to work in 8 days, but this is not necessarily what most people can expect.
Another reason this is a hard question to answer is the different people have different expectations and also different definitions of the word “recovery.”
Here we’ll try to break down the road to recovery into phases, but just remember we all recover at our own pace, and while some people will recover a little faster than average, some will also be a little slower.
The first phase of “recovery” actually start before surgery. How prepared you are for surgery often influences your speed and degree of recovery.
- Range of motion: Patients with better range of motion (how well you can bend and straighten your knee) before surgery are often able to regain their motion back faster and better after surgery.
- Weight: Patients who maintain a healthy body weight often recover faster (and have fewer surgery related risks) compared to those who are overweight.
- Stamina: Those with better exercise tolerance who are in better physical shape, often recover faster than those who are not.
The next thing that everyone always wants to know is how long the surgery will take. The answer is generally around 90 minutes.
Hospital Phase: Most patients stay in the hospital two nights. Most patients have their first physical therapy session on the day of surgery! This usually entails standing up and taking a few steps. Getting out of bed on the day of surgery has been shown to expedite recovery. The next two days are focused on getting you ready to go home, which means walking longer distances, going up and down stairs, and learning how to take care of yourself with your new knee.
The first six weeks is the next phase and is the one in which there is the most swelling of the leg, feet, and ankles. The knee is somewhat tender and sore with weight bearing. The old arthritis pain is usually gone after two weeks, but the soreness from the surgery will depending upon the level of activity. You will most likely need a cane for indoor activities for 1-2 weeks and for outdoor activities for 4-6 weeks. There is no need to rush the rehabilitation time and there are no gold medals for getting off the cane sooner. It is critical during this time frame that you do not overload the leg and you should use the cane if you are having a significant limp.
The next phase lasts about 3-4 months and at this time most people are able to be off the cane and do recognize that they have some return of leg strength. The leg will still be sore at this time, sometimes in the thigh and sometimes in the groin and sometimes in the lateral knee, particularly if the leg is overloaded. There cannot be rigid guidelines for activity levels because each patient does differ. However, you need to use your common sense and determine what activities you can be doing at this three month time frame and not exceed them. For golf, patients can chip and putt at 2 weeks and begin swinging the club at 4-6 weeks and play the course with some breaks at 2-3 months. Many patients return to work sometime during this phase depending on their workload.
The final phase is the 6 month time frame at which time activities can be done all day long without having to rest and endurance capability is near normal. The difference in the strength of the leg between 3 months and 6 months will be recognized, particularly for those patients who are involved in any sporting activities. More vigorous sporting activities such as snow skiing, water skiing, beach volleyball, mountain hiking, and the like should really wait for 6 months because the leg strength is so much better at 6 months and the ability to perform these activities with strength is much easier.
Some patients will take up to a full year to regain their full strength and stamina and get rid of all of the soreness.
The most important thing you can do is listen to your body and recover at your own pace.