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Top 5 Mistakes After Knee Replacement

People with severe knee osteoarthritis experience knee pain and reduced mobility. If you have this condition, undergoing knee replacement surgery may help you live a pain-free life with improved mobility and an overall better quality of life. 

However, the knee replacement surgery itself will not immediately solve these problems. What you do during the recovery process will greatly influence the outcome from the procedure. 

Here are the top 5 common mistakes people make in the initial recovery phase after knee replacements. Avoiding these mistakes and following simple recovery tips can help prevent knee replacement complications and ensure a smooth recovery.

Avoiding Physical Therapy

Your first instinct after knee replacement surgery may be to avoid all movement due to the postoperative pain you’re experiencing. However, avoiding rehabilitation exercises can actually make the pain worse and have a negative effect on the recovery process. 

Physical therapy is a key aspect of successful recovery from knee replacement surgery. It is necessary to strengthen the muscles surrounding the knee joint to prevent future injury. Physical therapy also prevents the formation of scar tissue that can affect joint mobility in the future. Additionally, physical therapy helps to: 

• Relieve pain

• Reduce swelling

• Improve range of motion and flexibility

• Increase blood circulation and promote healing

• Enhance stability to prevent falls

Your physical therapist will give you a tailored exercise program to get you back to full fitness. They will work alongside an occupational therapist to teach you the best ways to get in and out of bed, use the toilet, dress yourself, and move around without discomfort in the early stages of recovery. During your physical therapy sessions, they will have you walk in the hallways and climb a few stairs so that you are mobile with assistive devices upon discharge home.

It’s important to do the physical therapy exercises recommended by your knee surgeon and physical therapist. This may include exercising for 20-30 minutes, up to 2-3 times a day, including walking and specific knee exercises. Doing these prescribed exercises during the rehabilitation process is vital to getting back to an independent life.

Overexerting the Knee

While it is important to start moving soon after your knee replacement surgery to prevent joint stiffness, doing too much too soon can delay the healing process. 

It can be tempting to get things done during a pain-free period (when prescribed medications for pain relief have kicked in). But, not following orders from your orthopedic surgeon to avoid certain activities in the early stages can put undue stress on the joint. This can result in worsening knee pain, reduced knee function, and knee injuries.

Wait for your surgeon to give you the green signal to go back to work, start driving again, lift heavy objects, and get back to your fitness regimen, especially lifting heavy weights. This will ensure a full and speedy recovery without setbacks.

Skipping Medication

Your healthcare team will prescribe medications for pain relief in the recovery period after knee replacement surgery. These will include over-the-counter pain relievers such as acetaminophen (Tylenol) as well as prescription medicine for short-term relief of severe, breakthrough pain. They will also teach you other drug-free pain management techniques, such as using an ice pack on the knee joint. 

In addition to pain medication, your doctor may also prescribe medications such as anti-nausea medicine or medications to treat constipation, depending on your post-op symptoms. Most patients follow these recommendations to get pain relief and symptom relief.

But it can be easy to forget to take some of the other prescribed medication during the recovery journey, and this can put your health at risk. For example, it’s important to take the following medications prescribed by your healthcare team:

• Antibiotics for infection prevention. A joint infection after knee replacement surgery can cause serious complications, including the need for multiple additional surgical procedures.

• Anticoagulant medications to lower the risk of blood clots after surgery such as aspirin, warfarin (Coumadin), enoxaparin (Lovenox), rivaroxaban (Xarelto), apixaban (Eliquis), and others. Failure to take these medicines as prescribed during post-operative care can increase your risk of deep vein thrombosis (DVT or blood clots in the legs), pulmonary embolism (a blood clot in the lung), and stroke (a blood clot in the brain). It is important to take your blood thinner precisely as prescribed to prevent the risk of blood clots, which can lead to stroke, heart attack, and even death. Knowing the signs and symptoms of blood clots can help you seek medical help promptly. It is equally vital to know that anticoagulants can increase the bleeding risk. 

Neglecting Proper Wound Care

It is important to follow the wound care instructions given by your orthopedic surgeon after knee replacement surgery to avoid infection and delayed wound healing. You will get detailed instructions from your knee doctor, but some general guidelines are as follows:

• Keep your incisions clean and dry. Change the dressing on the wound only if your orthopedic surgeon has told you to do so.

• Wash your hands with soap and water before touching the dressing. Do not pull on the dressing too much. You may need to soak it with sterile water to loosen it. 

• Wipe the incisions in one direction with a clean gauze soaked in saline. Do not wipe back and forth.

• Dry the incisions with a clean, dry gauze before replacing the dressing, as directed by your surgeon.

• Keep your follow-up appointment to have the sutures (stitches) taken out. This is typically done 10-14 days after knee replacement surgery.

• Follow your doctor’s orders on when you can shower. Do not soak in a bathtub or go swimming until your doctor says it is okay to do so.

Not Preparing Your Home

You will need to make certain adjustments to your home for the initial recovery phase. These changes will help you manage daily activities safely. Not doing so can result in falls and injuries, including knee injuries that can cause potential complications or delay the healing process. Here are some recovery tips to prepare your home:

• Your bed should not be too high. Your feet should touch the ground when you’re sitting on the edge of your bed.

• There shouldn’t be any tripping hazards in your home, such as loose wires and cords, throw rugs, uneven flooring, or even small pets. Make sure you remove these to prevent falls. Ensure good lighting throughout your home, including the hallways.

• Install handrails and grab bars near your toilet and shower, and use a slip-proof mat to make your bathroom safe for you post-surgery. 

• Avoid carrying objects while walking. You need your hands free to grab something for support or balance. Attach a basket or pocket to your walker or crutches if you need to carry things.

• Keep things within easy reach. Have a chair available in the kitchen and bathroom so you can sit while you do daily tasks.

• Have a family member help you with tasks such as using the toilet, bathing, cooking, shopping, and going to doctors’ appointments in the early stages. If you don’t have a caregiver at home, talk to your healthcare provider about having a trained professional come in for a few hours every day. 

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What is Knee Replacement Surgery?

Overview of the Procedure

Knee replacement surgery, also called a total knee replacement or total knee arthroplasty, is a surgical procedure that is done to relieve pain and restore mobility in the knee joint. It is offered to people with severe knee osteoarthritis who have not responded to conservative (non-surgical) treatments. During the surgery, an orthopedic surgeon removes damaged cartilage from the surfaces of the knee bones, places artificial metal implants to recreate the knee joint, and inserts spacers to create a smooth, gliding surface in the joint.

Learn more: Is Osteoarthritis Genetic?

Expected Recovery Time

Recovery from knee replacement is a gradual process. Each person may recover at a different speed, but a general recovery timeline is as follows:

• One day post-surgery: Getting out of bed and walking short distances with assistive devices such as a walker or crutch are highly encouraged.

• 2-3 days post-surgery: It is recommended to try simple tasks such as climbing a short flight of stairs with assistance and showering. 

• 3-6 weeks post-surgery: You should be able to start walking without walking aids and driving

• 12-24 weeks post-surgery: All regular activities are likely to resume.

Read next: How to Prepare For Knee Arthroscopy Surgery

Home Care Tips for Knee Replacement Recovery

Proper Rest 

Movement is important for regaining mobility after knee replacement surgery. But adequate rest is equally important. For the first few months, make sure you do the prescribed rehabilitation exercises, but also get appropriate rest. Your need for pain medication should decrease over time. Use non-drug methods such as icing and elevation to reduce pain. Stop any activity if your pain suddenly flares. Call your doctor if you have increased pain in your new joint after a pain-free period. 

Sleeping Position

Sleeping on your back is the best sleeping position after knee replacement surgery as it provides support for your knees. You can place a pillow or cushion under your knees to elevate them slightly.

Diet and Hydration

A healthy diet and adequate hydration can help your body heal from the surgery and ensure a smooth recovery. 

Common Questions and Concerns After Knee Replacement

What Is The Biggest Complaint After Knee Replacement Surgery?

One of the biggest complaints after recovery from knee replacement surgery is residual joint stiffness or limited range of motion. Doing the prescribed physical therapy exercises diligently in the postoperative period can prevent this complaint and ensure a successful recovery.

What Can You Never Do After A Knee Replacement?

After knee replacement surgery, you should never do high-risk activities such as contact sports, downhill skiing, or sports that involve pulling, jerking, or twisting the knee joint. Other than this, there are no long-term or permanent restrictions after a full recovery from knee replacement surgery. Low-impact activities like swimming, tennis, golfing, hiking, and gardening are permitted. Running is a high-impact activity, and while it is permitted, it may wear out the new joint faster.

What Are Red Flags After Knee Surgery?

Red flags after knee surgery are signs of surgical site infection, such as sudden pain after a pain-free period, increased pain, swelling, or redness in the wound, or foul-smelling drainage from the wound. Call your knee surgeon immediately if you develop these signs and symptoms post-surgery. (Mild swelling and slight redness or bruising around the wound can last several weeks and is normal).

What Are The Hardest Days After Knee Replacement?

The first two to three weeks post-op are the hardest days after knee replacement. However, knee pain after a knee replacement surgery is typically no worse than your worst days before knee surgery. Pain medications and other pain management techniques (icing, elevation, rest) can provide relief from postoperative pain in your new knee. These measures will allow you to do daily activities as well as the prescribed exercises to restore joint mobility.