Preparing for Knee Replacement Surgery: How to Make Your Recovery Easier

When wear and tear on your knee causes pain and stiffness, knee replacement surgery can help repair the damage. There are several options for knee replacement surgery, and regardless of which option you and your doctor choose, recovery after surgery can go smoothly with thoughtful planning.

“It’s important for me to understand the patient when I meet them in the office: what is their activity level, their job and what do we need to consider specific to their recovery?” said Dr. Michael Gabbard, an IU Health orthopedic surgeon specializing in hip and knee replacement surgery. “Before surgery, all our patients attend a patient education class. We work with you to create an appropriate plan for your recovery before and after knee surgery.”

Before Surgery

You’ll be able to walk immediately after knee replacement or knee revision surgery, but you won’t get around well, and you’ll be using a walker or cane. There are several things to consider in preparing both you and your home.

• Prepare your home. If your house has stairs, it can be helpful to bring frequently used items downstairs and set up bathing and resting areas on the main level. Avoid using step stools by moving kitchen items to waist level, stock up on pre-prepared meals and make sure to have firm chairs and good lighting. Fall-proof your home by removing rugs, clearing walkways wide enough for a walker and preventing pets from being underfoot when you’re walking.
• Arrange for help. Plan to have someone available to help you around the house and provide transportation during the first few days to a week after surgery. This is important until you’re comfortable moving around on your own, especially at night.

“If possible, we arrange for patients to have home healthcare for the first couple weeks,” Dr. Gabbard said. “They check in a couple times a week to get them moving, start physical therapy and make sure the patient is safe and doing well.”

Returning Home After Surgery

About half of the patients who have knee replacement surgery return home on the same day of their surgery. You’ll leave the hospital with antibiotics and pain medications.

• Practice proper wound care. Waterproof surgical bandages will stay on your knee for five to seven days. If your surgeon uses staples, those will come out in two weeks. While you can’t submerge the wound, at two weeks you can air it out and gently wash with soap and water. Monitor your incision site and call your doctor if you notice any redness or drainage.
  
• Begin physical therapy. A physical therapist will visit you in the hospital to get you up walking and then visit you at home for the first two weeks. You’ll complete outpatient physical therapy for another four to six weeks.
• Manage your pain. The spinal pain blocks from surgery will wear off the next day, so you will go home with several pain and anti-inflammatory medications. Begin using pain medications routinely for the first few days until you have a sense of your pain levels. As they improve, gradually back off the frequency of your medications.

“Most patients use pain medications for knee replacement for two or three weeks, with the goal to be off of them by six weeks after surgery,” Dr. Gabbard said. “Swelling can be persistent for months after surgery, so we encourage a lot of ice and elevation for six to eight weeks.”

Long-Term Recovery

Once your knee is replaced surgically, you’re encouraged to return to your active life.

“I tell patients that we put in these new knees for them to use them. I want them to get back to doing activities they enjoy,” Dr. Gabbard said. “There are no real long-term limitations after knee replacement surgery. We find that getting patients active and moving around is good for their overall physical and mental health.”

You can expect to use a cane or walker for an average of two to four weeks, and you’ll likely begin driving again a couple weeks post-surgery, once you are off narcotic pain medications. Returning to work depends on the type of work you do. Most patients return to work in about six weeks, but sometimes can be as early as a couple weeks after surgery.

1. Follow up with your doctor. You’ll have follow-up appointments at two weeks and again at six-to-eight weeks after surgery. If recovery is going well, you’ll return at a year. In the long term, you’ll have routine x-rays of the new knee every two to three years to ensure there is no sign of the implants failing.
   
2. Recognize warning signs of implant failure. Any increased or unexplained pain, an infection, fall or broken bone, damaged ligament or stiffness from scar tissue could indicate problems with the knee implant. While the replacement parts do wear out over time, knee replacement implants typically last more than 20 years.

As you recover from surgery, keep in mind that it’s likely going to hurt more before it feels better. Everyone has a unique recovery experience. It takes time, planning and patience to achieve the pain-free and active lifestyle you had in mind when planning your knee replacement surgery.

“When we put in a brand-new knee, it doesn’t feel better overnight. At six weeks after surgery, you’re only about halfway recovered, even though you’re getting back to many regular activities and work. Your knee is still achy and swollen,” Dr. Gabbard said. “It takes a few months for the dust to settle, but the vast majority of patients are satisfied with surgery because they finally have less pain and better function.”