Total Knee Replacement: Your Journey from Preparation to Full Recovery
The week before your total knee replacement surgery is crucial for preparation. You'll need to stop certain medications, particularly blood thinners, as directed by your surgeon. This is to reduce the risk of excessive bleeding during surgery. You may also be advised to stop taking supplements and to inform your doctor of all medications you're currently taking. It's important to prepare your home for your return, setting up a recovery area and removing tripping hazards. Some patients attend a pre-operative class to learn about the procedure and what to expect during recovery.
The night before surgery, you'll need to follow strict instructions to become NPO (nil per os, or nothing by mouth). This typically means no food or drink after midnight, including water. This precaution is necessary to prevent complications during anesthesia. You should also shower with an antibacterial soap as instructed by your surgical team to reduce the risk of infection. Get a good night's sleep, as rest is important for your body's preparation for surgery.
On the morning of surgery, you'll arrive at the hospital for your preoperative assessment. This includes a final check of your vital signs, confirmation of your medical history, and a review of the procedure. You'll meet with your anesthesiologist to discuss the type of anesthesia you'll receive. The surgical site will be marked and you'll be prepared for the operating room. It's normal to feel nervous, but remember that your surgical team is there to support you through every step.
Immediately after surgery, you'll be taken to a recovery room where nurses will monitor your vital signs as you wake up from anesthesia. You may experience some pain and grogginess, which is normal. Pain management will begin right away to keep you comfortable. Once you're stable, you'll be moved to your hospital room. Physical therapy often begins the same day as surgery, with simple exercises and possibly assisted standing or walking.
Weight bearing restrictions after total knee replacement are typically weight bearing as tolerated. Most surgeons encourage patients to put as much weight on the new knee as is comfortable, using a walker or crutches for support. This early weight bearing helps prevent muscle atrophy and promotes healing. However, always follow your surgeon's specific instructions, as they may vary based on your individual case and the surgical technique used.
The first week after surgery is focused on pain management, preventing complications, and beginning your rehabilitation. You'll work with physical therapists daily to start exercises that improve your range of motion and strength. Nurses will monitor your incision and teach you how to care for it at home. You'll likely be discharged from the hospital or surgicenter that same day, depending on your progress. At home, continue your prescribed exercises, manage pain with medication as directed, and watch for any signs of infection or complications.
Your first postoperative appointment usually occurs around 2 weeks after surgery. During this visit, your surgeon will check your incision, remove any stitches, assess your range of motion, and review your progress with physical therapy. They may adjust your pain management plan and provide guidance on increasing your activity level. This is also an opportunity to ask any questions you have about your recovery process.
Moderate activity recovery typically begins around 4-8 weeks after surgery. By this time, many patients can walk without assistive devices and drive ( 4 weeks for left, 8 weeks for right) if cleared by their surgeon. You may be able to return to light work duties, depending on your job requirements. Continue with your physical therapy exercises, which will become more challenging to build strength and improve flexibility. Listen to your body and don't push too hard too fast.
Full recovery from total knee replacement can take 6-12 months, depending on various factors including your age, overall health, and commitment to rehabilitation. Most patients see significant improvement in pain and function by 3 months post-surgery. By 9 months, many can return to most of their normal activities, including low-impact sports. However, it's important to note that healing and strengthening can continue for up to a year or more. Your new knee may feel different from your natural knee, but most patients report high satisfaction with their improved mobility and reduced pain.