Recovering from knee arthroplasty -the physiotherapist’s point of view

Are you going to have a knee arthroplasty? Are you nervous? No worries, it’s normal to be nervous! They’ve done more than 12 000 knee arthroplasty-surgeries per year only in Finland, so the surgeons are very experienced and they know what to do! In this blog post I’ll tell you some important thing about recovering from the surgery as well as the recovering progress.
The knee arthroplasty surgery is usually planned beforehand, so you will arrive to the hospital on a certain day on a certain time. After the surgery you will be transferred to the recovery room and after that to the ward, you’ll be staying at the ward for a few days. The recovery from the surgery begins at the ward and you can affect you recovering progress WILDLY.
Recovery at the ward
Right after the anaesthesia has gone, you can start to flex your ankles, activate the muscles of your tights and glutes and start to flex your knee a bit. With the help of a physiotherapist, you should try to stand up and walk at last 6 hours after the surgery. Walking is usually started with the help of crutches. Usually you are allowed to carry your entire body weight on the operated leg, but the surgeon will have the last word of that.
Here’s a super important fact: YOU WILL HAVE PAIN IN YOUR KNEE. Even with the painkillers, walking will be painfull and it’s just normal! If the pain is unbearable, ask for more painkillers. The fact just is that if you don’t move your knee and skip the walking-practices, your recovering will be delayed.
At the hospital, the physiotherapist will go the mobility exercises of the knee through with you, such as knee flexion and extension, activating and strengthening the thigh muscles and walking with the help of the crutches on the floor and at the stares. I won’t post pictures of those exercises for this post, since you can find very good instructions from the links below (in Finnish though).
https://www.ksshp.fi/fi-FI/Potilaalle/Potilasohjeet/Tekonivelpotilaalle
Okay, how does the recovering proceed at home?
In the beginning the training is just walking at home with the help of crutches, first inside and later on outside as well. Also keep practising the mobility exercises of the knee daily. If you are uncertain about your ability to walk outside, don’t hesitate to ask a friend or a family member to come with you! When walking outside, you should remember to take breaks, since it’s wiser to walk short distances with a good technique, rather than long distance with a bad one. If your walking technique is bad, the risk of falling increases.
If you have an exercise bike at home, you can gently start biking without any resistance/with a very low resistance about 3 weeks after the surgery. Start biking only for a few minutes, add the time of biking gently. The biking will add the oedema and the pain in the beginning, but that’s normal. You can add the resistance of biking 6 weeks after the surgery so that the surgical wound gets to heal.
The strength training with added weights may began only 6 weeks after the surgery!
You shouldn’t forget about the mobility exercises of the knee even when the recovery proceeds, because the extension and flexion of the knee are super important for some many things! I’ve seen so many clients that have given up the knee extension exercises and the knee will remain a bit flexed for good.
For how long will the knee be swollen?
Your knee will probably be swollen for months after the surgery, stress of the knee and sitting for long add it up. The operated knee can be warmer than the other knee and the other parts of the leg even for a year, so don’t worry about it!
Particularly in the initial phase of the recovery the oedema can “stream” to other parts of the leg, for example to the ankle and to the foot, that’s why you should keep moving and flexing your ankles even after the time on the ward. You can reduce the oedema and pain by lifting your leg up and using an ice pad on top of the knee.
How well is it possible to recover from the surgery?
If everything goes as planned, the artificial joint can operate almost as well as a healthy knee joint. Usually people recommend gentle and shock-free exercises for people with an artificial joint so that the joint would work better and longer. That recommendation doesn’t base on evidence though, it’s just a common way to operate. The way you exercise or the sport you do doesn’t affect the artificial joint, so all the sports are allowed.
I’ve seen patients whom quality of life has increased a lot after the surgery. The recovery depends on you though, so it’s important that you PREPARE yourself for the pain and unpleasant feelings. After 10 year of the surgery 95% of the artificial joints are still on place and working, so most of the patients recover well and have gotten so much help from the surgery!