Overview of Knee Replacement Surgery and Recovery for Seniors
Many older women and men have knee replacement surgery to enhance their mobility and improve their overall quality of life. If you are a senior considering the possibility of knee replacement surgery, you may be interested in obtaining more information both about the surgery itself but also the recovery process that follows. This article is presented to provide you with a basic overview of knee replacement surgery and recovery. Your doctor can provide you with more information about what to expect regarding a knee replacement.
What Is a Knee Replacement?
Knee replacement surgery is designed to relieve pain and restore function in severely diseased knee joints. The procedure is also known as knee arthroplasty. The knee replacement procedure involves removing damaged bone and cartilage from a patient’s thighbone, shinbone, and kneecap. The material removed is then replaced with an artificial joint or prosthesis. The artificial joint comprises metal alloys, high-grade plastics, and polymers.
An orthopedic surgeon assesses your knee’s range of motion, stability, and strength in determining whether a knee replacement is right for you. X-rays help determine the extent of damage, according to the Mayo Clinic. A doctor can choose from a variety of knee replacement prostheses and surgical techniques, considering a patient’s:
- Age
- Weight
- Activity level
- Knee size and shape
- Overall health
Most Common Risks Associated With Knee Replacement Surgery
As with any surgical procedure, there are some risks associated with a knee replacement. Knee replacement surgery is a relatively easy procedure for most individuals, and complications are not particularly common. According to the Mayo Clinic, the most common risks of knee replacement are:
- Infection
- Blood clots in the leg vein or lungs
- Heart attack
- Stroke
- Nerve damage
Pre-Op Period
Several things will need to be done before the leading up to a knee replacement surgery.
For example, if you are scheduled for knee replacement, you can use the time before surgery to prepare for your return home for recovery. The steps that you will want to take to prepare for your return home during the recovery period include:
- Reduce the fall risk: You must prevent a fall, which will complicate your recovery if you climb stairs to reach your bedroom or living space, set up a comfortable sleeping and living space on the ground floor. If you have to use stairs, clear the stairway, and ensure the rails are securely fixed. Clear tripping hazards from areas in the home you will use during recovery. These include appliance cords, loose rugs, and even bulky furniture pieces.
- Give yourself a raise: Add a raised toilet seat and grab bars to your shower. You might also want to consider getting a shower chair so you won’t have to stand the whole time. Use a stable living room and dining room chair with a firm seat and raised arms for support.
- Cool it: Your knee will be swollen and tender after surgery. Ensure you already have an ice pack (or a bag of frozen peas) in your freezer. You’ll also need a comfortable place to rest and elevate your leg.
Knee Replacement Surgical Procedure
Knee replacement surgery typically lasts between one to two hours. You will receive either general anesthesia or epidural anesthesia. An epidural anesthesia blocks pain below your waist.
An incision is made over your kneecap. The damaged portions of cartilage and bone are removed. The surgeon will then insert and attach a new artificial joint. When that is completed, the incision is closed, and you will be taken into recovery.
Immediately Following Knee Replacement Surgery
When you’re out of surgery, you’ll receive medication, which may include pain medication and antibiotics to prevent infection. You may also receive blood thinners to prevent clots. You may take these by mouth or via an IV, which will also provide fluids. Most post-op patients wear compression stockings to improve circulation. Sometimes, a patient uses a urinary catheter for some time following an accident. This typically is about a week.
Knee Replacement Recovery Process
In some cases, knee replacement is done on an outpatient basis. In others, an individual will spend some time in the hospital.
Day One
You’ll be encouraged to move immediately to get your strength back. Initially, you will walk with an assistive device such as a walker or crutches. Your physical therapist will teach you exercises to regain knee mobility and encourage blood flow.
Day Two
You may be switched to oral pain medication. By day 2, you can probably eat regular food. Your physical therapist will teach you how to watch for signs of infection, clots, or chest congestion. You should be able to get to the bathroom with a little help.
Day Three
Your doctor will confirm if the incision is healed enough for you to take a shower. Once that is confirmed, you can shower with the dressing on. When you finish bathing, remove the dressing, gently pat the area dry, and apply a new dressing. Don’t use any creams or lotions on the area other than what your doctor prescribes. Your stitches or staples should be healed and removed in about two weeks.
Day Four
If you are an inpatient, you may be ready to return home if you can get in and out of bed or a chair without help and use the bathroom unassisted. You may still be using a walker or crutches. Some seniors do spend time in a rehabilitation center following knee replacement surgery.
Day Five Through Week Three
Some seniors are in a rehabilitation center during part of this period. Age, overall physical health, rate of recovery from surgery, and rehabilitation progress all come into play regarding how long a senior may be in a rehab center. If a senior is discharged to home, outpatient physical rehabilitation commences during this period.
Week Four Through Week Six
Your stitches or staples should be out by now. You should be able to fully immerse your leg in the tub or a pool. You should be feeling more like yourself again. If you have not made the change, ask your doctor if you can switch to over-the-counter painkillers such as acetaminophen or ibuprofen.
There should be a significant improvement in the weight your knee can support. You should also be able to bend your knee more easily. If healing progresses, your physical therapy exercises will become more challenging. You may now also be practicing walking without support. You may still need some help with driving and grocery shopping. Ask your doctor or therapist if it’s acceptable to resume activities like swimming, gardening, or cycling. High-impact activities like jogging or tennis are still out for now.
Week Seven Through Week Twelve
Once you cross beyond the seven-week mark, you can do a wider range of low-impact exercises. Your physical therapist, surgeon, or primary care physician (or all three) will likely encourage you. Examples of these types of exercises include:
- Cycling on a stationary bike
- Toe and heel raise
- Mini squats
- Leg balances
- Step-ups
Physical therapy continues during this period to improve your overall strength and endurance.
Knee Replacement Surgery Follow-up Care
Finally, during the 12 months following your knee replacement surgery, your doctor will schedule regular follow-up appointments to see how you are progressing. At the one-year mark, if all is well, you probably won’t see your doctor again till next year. It’s good to know that over 90 percent of knee replacements still function appropriately 15 years after surgery.