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Preparing For and Recovering From a Knee Replacement: What You Need to Know

Debra Gordon

Last updated: November 22, 2016 3:18 pm

The number of total knee replacements in the United States has more than doubled in the past 15 years among all age groups. Thus, it’s quite possible that at some point you’ll find yourself talking to an orthopedic surgeon about swapping out the old damaged knee for strong new one.

The better educated you are about the surgery and what to expect, the better you’ll do. Here are some other things to do to prepare to ensure a faster, less painful, more complete recovery.

Ask the right questions about the surgery.
Specifically ask about:

  • The type of surgery, the type of implant used, and the risks and benefits
  • How often the surgeon has performed this type of knee replacement with this type of implant
  • If the surgeon consults for or receives fees from the implant manufacturer. There is some evidence that doctors who receive payments from drug or device manufacturers are more likely to prescribe or use those products. A good starting point is Pro Publica’s Dollars for Doctors web site.
  • How you should handle post-operative symptoms, particularly pain
  • Who will handle your discharge and when discharge planning begins
  • Where you will be discharged
  • How much the surgery and post-surgical rehabilitation will cost, including all physician, supply, hospital, and transportation costs.
  • How much mobility you can expect to recover

Ask the right questions about post-operative physical therapy.
The rehabilitation period after your surgery is almost more important than the surgery itself in terms of returning you to full function. However, when 100 patients who underwent knee replacement were surveyed about their rehabilitative experience, more than a third were unhappy. 1 The major reasons included:

  • Therapy sessions that were too short
  • Too many therapists involved
  • Too many patients in each therapy session

So check out any facility or practice your doctor suggests for rehabilitation. You want to know:

  • The length of the average therapy session
  • How much time the therapist will spend with you during the session (versus other providers)
  • How many therapists will treat you
  • If your therapy occurs on a one-to-one basis, or, if not, how large the groups are

Rethink a double knee replacement.
Although it might sound like a good idea to get both knees replaced at once (one hospital visit, one rehabilitation) be careful. Studies find a much higher rate of complications from a double knee replacement. In fact, recent recommendations from a consensus group of orthopedic surgeons urged caution before performing double knee replacements, particularly for people with other medical conditions. If you don’t get both knees replaced at the same time, however, the panel recommended the second surgery at least three months after the first, if not later. 2

Strengthen those leg muscles.
A review of four studies found that the stronger the leg muscles, the less pain patients had after surgery and the more easily they could climb stairs. 3

Go home as soon as possible.
The longer you’re in the hospital, the greater the risk of an infection. In fact, one study that evaluated readmissions of 10,600 patients who underwent a total knee or hip replacement found the longer patients stayed in the hospital—particularly if they were then released to an inpatient rehabilitation facility—the greater their risk of readmission. The most common cause? Joint-related infection. 4

Take your meds.
You should be discharged with prescriptions for antibiotics to prevent infection and blood thinners, to prevent blood clots. Make sure you take both as directed.

Follow this advice and you’re much more likely to have a smoother recovery. And good luck with the new knee!

  1. Johnson AJ, Issa K, Naziri Q, et al. Patient Dissatisfaction with Rehabilitation Following Primary Total Knee Arthroplasty. The journal of knee surgery. 2013 

  2. Memtsoudis SG, Hargett M, Russell LA, et al. Consensus statement from the consensus conference on bilateral total knee arthroplasty group. Clinical orthopaedics and related research. 2013;471(8):2649-2657. 

  3. Witchelo T, McClelland JA, Webster KE. Factors associated with stair climbing ability in patients with knee osteoarthritis and knee arthroplasty: a systematic review. Disability and rehabilitation. 2013 

  4. Zmistowski B, Restrepo C, Hess J, et al. Unplanned readmission after total joint arthroplasty: rates, reasons, and risk factors. The Journal of bone and joint surgery American volume. 2013;95(20):1869-1876.