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Knee Bone or Joint Injury

Top 5 Mistakes After Knee Replacement

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Posted 1 month ago

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Last updated: 29/11/2022

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by James McCormack

Knee arthroplasty, commonly referred to as knee replacement is a very common and successful surgery for people suffering from severe arthritis and pain in the knee. The procedure can replace the whole knee, a total knee replacement (TKR), or just one of the two compartments of the knee, a partial knee replacement (PKR). Recovery from a PKR will be faster and less painful, for the most part, than recovery from a TKR, but both are major surgeries and should not be underestimated.

You can read more about knee arthritis, a common cause of knee replacement, in our related article: Knee Arthritis.

1. No Being Prepared For Limitations After Surgery

After this major surgery, there will be significant pain and functional restriction for a significant period of time. Certainly weeks, and more often months following the surgery. You will not be able to drive for at least 6 weeks after surgery and you will not be able to climb stairs initially. It is imperative to have a plan for how you will manage during this period. This includes simple practicalities such as:

  • Will you need additional help if you live alone?
  • Do you have stairs at home? Can you move your bed downstairs?
  • How will you prepare and cook meals?
  • Do you need to get equipment to help you wash, like a stool for the shower?
  • How will you get to your follow-up appointments and physical therapy?

2. Not Taking Pain Medication Regularly

Medication is essential after surgery, it will help to manage the inflammation that is caused by the major surgery and to keep pain to a tolerable level to help you recover. If your knee pain is too high you won’t be able to sleep well, which will slow down your recovery. Also, if your pain is too high you won’t be able to complete the essential mobility and other physical therapy for your recovery. A common mistake that is made is not taking the medication regularly, and only taking it when the pain starts to get worse. This can be ok for some people but the risk is that the pain will get too high and take a period of time to reduce, which can be several days. It takes a lot longer for medication to take effect once the pain has increased to a high level, but works best to keep pain down. If there is a repeated cycle of no medication, followed by high pain, meaning no rehabilitation for several days while pain is gradually reduced by retaking the medication, you will overall take longer to improve.

3. Doing Too Little Movement or Rehabilitation

As mentioned above pain is a significant obstacle to rehabilitation and it can be a deterrent to movement. However, most people find that there is an improvement in pain with movement, up to a point. So while the first few bends of the knee or the first few steps of walking might be very painful, it is common for this to significantly reduce with further repetitions. Frequency of movement is essential, especially in the early stages of your recovery. You must do your physical therapy exercises and walk regularly throughout the day for the best results. This means that the right amount and the correct level of exercise must be found so that you can do them several times per day, little and often.

You can read more about rehabilitation for knee arthritis in our related article: Arthritis Knee Exercises.

4. Doing Too Much Activity Too Soon

Doing too much too soon can be a pitfall, especially with very fit individuals who are very motivated to return to all their activities. There is a fine balance to be found with recovery from knee replacement surgery. You need to push through some pain but not too much and not for too long.

If you overdo it you may be unable to repeat your exercises for that day or the next few days as your knee might be too painful or swollen. We call this boom-bust. When you do too much when you feel good, then being laid up because you have overdone it. A good rule to follow is that pain and swelling after exercise should settle quickly, within an hour or two, so that you are able to repeat it several times per day. To aid recovery you can use ice packs, medication (as we mentioned above) and good sleep, rest and nutrition.

5.  Not Doing Pre-Surgery Rehabilitation (Prehab)

Benjamin Franklin once said, “By failing to prepare, you are preparing to fail”. Before going for major surgery you need to prepare your body. There are two main reasons for prehab. Firstly, you can get your muscles stronger before so that you will be able to cope with the surgery better. After surgery, there is always a period of significantly less activity, during which time muscle bulk and strength will always be lost. Therefore, the more you have before surgery the better. The second main reason for doing prehab exercises is that they will be similar to post-surgery rehabilitation. You can therefore teach your body how to do these movements so that they are familiar to you. After surgery, your body will feel different and it takes time to regain your full control, having a good memory of how exercises should be done, and how they should feel will speed up this process.

Physiotherapy with James McCormack

This is not medical advice. We recommend a consultation with a medical professional such as James McCormack. He offers Online Physiotherapy Appointments for £45.

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