5 Questions About Knee Replacements, Answered by a Physical Therapist
The thought of a knee replacement can be intimidating. It is a serious surgery with 3-6 months of recovery time. Recovery time can vary depending on your status going into surgery and what your goals are after surgery. Despite difficulties, a knee replacement surgery can provide a new lease on life for an individual who has been limited by their knee.
Any major decision warrants a lot of questions. This article aims to answer a few frequently asked questions surrounding the knee replacement process. If you want answers that are specific to your case, a thorough examination by a physical therapist will identify all of the factors contributing to your knee pain, as well as what our treatment options are.
1. What is a knee replacement and who needs one?
A knee replacement is a surgery that aims to remove the damaged or degenerative joint surfaces on the bottom side of the femur and top part of the tibia and replace them with a metal and silicone implant. In some cases, the underside of the knee cap will be replaced as well. The goal of the surgery is to reduce pain that was caused by the joint, enhance range of motion, and increase tolerance to activity and exercise to improve functional status.
A common misconception is that all individuals with knee arthritis will need a knee replacement. The truth is that MOST patients will be able to improve, if not eliminate, their pain with a combination of physical therapy, exercise, and sometimes dietary changes.
Speaking with a surgeon about a knee replacement may be appropriate for you if:
Physical therapy has not helped
The pain does not allow you perform physical therapy
Your range of motion is severely limited due to the joint changes
2. Do I need Prehab?
Prehabilitation, or prehab, is beginning rehabilitation prior to your surgery. Improving your strength before surgery is the best way to improve how you feel and how quickly you progress after surgery. Some of this benefit is due to actually improving your strength, but an overlooked benefit is the education you receive from your physical therapist on what to expect, as well as learning some of the exercises and treatments you will be doing after surgery. You will not be forced to do prehab, but it is in your best interest if you are looking for an optimized surgery.
3. What will my recovery and rehab look like right after surgery?
Modern knee replacements have significantly improved over their ancestors of just a few years ago. Robotic surgery techniques are even used that often make the early recovery easier. In many cases, patients experience moderate to high pain levels immediately after surgery. Every case is different and some patients report minimal pain, but this is less common.
Swelling is normal, but this needs to be managed. Increased swelling will cause increased pain, decreased range of motion, and even limit the strength of the muscles around the knee. As such, it is important to ice and elevate your knee, as well as make sure to rest and not over-do activity to avoid significant increases in swelling.
Early rehab and physical therapy will be focused on:
Reducing swelling—the most important key to success early in the process
Restoring full straightening of your knee—this is needed for walking and standing
Improving quad strength to reduce buckling and reduce strain on the knee joint
Work on functions such as walking properly and using stairs.
4. Can I get back to the activities that I love?
Yes, but there are some caveats. The biggest predictor in getting back to an activity after a knee replacement is your ability to do that activity prior to the knee replacement. If you did not play basketball prior to the surgery, it is unlikely that you will become a basketball player. Much of your functional ability after a knee replacement does not depend on the replacement itself, but how well your muscles and the rest of your body can perform a task.
Quad strength is the biggest predictor in how well you will function after a knee replacement. This will be crucial, especially if you have any intention of returning to an impact-based activity that includes running, jumping, changing direction, or similar motions.
5. Are there ways to avoid a knee replacement?
Yes! A study found that 70% of patients who worked on strengthening at least two times per week were able to avoid a knee replacement. It may be best to initiate this process under the supervision of a physical therapist in order to get on the right track. Continuing this program may be the key to avoiding surgery.
There are some other options to avoiding knee surgery such as injections or considering weight loss and diet change to reduce your symptoms. These other options are much more effective when done with physical therapy and strength training.
Wondering what to do next about your knee?
If you are unsure of the path that is best for you, or you would like a physical therapist’s recommendation, request an appointment now or call our office at 908-598-9009.