20 Feb Life after knee replacement surgery
Total knee arthroplasty (TKA) has revolutionised the care of patients with end-stage knee arthritis. Patient satisfaction is the most important outcome measure. Despite substantial advancements in primary knee replacement surgery, numerous studies suggest only 82% to 89% of primary TKA patients are satisfied. It would be wise for orthopaedic surgeon and patients to discuss expectations before TKA surgery to assure that these are realistic. Finally, studies confirm the effect of a complication requiring hospital admission as an important factor in patient dissatisfaction.
The successful TKR surgery depends upon: Patient factors: age, bone quality, level of activity before surgery and motivation. surgeon factors: His training and experience Implant factors: Type of implant used and most important alignment rehabilitation after surgery.
How many people are highly satisﬁed after TKR surgery?
Different studies have shown 85 percent of people are quite happy after the surgery. One in ﬁve patients still complain of pain.
Why some patients are not as satisﬁed as others?
The patient satisfaction depends upon their expectations before surgery. Inability to meet their expectations after surgery or any post-operative complication requiring admission.
How long will it take to walk independently?
Generally speaking patients who have had one knee replacement surgery are able to walk without any aid by 4 weeks and those with both knee replacement take 6-8 weeks’ time.
Can I sit cross-legged or squat after surgery?
Ability to sit depends upon quality of bone which can be normal or weak. You also need a sound hips and spine for such activities. Most important your ability to sit or squat before the surgery. Some studies have suggested that those who have knee cap replaced ﬁnd it easier to squat. Having said that researchers have shown that it does load your knee implant and causes high wear rates.
When can I drive ?
Your ability to drive depends upon how enough bending to operate on pedals and the Brake response time. It is easier to drive automatic compared to manual cars. Patient’s should not be on any medications that can cause drowsiness. On an average people drive by 6 – 8 weeks.
How will I know am I safe to drive?
The time taken to apply the break and vehicle to stop completely is called the brake response time. Those who ask this speciﬁc question before surgery we measure the BRT before surgery and then 3, 6 and 8 weeks after surgery. The BRT should be either equal or less than pre-operative time.
How will I know healing after Total joint replacement is complete or not?
Everyone heals at a different pace. Hence please don’t compare yourself. Absence of warmth on touching your knees, swelling and pain can predict that healing is nearly complete.
When can I travel long distances and ﬂy?
Recommendation are to avoid travelling for ﬁrst three months but there are conﬂicting reports in the literature. If you decide to travel it is advised to drink plenty old water , avoid alcoholic beverages, use compression stockings and consult your doctor if you need a medication to prevent clots in legs .
When is it safe to engage in sexual activity?
Knee replacement surgery is not only restricted to elderly age group. It generally takes 4-6 weeks after surgery to be comfortable and pain free for sexual activity.
What all sports activities are recommended after TKR?
It is advised to engage in low impact sports such as doubles Tennis and doubles badminton since doubles game require less movement. Other exercises like swimming and hiking are also recommended. 73% patient who had knee replacement surgery are able to continue low impact sports compared to only 43% of patients who could participate in intermediate sports like badminton and tennis. The contact sports like foot ball and jogging are generally not recommended.
How long should I avoid major dental procedure?
It is recommended to avoid major dental procure for at least three months following surgery to avoid infection in your knee.
How can I prevent infection in my knee replacement?
A common cause of infection following total knee replacement surgery is from bacteria that enter the bloodstream during dental procedures, urinary tract infections, or skin infections. These bacteria can lodge around your knee replacement and cause an infection. After knee replacement, patients with certain risk factors may need to take antibiotics prior to dental work, including dental cleanings, or before any surgical procedure that could allow bacteria to enter the bloodstream.
How can I prevent falls after TKR?
The risk of fall is higher in the ﬁrst few weeks after the surgery. This can damage your new knee and may result in a need for further surgery. Stairs are a particular hazard until your knee is strong and mobile. You should use walking aid and have someone to help you until you have improved your balance, ﬂexibility, and strength.
How can I protect my knee replacement surgery?
- Participate in regular light exercise programs to maintain proper strength and mobility of your new knee.
- Take special precautions to avoid falls and injuries. If you break a bone in your leg, you may require more surgery.
- Make sure your dentist knows that you have a knee replacement.
- Talk with your orthopaedic surgeon about whether you need to take antibiotics prior to dental procedures.
- Routine follow-up examination and x-rays, usually once a year.
Director and Head,
Department of Orthopaedics, W Pratiksha Hospital
FRCS (UK), MRCS (UK), DNB, D.Ortho
Specialist in revision lower limb arthroplasty, complex hip, knee and sports injuries