Total Knee Replacement (TKR)
Rehabilitation - Recovery
How long does it take to recover after TKR?
Most patients undergoing total knee replacement surgery want to know when they’ll be able to return to their normal life. Questions about “recovery time” are common. There are many factors that can affect recovery time, but typically patients can return to normal life activities within 3 to 6 months, but it can take up to 12 months to achieve in some patients.
Short Term Recovery
Short-term recovery involves the early stages of recovery, such as the ability to get out of the hospital bed and be discharged from the hospital. On days 1 or 2, most total knee replacement patients are given a walker to stabilize them. By the third day after the surgery, most patients can go home. Short-term recovery also involves getting off major pain killers and having a full night’s sleep without pills. Once a patient no longer needs walking aids and can walk around the house without pain–in addition to being able to walk two blocks around the house without pain or resting–all of these are considered signs of short-term recovery. The average short-term recovery time for a total knee replacement is about 12 weeks.
Long-Term Recovery
Long-term recovery involves the complete healing of your surgical wound and internal soft tissues. When you are ready to return to work and the activities of daily living, you are on the way to achieving full term recovery. Another indicator is when the your finally feels normal again. The average long-term recovery for total knee replacement patients is between 3 and 6 months.
There are a number of contributing factors that influence recovery time. A motivated well informed patient is the best start. A positive attitude is everything. Patients should be prepared for diligent work, some pain and an expectation that the future is going to be bright. Having access to information about knee replacement surgery and a strong support network is also important to recovery. Make sure you have some close family or friends able to assist and help you once you are home. Having someone help you do the groceries, cook or clean for a short period of time is really helpful whilst you continue to recover when you go home.
Day 1 to Week 3
What to expect
You will have a large bulky dressing on your leg when you awake after your surgery. This will be removed approximately 72 hours (3 days) after your surgery by the nursing staff. You will be required to wear elastic stockings (TEDS) for six weeks following your surgery.
It is recommended that you apply ice to your knee to help reduce pain and swelling, up to 30 minutes out of every 2 hours. It is normal to have knee swelling and bruising following the surgery. It will often increase as your activity level increases.
Change knee position at least once an hour, while awake, to avoid stiffness Walker or crutches should be used until discontinued by surgeon or physiotherapy. If your knee swells, rest and elevate it. Apply ice. It should settle over time. If you are concerned, contact Dr Damasena in his rooms on 90819305. You will not be allowed to swim, either in a pool or the surf, until these wounds are completely healed (approximately 10 to 14 days)
Start the following exercises
1. Heel Slides. Lying on your back. Slide your heel up towards your buttock. Only move as far as you can without any pain. REPEAT 10 times
2. Knee Bend. Standing holding something stable. Lift your LEFT / RIGHT heel towards your bottom. REPEAT 10 times
3. Static Quadriceps. Tighten the muscles at the front of the thigh by straightening the knee. Imagine you are trying to push the back of your knee into the bed. Concentrate on the inner part - just above and inside your kneecap – your VMO muscle. HOLD 15 secs REPEAT 10 time
4. Inner Range of Knee Extension. Place a rolled towel under your knee. Now tighten the front of your thigh again and lift your heel off the ground. Keep the back of your knee on the towel. Try to get your knee as straight as possible. HOLD 15 secs REPEAT 10 times
5. Straight Leg Raise. Tighten the muscle on the front of the thigh and straighten your knee as straight as possible. Now keep it straight as you lift your heel off the ground about 2-3 inches. Return to the bed. You may bend your other knee up to support your back. REPEAT 10 times
Week 3 to Week 12
During this phase you should aim to normalise your gait and achieve a good range of motion. Your knee should be fully straight i.e. 0 degrees and bend to 120 degrees by the end of the week 12. Manage your swelling and scar by using the compression bandage (Tubigrip) and gently massaging it using bio-oil or a vitamin E moisturizer.
Work with your physiotherapist and Start the following exercises.
1. Straight leg raises: with a maximum of 2lbs weight doing flexion, abduction and adduction.
2. Hamstring curls.
3. Heel raises.
4. Standing terminal knee extensions.
5. Standing hip abduction.
6. Standing hip flexion.
7. Bridges.
8. Short arc quad.
9. ¼ lunges.
10. One leg balancing/ balance board.
11. Pool therapy.
Week 12 onwards
Start the following exercises
1. Cardio-vascular- walking, bike, rower, x-trainer, swimming
2. Flexibility- hamstring stretch, calf stretch
3. Squats- as able
4. Single leg balance-
5. Forward step ups- advance in 2 inch increments
6. Forward step downs- advance in 2 inch increments
7. Leg press