Scientific American Health Alerts Guide to Knee Replacement

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After Knee Replacement Surgery: Rehab and Recovery

Successful knee replacement requires a considerable investment of time and energy in rehabilitation following the surgery. Rehabilitation begins in the hospital, usually the day after surgery. During this period, a strict timetable of exercise, rest, and medication is crucial to the success of the sur­gery. You may feel considerable pain immediately after the surgery (from muscles disturbed during the operation, rather than from the joint itself), and that can make rehabilitation difficult at first.

Recovery from knee replacement surgery requires a series of sessions with a physical therapist. Physical therapy exercises focus on building strength and regaining flexibility. The physical therapist may also use techniques such as massage and application of cold to minimize swelling, which interferes with flexibility. In addition, every patient receives a regimen of exercises to perform at home. Use of continuous passive motion therapy using a machine for rehabilitation has not been shown to increase motion or to accelerate recovery.

With rehabilitation, recovery from a knee replacement is usually 80% complete within four weeks. Full recovery usually takes a year, sometimes even longer.

You can increase your chances of having a successful recovery by keeping excess weight off. After surgery, overall complication rates are more than double in obese people. Some studies show that obese people are more likely than individuals of a normal body weight to develop infections after surgery. Experts attribute the increased risk to the difficulty of keeping adjacent skinfolds clean as well as other common problems in obese people, such as diabetes and poor blood circulation that predispose them to infection. Blood clots and pneumonia also occur more often after knee replacement surgery in obese people than in individuals at a near-normal body weight. Because of all of these risks, some surgeons refuse to operate on obese patients unless they lose weight before the operation.

Postsurgical rehabilitation is yet another challenge for obese people facing knee replacement surgery. After the operation, it is important to get the affected joint moving again, and the larger the joint and limb, the harder this will be.

Because joint replacement is rarely an emergency procedure, you will have time to lose weight before undergoing surgery. According to surgeons who do these procedures, every bit of weight loss helps, reducing the risk of complications and making a prompt recovery more likely.

More on Knee Replacement Surgery

What Happens During Knee Replacement

Joint replacement is called arthroplasty, and the most common type of arthroplasty is total joint replacement. In this procedure, the entire diseased or damaged knee joint is removed and replaced with an artificial one (a prosthesis) to relieve pain and restore function.

Weighing the Pros and Cons of Knee Replacement Surgery

Knee replacement surgery is not a quick fix, and it is not without risks. Serious complications, such as blood clots and infections, can occur—but precautions can be taken to prevent or control them. In addition, the road to recovery can be difficult and time consuming, particularly with joint replacement surgery.

Is Age an Obstacle to Knee Replacement Surgery?

Some people may worry that they are too old too benefit from having a total knee replacement. But even osteoarthritis patients 75 and older appear to benefit greatly from joint replacement surgery, as a study in the Archives of Internal Medicine has indicated. Researchers followed 174 elderly patients with severe knee or hip osteoarthritis—average age 75—for 12 months, assessing them at six weeks, six months, and one year.

Minimally Invasive Knee Replacement Surgery

Surgeons continually seek ways to make joint replacements and repairs easier, safer and less arduous for the patient. A number of new techniques are currently under development.

Female Knee Replacements

Designed specifically to fit a woman’s knee, female knee replacements have been available only in recent years. Prior to 2006, when the Gender Solutions knee was approved by the U.S. Food and Drug Administration (FDA), knee replacements were unisex—designed to fit both men and women.

Resuming Physical Activities After Your Knee Replacement

If you are facing a knee replacement or have had one, you should talk to your physician about the risks of physical activity, such as a loosening or dislocation of the replacement and the possible need for a repeat surgery. Chances are, though, that a knee replacement won’t halt your golf game or drive you from the bowling lanes.


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