Having knee replacement: how to prepare and questions about PT

Hello @dkapustin, you may notice I actually combined your discussion with an existing discussion titled, "Having knee replacement: how to prepare and questions about PT." I did this so your post, and those who have replied to you, could reanimate a good discussion on how to prepare for an upcoming knee replacement and tips and tricks for when you return home. If you are replying by email, I suggest clicking on VIEW & REPLY so you can read some of the older posts as well.

Hello @dkapustin, I am hoping to have a knee replacement this spring and have been doing PT exercises for the past 4 months daily to keep the leg and knee strength and range of motion as good as I can. Here are some exercises I use daily.

The pool is a great suggestion. I had my knee replaced when I was 19 due to severe internal injuries that caused end-stage arthritis at an early age. My regret, because my recovery was not great, was that I don't think I was diligent enough with my PT. PT hurts and I don't think I was mentally prepared at 19 to push through that. Obviously, you don't push through sharp excruciating pain, but preparing yourself mentally that it will be hard the first few months and knowing you have to push through with your PT will put you on a better path for faster recovery and better range-of-motion. We are all different in how we respond to surgery and how we recover, but we are all similar in that we have to be consistent with our PT.

Thank you very much!

Hi @dkapustin - I had my right knee replaced April 2017 and I'm having my left knee replaced the 29th of this month. I will echo what many of the others said: it's important to do some strength training prior to the surgery. Going into it strong helps.
- In my case, my surgeon kept me in the hospital (Mayo Jax) for 2 nights. In the hospital, I used the walker. I also had to learn to go up and down stairs since we have stairs front & back in my house. Right before I was released, I was at 105 degrees flexion.
- I started in-home PT once I was home. Also, iced my knee after exercise and kept it above my heart as much as possible. One week after I was home, I traded the walker for a cane. I could do 10 minutes on the stationery bike and I could take a shower.
- 10 days after surgery, I could walk around outside with a cane. I'd gotten to 120 degrees flexion, but I still lacked about 5 degrees on total extension. Extension was the hardest for me.
- 2 weeks after surgery I could walk around anywhere in the house w/o a cane or any aids. At 2 weeks, I got the stitches out. It hurt. (Take some Tylenol before you go for stitch removal!)
- 3 weeks after surgery I got 100% full extension. I also got completely off pain pills during the day so I was allowed to drive. This meant I could start going to out patient PT. By this time I could walk outside w/o cane.
- By 5 weeks, I was walking 1 mile every morning. (Prior to surgery I walked 2 - 3 miles each morning.)
- By 6 weeks, I could walk 1.5 miles. I still limped noticeably when tired. Also, still occasionally needed to take pain meds at night in order to sleep
- By my 8 week check up, my right knee had become stronger than my left. So my operated knee was officially now my "good" knee. I had 125 flexion and 100% extension. I was released from PT the following week.
-By 12 weeks, I felt pretty much completely normal. I didn't limp anymore although there are things I still can't do comfortably including kneeling on my operated knee and twisting it sideways.
Hope this helps. It was actually helpful to me to go through that timeline and guess where I'll be in the next few months. As others have said, every surgery is different, but I'm keeping my fingers crossed that my left knee recovers as well as my right one did.

Thanks for the reply. It really helped. I just have one question. You said it took 10 days before you were able to take a shower? Why that long? I'm not good with sponge baths and I'll probably want to take a shower ASAP. TIA

dkapustin @dkapustin 10 DAYS seems like a long time. Maybe its the type of long bandaid that Dr. puts on? Leaving the Hospital - @ 4 different PA, Nurses, personnel, etc. said "Don't get it wet" to avoid infection! Then I was allowed a shower after 3? days. How long b4 post op? Maybe you Dr. is Old Fashioned ?

Showering depends...... I had a water-proof, super secure XL bandaid-type covering and was allowed to shower as soon as I got home. Also, only had 2 stitches, remainder of fairly short 5” scar was closed with surgical glue. No idea of advantages or disadvantages of either method, but it sure eliminates the pain of suture removal. Perhaps check with Dr. or his nurse before surgery? He will have his preferences, but at least you can plan.

Some more incidental information - and, bear in mind, it is different for each patient: very definitely you will have an area of numbness, probably to the outside of the surgery scar, starting out with about 3 to 4 square “. This will gradually fade away as nerves and blood vessels regenerate. I had fully recovered all feeling by week 12, but some people retain small areas of numbness permanently. There will also be an area of what I call “sandpaper” skin, just rough and scaly feeling. Mine was at the lower outside area of the scar. Daily massages with bio oil and time and healing have completely taken care of that. The swelling will take time to go away. Some may be permanent. At almost 4 months my right knee is still 3/4” bigger than the left, but that is very acceptable. Regarding PT and general recovery: Debbra’s timeline is fairly close to what I experienced, but it also is an above average scenario. I left the hospital with 103 flex, but it took me much, much, longer to get my extension. I wish I had had input from this forum prior to my TKR, and for what it’s worth, I found that a lot of questions can be dealt with over the phone, and that the Ortho’s nurse often is more compassionate, patient, and willing to address odd concerns than the busy physician.

I had bilateral knee surgery 6 weeks ago today and was able to shower with adhesive waterproof bandages 3 days after surgery. I love my showers too!