Knee replacement: How helpless will I be and for how long?

September 9, 2022 10:07 AM

I’m close to scheduling partial knee replacement #1 in January. I’m trying to get a handle on what recovery might look like in terms of how much and what kind of help I’ll need, and what I might be able to do when.

I’m 50, with bad knees for most of my adult life--bone on bone by now. I’ve decided the sooner the better for knee replacement surgery, and have a doctor who has done hundreds if not thousands of these procedures.

The plan is to do one knee in January, and assuming all goes well, do the second before the end of the year for insurance reasons.

I want to be as prepared as possible, and I’m trying to get an idea of how helpless I’ll be immediately post-surgery and for roughly how long. And when the doctor’s office says “you’ll need someone there 24/7 for the first 2 weeks,” I’m thinking—really? Because the odds of that happening are pretty low.

Details:

1. I’m in good shape: hike, mountain bike, lift weights, do yoga regularly. I plan to do PT religiously; I’ve already had both knees operated on, ACL and meniscectomy, so I know the drill at least somewhat. I’m also planning to have laser therapy, which my chiropractor swears (and evidence suggests) can help a lot. All of which I hope will shorten my recovery time.

2. I live in a 2-story house, but I can set up my office on the first floor as a bedroom, and there’s a shower there too. My house does have about ten steps to reach the first floor from the street.

3. I have my 2 kids (10 & 13) about 1/3 of the time, and they need driven to school and sports practices daily. I think I'll be able to rearrange the schedule with their mom to get 9-10 days free.

4. My parents live in town and are happy to do what they can, but they’re in their 80s, and I can’t ask them for more than stopping by once a day, maybe help with some food and occasional kid transportation. Definitely not 24/7.


So I’m wondering, with the usual caveats of YMMV:

a) How much actual, full-time live-in help I'll need. A few days, I think I could swing through some combination of friends & family. But if we’re talking about a week or more, is not having that a dealbreaker? What other options are there?

b) How soon I'll be able to drive, so I can start ferrying the kids around again?

c) At what point, assuming this is not (b), will I be able to get around more or less on my own with crutches, navigating some stairs, etc?

d) I'm so bowlegged my doctor says the surgery will make me 3/4" taller. I'm wondering how much my biomechanics will be thrown out of whack between doing the first knee and the second.

e) What else should I be factoring in?

posted by gottabefunky to Health & Fitness (10 answers total)

My own surgery was adjacent - it wasn't a knee replacement, it was a patella fracture (and a particularly gnarly one). I can tell you my own experience, and tell you how it differed from the experience my mother told me her cousin had with a more proper knee replacement.

* Immediately after the surgery, I had crutches, and was in a plaster cast that ran from my hip to my ankle for 3 weeks. My leg with the cast was literally too heavy for me to lift, so whenever I had to get up to use the bathroom, I had to ask my roommate to come in and literally pick my leg up off the bed, hold it steady while I stood, and then lower it to the ground for me. When I needed to sit down or lie down, he picked my leg up and put it down on the bed or couch for me as well.

* I could move about with crutches on my own once I was all the way standing. We still defaulted to my roommate doing all the cooking and meal prep for those 3 weeks. Hygiene issues were handled thanks to a care package my BFF sent me filled with extra-large wet wipes and a bunch of these shampoo-impregnated shower cap thingies. I was fortunately able to figure out a way to use the toilet without assistance (the people in the ER showed me how to maneuver my leg so I could sit to pee).

* Things got a little easier once I got the cast off after 3 weeks. I still had to wear a brace and used crutches - but my leg was more lift-able on my own with just the brace, and my physical therapist also showed me a way to use one of my crutches as a sort of lever to help lift my leg off the bed if need be. My roommate still did a good deal of the cooking, and had to spot me when I went up and down the stairs in our building (we were on the 4th floor and the stairway was too narrow for me to manage on both crutches so he had to carry one and spot me). We also graduated to showers; I got a shower chair from a neighbor, and we figured out a way for him to help me into and out of the shower chair without my losing any dignity.

* I started physical therapy almost as soon as the cast was off, seeing them 3 days a week at first; within a month I was able to manage just on one crutch, and started being able to cook for myself; and within another month or two I ditched the brace and graduated just to a cane and was also able to shower on my own. Five months after the surgery, I stopped needing the cane.

The bad news: my injury was just shy of two years ago, and only now do I feel like I am within shouting distance of "back the way I was." But the good news is, I only really needed "live-in help" for a few weeks, and was able to do some basic life activities after only a couple months.

And an additional bit of good news: my surgery was different from yours, and I think that made a difference. A relative had knee replacement a short while before my own injury, and my mother and I compared notes about that - the doctors had my relative up and trying to walk around only two days after surgery, while I had to stay in a cast for three weeks. The reason they got my relative up so soon was that the longer you stay immobilized, the more the muscles atrophy, and the longer it takes for them to come back. But since I had broken bones, I had to keep things immobilized to let the bones heal, even with the wire holding things together. So I was gonna be screwed either way - if I tried moving too soon it would ruin the healing bones, but if I waited too long my muscles would take the hit. With a knee replacement, there aren't any broken bones that need to be immobilized so that they can heal, so you can start moving sooner and odds are you will bounce back faster.

But even with my having to be laid up for three weeks I really only needed hands-on help for specific things, and it was only three months before my roommate and I realized that "yeah, I think I can go about totally on my own from here on."
posted by EmpressCallipygos at 10:33 AM on September 9, 2022 [1 favorite]

My dad had one knee done last fall and is having the other done... this week? He's a bit older than you but very fit - climbed Kilimanjaro a couple years before the new knee, just did the Tour de Mont Blanc on the new knee, skied on the new knee last year and is timing the second surgery at least in part so that he will likely able to ski on two new knees this year. He does not do yoga and is notoriously non-flexible.

I was not around much during the first couple weeks after his surgery but my impression was that the "helpless" period was very short, certainly compared to other orthopedic surgeries he's had. Seemed like just a day or two before he was ambulatory (albeit creaky and uncomfortable). If I recall correctly, he was attending my niece's birthday party within a week or so after surgery. As EmpressCallipygos says, they want you up and moving around ASAP. He was really, really uncomfortable a lot of the time for the first few weeks, and his knee looked like a basketball at the aforementioned birthday party, but I'm not sure there was a whole lot his wife could do to help, besides household/cooking/cleaning stuff.

I think driving is very dependent on which knee is it - for your right (driving) knee, you won't be able to drive for like a month, whereas for your left knee, it will be more like a week. If you don't already have a plan for which knee to do first, it might be a good idea to do the left one first so you know the drill a bit better when it's time to do the right one. Even aside from actually being able to operate a car, though, staying in a confined position can be extremely uncomfortable, so have a plan that lets you keep your time spent in cars (or planes/trains/busses for that matter) to a minimum.

Finally, though: I would really encourage you to reach out to your friends, even distant-ish ones, and see if there's anyone who would be willing to stay with you for a week or two. With so many people working remote nowadays it's easier than ever, and speaking as a person who lives by herself and is entering middle age, I'm all too aware that I will probably need help like this at some point in the future - I would be happy to do something like this for a friend, at least in part because then I'll have a favor I can call in when I need help in the future!

Basically I bet you can do this with just a few days of help (especially if you plan ahead re: meals, rides to PT, etc.) but it would be good to have a backup plan.
posted by mskyle at 11:34 AM on September 9, 2022 [4 favorites]

Could you stay at your parents' house for 2-3 days? That would minimize the effort for them to care for you. As long as they have a room with bathroom on the same floor, I think that would be ideal. For driving your kids, I'd see what you can do to get help from other parents as well and have a backup plan if you aren't able to drive as soon as you plan to be. It is better to have a backup plan and not need it than to not have one and pressure yourself into doing too much too soon.
posted by soelo at 12:10 PM on September 9, 2022 [1 favorite]

At my age I've known a few people who have had it done. Recently a relative and also a neighbour had it done. Everyone has been pleased with the outcome. Would recommend.

As far driving goes, it really depends on whether right or left knee.
Right knee may be as long as 6 weeks no driving.
Now this may not be up to the individual. You may not have a choice.
In my province you may get a medical suspension of your license.
The doctor's office informs the MOT and they issue the medical suspension, typically 6 weeks.
you can get it lifted earlier though.

Left knee you can drive in a week or two.
don't normally bother with the medical suspension.

My friends had the left knee done.
They'll give you painkillers. Use them.
They'll try to have you moving quickly ,But do NOT overdo it or push too fast.
There is a tendency to do that, Don't. It won't help.

Initially stairs are a problem, shower is a problem ,toilet is a problem. Hell sleeping is a problem.
You'll get through it, probably quicker than you might think, but initially it's a pain.

Here's a link to a 45 page pdf patient guide to knee replacement.
Includes recovery guides and illustrations of post op exercises.

The exercises work, just don't overdo them,.
posted by yyz at 12:23 PM on September 9, 2022

Forgot to add they all had some in home follow up.
A nurse, physiotherapist.
Check the surroundings and assist with exercise etc
Not for long though, just a few visits.

Family .friends would overnight. Get takeout etc
Particularly the first week.
After that it wasn't that bad. Just make a grocery, drug store run.
Keep them company
posted by yyz at 12:36 PM on September 9, 2022

One of my employees just helped a friend through their knee replacement. The patient had the surgery on a Wednesday morning, and were back home that afternoon.. They needed help moving around until Saturday morning, when they could largely do it solo. They benefitted from "can you get that for me?" help for another week and a half (two weeks in total from the date of surgery).
posted by NotMyselfRightNow at 1:16 PM on September 9, 2022

I'm about ten years older than you. I had a total knee replacement a few months ago. I was actually in the hospital for more than a week, though my recovery went well, because I live alone on the third floor and they wouldn't release me until I could walk up that many stairs with a cane. I'd say I felt "helpless" for 4-5 days after the surgery, while I was still in the hospital. I was already up and walking around on day 2, but I would have needed help if I'd been at home. I used a walker for a week, then a cane. I never used crutches. Once I was home, I could take care of myself, but it was super helpful that friends and neighbors brought up packages and made grocery runs, drove me to the doctor, etc. (I don't drive, so I can't comment on that, but I did have some trouble bending my knee enough to get into a car at first.)
posted by pangolin party at 2:07 PM on September 9, 2022

I had both knees replaced 3 months apart; recovery was very different for each. The above info is correct for driving. Right knee was 6 weeks, left was 4. I used a walker for about a month with the first one, about 2 weeks for the second. Then a cane. Practice so you are using the cane correctly. I was fairly self sufficient except for driving after about 2 weeks, but didn’t need to climb stairs. And I will say what everyone says—do the rehab, take the meds, & don’t overdo it.

Yes, I am taller! Regained almost an inch in height lost due to super bowed legs. Related to that, shoes that I wore regularly no longer fit comfortably due to how they had worn down unevenly from the bowed legs. Didn’t expect that. I went to the ‘comfort shoe store’ to consult wit a pedorthist who recommended some insoles. They help, but you may need to refresh your shoe supply when it is over. In the meantime, you could consult with them about an uneven gait. It was noticeable for me to have one leg longer, but it was only three months, not a year.
posted by Nosey Mrs. Rat at 8:54 AM on September 10, 2022

I had both knees replaced (at the same time) not quite a decade ago, when I was about your age. I had biked regularly until my knees went bad, and walked semi-regularly after. I had a “resurfacing” in which a 5mm thick plate of titanium was placed where the end of the bone had previously been.

I had three days after discharge from the hospital in which I could not do stairs and used a walker (for the first day, and then very rarely on day 2). I stayed with my sweetie, who had everything on a single floor, for those days.

On day 4 (after discharge) I went back to my own home, which had 16 steps from the ground floor to the upstairs where my bedroom was. Kitchen and bathroom were on different floors, so I was doing stairs pretty regularly. I also had four stairs (exterior, in MN, during potential snow season), so I made sure I had supplies at home for a few days of being house-bound in case it snowed.

I owned a full-size pickup, and was driving after 2-3 weeks and back to work, though I was not working full days initially (desk job, computer biz). I also drove myself to and from PT once I went home (so beginning sometime about 10 days post-surgery, IIRC - you have PT in the hospital post-surgery, but then a few days off before outpatient PT, during which time you need to keep doing any exercises). I also got a recumbent exercise bike and rode it for 30 minutes every morning in addition to everything else.

As I am tall (6’5” or 195cm), one of my biggest challenges was getting up from low chairs. One of the conference rooms at work had chairs that were all 15-17 inches high (37.5-43 cm) and I initially needed help or to grab the table and push myself up using it in order to stand, but I never got “stuck” probably because I could use my upper-body strength to get myself out of difficult situations. When I couldn’t get a chair at the table, I had to wait for people to leave so I could roll to the table to stand up. Bother.

My sweetie helped me quite a bit, but as she was a PT, she knew that I had to get “back on my feet” quickly, so she encouraged me to do as much as I could as quickly as I could.

Talk to your doc, and most especially your PT about restrictions. They know where you’re at, and can help set reasonable expectations. I also am a very strong advocate for doing both knees at once if at all possible. It is impossible to “cheat” on your therapy with your “good” knee when you’ve had both replaced.

Good luck! Getting a knee replacement is scary, but it’s really nice to have had it done.
posted by DaveP at 5:29 AM on September 11, 2022 [1 favorite]

One additional comment. If you have specific questions you’d like to ask privately, feel free to MeMail. I don’t check super-often, but once I’m aware I have mail, I respond quickly.
posted by DaveP at 5:32 AM on September 11, 2022