Tips for post-knee replacement?
November 29, 2024 6:29 AM   Subscribe

I'm having a total knee replacement on December 18th. Are there any tips you might have for a good recovery? Any equipment you found helpful? Anything else? thanks.
posted by DMelanogaster to Health & Fitness (18 answers total) 1 user marked this as a favorite
 
I broke my knee years ago and had a bunch of hardware inserted. What I'd recommend:

1. Stick with the physio. It's awful, and hurts more than the original pain, but it really helps in the long run.
2. Stick with the pain meds. Don't let the one run out before taking the next. You don't need to be a hero or prove something.
3. Get extra pillows for sleeping, to prop your leg in place. Your sleeping habits will be disrupted, and staying in one position will be its own chore to manage.
4. Sleep, sleep, sleep. Forget about goals of Netflix marathons or reading -- sleep and let your body focus on healing.

Good luck!
posted by Capt. Renault at 7:17 AM on November 29 [8 favorites]


My mom had both of hers done, separately, last year. Her advice to her friends in her age bracket has been:

- get a recirculating ice pack/cold therapy machine. It'll make the continuous on/off icing cycle of the first days easier

- go hard on your post-surgery rehab. She has great strength & range of motion now, and credits her quick and complete recovery to how hard she pushed her rehab. How hard was she pushing things? Her surgical center's post-op instructions required her to get up & walk once every hour she was awake, starting the day after surgery, and noted that 'walking 1/4 mile' was a good rehab goal for weeks 1-3, so my mom decided she would hit 1/4 mile *every* time she got up to walk. She calculated how many laps around the living/dining room area would be 1/4 mile, and off she went every hour. She was walking 1/4 mile 7-8 times a day by day 3 both surgeries. The brought that same attitude to the exercises prescribed, which she said hurt like the dickens, but were worth it.

- do think about the trip from your bed to the bathroom. My mom ended up sleeping in her guest bed because the route from there to the bathroom was easier to navigate with a walker than the route from her main bedroom.

- her insurance gave her access to a few rehab sessions with a PT, and she was lucky enough to find one where as long as she had an appointment upcoming, she could come in & use the equipment on her own. She spaced her PT appointments widely, & was able to gain access to some strength & balance building equipment that she really appreciated.

Otherwise, I think her equipment was really minimal: a yoga mat, resistance band & foam roller for the rehab exercises, her walker (which she was ready to ditch after 3-4 days) & a cane. I do think she found it helpful to have someone stay with her during the first several weeks & really take over being 'the responsible adult' in the house - monitoring med schedule, cold therapy timing, rehab exercise timing, keeping track of once-an-hour walks, etc as well as the regular stuff like meal prep. This let her relax into restful sleep, knowing someone else was handling things, more easily than she would have otherwise.

On preview: yep, extra pillows. You'll need those for sure.

Good luck! And I hope your surgery & recovery go as well for you as they did for my mom!
posted by wind_up_horse at 7:23 AM on November 29 [3 favorites]


Take the physical therapy seriously, do as much of it as you can, and pay for additional sessions if you are able too. If you do get released to a rehab facility instead if home, ask for exercises you can do from your own room/bed so you don't get stir crazy. (And bring an earplugs/eyemask and loose fitting sweats). Nthing to try to sleep as much as possible and to relocate your bed near a bathroom at home, or to use a commode. If you can, set up a weekly housekeeping service for about 2months. It really helps to not have to worry about cleaning and tidying amongst everything else.

Install grab bars in your bathroom now, and along any small steps (there are so many that look actually decent now, but the ones at a home depot are good enough. Order them online for aesthetic options!). Do a deep clean, and declutter as much as you can.

Good luck!

experience: helping parents go through multiple knee and hip rehabs over the years
posted by larthegreat at 8:07 AM on November 29 [2 favorites]


Remove throw rugs while recovering to reduce the risk of tripping and falling in your home! Personal experience with this one.
posted by citygirl at 8:19 AM on November 29


Agree that you should really work the PT. It will HURT to bend your knee to get the range of motion back, but it's worth it.
posted by pangolin party at 8:43 AM on November 29


Seconding PT. Do it.
It will hurt.
A lot.
Do it anyway.
posted by BlueHorse at 9:09 AM on November 29 [1 favorite]


Mom-Chick, late seventies, just had her knee replaced this summer. What worked for us:

- Recirculating ice machine as mentioned above - you can rent one. They are amazing. Your fridge ice maker will not be able to keep up with the demand so either start stocking up now (ziploc bags) or get someone to deliver a couple 5lb bags of ice every other day during recovery.
- Freezer meals - stock up, you will not feel like cooking but you need to keep up your strength
- We used a shared Apple Note to track medications. There are A LOT of meds, so documenting them every day helps both yourself and your caregiver(s) keep track of what you're taking. Also, the doctors were delighted when Momma could just show them the Note when they asked what meds she was on.
- You will have constipation from the surgery, the painkillers, and the decrease in exercise. Address quickly and aggressively with senokot, ducolax, psyllium, polyethylene glycol.. or whatever works for you.

Good luck with the surgery!
posted by some chick at 9:33 AM on November 29


Like Capt Renault, I also broke my knee a few years back. A knee replacement is likely going to be even EASIER than I had it because you don't have any bones that need to heal, so you won't need to keep things immobile for 3 or so weeks (that was the kicker for me, I had to let the bones heal and that meant the muscles started to atrophy and that made PT all the harder).

Nthing what others say about the PT, clearing throw rugs out of the way, getting extra pillows and getting yourself close to the toilet. Lean on family and friends for the meals (banking some freezer meals is a great idea, I was stuck having to lie on the couch with a cookbook and holler instructions into the kitchen at my roommate). Other things I haven't seen covered:

* Make sure you can figure out a way to get yourself onto and off the toilet unassisted before you leave the hospital, if only for the sake of your own dignity. Neither my roommate nor I were all that interested in the prospect of him having to help me onto a toilet. (Him trying to help me into the bathtub for a sit-down shower was bad enough, but we did come up with a system involving an easily-removed nightshirt that I took off once I'd assumed the position and he'd left the room.)

* Speaking of which - a stool for sit-down showers is vital. If you can't swing that - they have some products that can help with hygiene for bedridden people. My BFF sent me a care package of these huge-sized wet-wipes and these things that are like shower caps impregnated with shampoo to deal with that; the shower cap things you just soaked with water, then put on and rubbed around on your head and then threw the cap away. No rinsing needed. It wasn't 100% equal to properly washing my hair but it dealt with the worst of it.

* And speaking of assistance in general - don't be a hero, let people help you. I could not have made it through the first 6 weeks of my recovery without my roommate on hand to help me out as much as he did. He even came with me to my doctors' visits for the first few weeks just to help me into and out of cars and chairs, hold doors, and suchlike.

* A word about the medication, especially painkillers - check what you get from the hospital pharmacy CAREFULLY. My orthopedist prescribed me Percoset, but I'd made a passing comment to the intake nurse that I'd thrown up once from Codeine and she marked me down as being allergic to opioids. So the hospital pharmacy changed the doctor's prescription to something else without telling him OR me. I was too stoned on anesthesia to notice and my roommate didn't know any different, and the painkiller they gave me was wholly ineffective and I spent the entire first night after surgery awake and in severe pain. Fortunately when I called my orthopedist the next morning to discuss, he told me how I could supplement what I'd gotten with OTC ibuprofen, but that was a very rough first night.

* If at all possible, get your surgeon to write down his post-surgical instructions for you, EVEN IF he has a conversation with you after the surgery. Apparently I had an entire conversation with my surgeon in the recovery room that I have zero memory of because I was too groggy and went back to sleep afterward, and then woke up later for real and spent another 20 minutes there waiting for my surgeon to come talk to me like he said he was going to. If he'd written that all down, I could have looked at it and realized "oh hang on, I'm all done here."
posted by EmpressCallipygos at 10:18 AM on November 29 [1 favorite]


do NOT under any circumstances stop doing the exercises you are instructed to do. not even once. it is a ritual you have to keep if you don't want pain and immobility.
posted by evilmonk at 10:59 AM on November 29


mr jane had his knee replaced last year.

Do your PT like it's your full time job. His surgeon told him if he was unable to fully stretch out his leg by the end of his PT, he would have to undergo another surgery, so that the surgeon could flatten it.

The ice machine was great at first, luckily we were able to borrow one from a relative who had had a previous surgery. If you do procure an ice machine, you will need to bring the pad from it with you to surgery, so that they can wrap your knee with the pad in place, rather than you having to deal with that at first. We used bottles of frozen water that we would switch out once they melted, in lieu of having to stock lots of ice. Later mr jane preferrred a frozen ice pad to fiddling with the ice machine.

You will have compression socks. You will struggle with putting on the compression socks. Mr jane had early morning PT appointments and we let the PT help him with the socks.

Mr jane would like you to know that you will not be able to kneel freely on your recontstructed knee, after you finish recovery. He wishes he had known that upfront.
posted by sarajane at 1:51 PM on November 29 [1 favorite]


TKR here. My MD team & PT team advised having ice packs on hand. However, they cited studies that found that ice slows healing. I tapered off ice then meds ASAP and don't regret that. YMMV.

Before surgery, with sturdy blocks I propped up the foot of my bed around 40 cm (18"). This counteracts swelling & related pain. Be sure to have plenty of pillows, a walker, chairs with arms, & in the bathroom appropriate handholds. Until further into recovery, I learned new tricks to rise from sitting, such as lean 'n lunge.

The hardest bit for me was relearning to walk down stairs. This requires the right mix of release and tension from opposing muscles: thus practice, practice. I came to appreciate my "IT band" that runs all the way into the hip. Not well-documented, a stretch that quite helped me was reclining on my back on the edge of a sturdy table, such that I could raise the straightened leg up for 30 seconds then with gravity assist let it stretch--still straight--below the table for 30 seconds. Repeat several times.
posted by gregoreo at 2:38 PM on November 29


Total knee replacement going on 3 months ago. I'm 46.

The first thing you need to know is that the first month or two are going to be brutal. You're very likely to have the worst pain you've ever had in your life.

You absolutely MUST take your pain meds by the clock. I struggled harder than I needed to, because I already take two scheduled drugs for my normal, day to day pain. My surgeon thought I'd be fine with that. I convinced him to prescribe a third drug for two weeks. Hindsight being 20/20, I should've talked to my pain management specialist about getting more pain meds for a short course after surgery. When I have my other knee done (please, gods, not any time soon!), that's my first priority.

You absolutely MUST do your pt and walking no matter how bad things feel. If I tried to do anything beyond walking to the bathroom, I would scream. White girl in a horror movie scream. Literally scream. Then I'd hit the floor. And keep screaming.

At my 2 week follow up, my surgeon was pissed that I was still using my wheelchair. He told me that this is a "no pain, no gain" surgery. That it didn't matter how much I screamed. That it didn't matter how much it hurt. That I had to bust my butt on walking and pt anyway.

Speaking of going to the bathroom - 1. Use a stool softener. Even if you don't think you need to. Especially if you don't think you need to. One of my closest friends stayed with me for a while after surgery. We got REALLY close when they had to manually help me have a bowel movement.

2. Get some sort of raised toilet frame. I'd been using a bedside commode for years, stopping before moving into my new apartment. (Pro tip: DO NOT move into a new home a week before surgery!!!) After surgery, I tried to use the toilet. And screamed. My friend brought the frame of the commode over. Using that helped WAY more than I'd thought it would.

I disagree vehemently with the folks saying to get extra pillows to prop your knee up. My surgeon and PT team told me that was one of the worst things I could do, because it could lock the soft tissues of my knee in that position, and they'd have to go back in and fix things. Even now, if my leg stays in one position too long, more than about 15 minutes, I'll scream when I try to move it.

Go for the circulating ice water device. I was told to use it around the clock for the first 3 days, then a minimum of 3x a day for 30 minutes at a shot. I still use it when I've pushed my knee too far. (My nurse told me to use 4 frozen water bottles instead of ice to save time and money.)

My surgeon also prescribed a continuous motion machine for 3 hours, 3x a day, for 3 weeks. I got that on loan before I left the hospital. He also prescribed a Styrofoam block with a cutout on one side, called a "zero degree knee." I still use it 1-2x a day to let gravity help my knee completely relax and stretch out straight.

DEFINITELY cook ahead to stock your fridge and freezer. My friend was essentially prescribed to me for 2 weeks post op. (They stayed a few extra weeks because I was in such rough shape.) I didn't want them to have to cook on top of helping me do everything. I made double batches of chicken casserole, white chicken chili, and chicken jambalaya, portioning them out into ziploc bags and Rubbermaid containers, and loaded up my fridge and freezer.

About 6-7 weeks post op, I'd graduated from a walker to a cane. At 9 or 10 weeks, I didn't need my cane beyond first thing in the morning, inside my apartment. Two weeks ago, I didn't use it much outside my apartment. Last week, I went without it for short treks at doctors appointments and such.
4 days ago, I walked around Walmart, from corner to corner, with no assistive devices whatsoever. First time in 15 years - 12 of which I'd been using the wheelchair.

I'm at the food bank every Friday morning. Two of the volunteers have told me that seeing me go from needing a wheelchair to walking on my own had inspired them to the point that they've scheduled their own knee replacement surgeries. A third has been asking me questions so he can help his friend through it.

Having a total knee replacement epitomizes the concept of hoping (and/or praying) for the best, but preparing for the worst. Please memail me if you have questions or need a "been there, done that" buddy.
posted by The Almighty Mommy Goddess at 5:49 AM on November 30


Re-framing of the pillow advice - your doctor can speak to whether to use a pillow to prop your knee specifically. But I personally still recommend gathering pillows anyway - because whatever your usual sleep position, it is gonna be FUCKED for a few weeks, and having a whole lot of different pillows on hand will let you build whatever unicorn of a nest your unique body is going to need to make up for the fact that you can't roll over and readjust yourself in the middle of the night. ( somewhere in my 2020 comment history is a post I made after finding the perfect body pillow that finally let me get some god-damn comfort with my knee in a big ugly brace.)
posted by EmpressCallipygos at 7:09 AM on November 30


You're not going to be bending over to pick things up from the floor for a while. Which you'd think isn't a thing you need to do much, until suddenly you really need to because you dropped something or whatever, and you can't get it.

So before you go in for the surgery, get yourself one of those long reach grabbing tools, and put it somewhere that you're going to be able to get to it when you need it.

It was a little thing that made a big difference for someone I know.
posted by automatronic at 1:41 PM on November 30


My brother, mid 50s at the time, says the key to his recovery was to ignore the pain and discomfort and start using the leg as soon as they say you should which I think was one day. He was adamant about walking as much as he could. He walked until his muscles fatigued and his pain was unbearable. Way more than the suggested schedule. He said the pain pills "were for pussies".

(My brother is one of the most intense people I know. In HS, he played a football game with a broken collarbone by not telling anyone, not even our mom, until after the game.) YMMV.
posted by JohnnyGunn at 2:03 PM on November 30 [1 favorite]


I was going to say above do your PT, and then do extra PT, but sometimes that's always not the greatest. Do AT LEAST as much as your told, and if you can, do a bit over, especially the first three weeks.

However, take your meds! Don't be a doofus. Stress doesn't promote healing. Pain is stress, and it's hard on your knee, interrupts your sleep, screws up your brain, and doesn't do your heart and nervous system any good. You really will heal better and faster if you're not stressing your body with pain. Take the meds when scheduled, at least the first two weeks. Don't fall behind the curve and have to play catch up. Around 14 days or so, might be able to start pushing out the time on the meds a little at a time--15 min-1/2 hr. until you're comfortable. I didn't use half the meds they thought I'd need, but I used them religiously at first, and then when I hurt from overdoing it. (I'm also a big believer in overdoing it--I was back on a horse more than a month before I was cleared. But it was a gentle old horse, so that made it OK by me, at least.)

Also, YMMV on how your knee operates afterwards. I regained nearly 100% ROM, and unlike Mr Jane, even with my crap arthritis I can kneel and even scrub my kitchen floor tiles. I can sit on the floor and cross my legs and hold it, but when I get up, I gimp around. While I can touch my heel to my rump OK, I can't do child pose and sit back on my hams.
posted by BlueHorse at 6:15 PM on November 30 [1 favorite]


Oh! My PT taught me a trick in our first session that was kinda genius. I was finding that getting out of bed was a bit clumsy because my knee was all straight and had a big heavy brace on it, so lifting my leg was a challenge. My therapist taught me a way to use my crutch or a cane as a sort of lever:

1. Turn your crutch the other way around, so the handle is down by your foot and the bottom of the crane is in your hands.

2. Brace your foot against the handle.

3. Then keeping your foot against the handle, then grab the bottom of the crutch with your hands and use it as a sort of lever to swing your leg up and around whereever you need to.

I think I actually said "I'll be damned" when I tried it for the first time.
posted by EmpressCallipygos at 7:24 PM on November 30


Recirculating ice machine as mentioned above - you can rent one. They are amazing. Your fridge ice maker will not be able to keep up with the demand so either start stocking up now (ziploc bags) or get someone to deliver a couple 5lb bags of ice every other day during recovery.

This was very he for my partner to keep swelling down. One issue with it is replenishing it. After the ice melts you’re left with a cooler full of water you need to dump out and replace with cold water plus ice (using frozen bottles of water worked better than ice because it melts slower due to being bigger chunks), and the cooler is heavy to move around. For a while you will need help with this so I hope someone can stay with you to do so.
posted by waving at 12:25 PM on December 1


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