5 Common Questions Patients Have After Their Knee Replacement

1. How long will my swelling last? Swelling is normal after a knee replacement.  You may notice that your knee is large and discolored after surgery.  Swelling is not something to worry about  unless the swelling becomes excessive or is acompanied with a fever, redness, and unusual discharge from the incision.  Most of the swelling will calm down in the first 12 weeks after surgery, but some swelling may be present up through a year after your surgery.

2. What can I do to help my scar? Once the incision is completely closed and the scabs have fallen off, you can begin to help the appearance of your scar.  Take any lotion, some patients prefer a lotion with vitamin E, and massage the scar.  Massage over the scar in a back and forth direction and with little circles.  Apply moderate pressure as you massage the scar.  Massage the skin surrounding the incision as well.  Massaging a scar can help it reduce in color, assist in avoidance of the scar adhering to the tissues beneath it, and help to flatten it out.

3. Why do I have pain at the joint or upper part of the shin bone? Knee replacement suregery involves cutting some bone and that bone is going to be a little angry.  I encourage my patients to learn a little bit about the surgery to help understand why pain is present and why pain may be at particular spots in the knee.  Here is a video of a knee replacement annimation: https://www.youtube.com/watch?v=DXXPKWCBqYk .  This video does not use real surgical footage, so those who have avoided learning about the knee replacement surgery because you feel it is too graphic may feel better viewing an animated video such as this one.  You will continue to make progress after your knee replacement up through a year.  Pain level often reduces quite a bit around the 6 week mark after surgery, and then even more at 12 weeks.

4. Why is it so hard to go up and down stairs? Negotiating stairs involves strength and control of your quad muscles, the muscles on the front of your thigh. During surgery, these muscles are put on stretch and moved a bit.  In addition, after surgery this muscle initially doesn’t work as well and has to be retrained.  Due to swelling, the quad muscle will have a hard time contracting, this is called quadriceps inhibition.  The exercises you learn in therapy will help to retrain these muscles.  Going down stairs may be especially difficult, as the quads must slowly elongate, controlling your descent.  This controlled elongation is more of a stress on a muscle compared to when this muscle contracts and shortens when you go up stairs.  Strength takes 6 weeks to truly improve, so stick with your exercises and therapy and stairs will get better.  The knee also requires 110 degrees of knee flexion range of motion to go up and down stairs.  As you gain more motion, stairs will also become easier.

5. Is it okay to walk, swim, kneel? Walking will be encouraged in the hospital very soon after surgery.  Slowly add distance to your walks over time.  If you walk or are on your feet for a prolonged period of time soon after surgery, you may notice some more soreness and swelling.  You aren’t harming the knee, but let pain be your guide.  If your knee is becoming progressively more sore, back off a little bit so it can heal.  Swimming is okay and great exercise as long as your incision has fully closed.  Start in the shallow end and become reaquainted with your new knee.  Jumping into the deep end when your muscles are not yet feeling up to par can result in a struggle.  Once you have a good feel for your leg, swim away!  Kneeling will take time.  After surgery your knee will be swollen and bruised.  Don’t expect to be able to kneel prior to 3 months or more after surgery.  When you do eventually kneel, place the pad you are kneeling on at the upper part of your shin bone instead of right at the knee/knee cap.  This will allow a bigger surface area to place the pressure through and will offload the joint itself.