Post Knee Replacement Surgery Care

A knee joint replacement can be the fulcrum of an active, second-innings in any patient’s life. Knee replacement surgeries re-instill the freedom of physical movement, allowing one to resume living a pain free lifestyle. To have maximum benefit of a knee replacement surgery, post-surgery recovery measures are extremely important.

Follow up consultations with the surgeon and guided rehabilitation by a physiotherapist is a given in the initial weeks after surgery. However, after 6-8 weeks of post-operative period is when most patients lack the road map to proceed further.

Who should undergo Knee Replacement Surgery?
Patients who are not responding to other alternative therapies for their knee problems should consider TKR. Common problems include:

– Pain and stiffness – Severe and chronic pain that makes it difficult to walk, climb stairs and get up    from a chair.
– Bone damage- Severe joint damage from osteoarthritis or other conditions.
– Deformity- Knee is severely swollen or leg is bowed.

THE TO-DOs & NOT-TO-DOs

  1. Cleaning wounds: For fear of applying water onto the surgical site, patients often stay away from cleaning their wounds. However, after stitch removal and healing, the area must be washed and cleaned with a soft muslin cloth, followed by application of coconut oil. Care must be taken to not scratch the area of surgery – if itching or any skin irritation persists, a dermatologist should be consulted.
  2. Regular Exercise: Regular exercise is a must, whether one has undergone a surgery or not. Three months after the surgery, 5 sessions every week of exercise for at least 30 minutes each, is necessary. Muscle strengthening exercises done by self-motivation prove better than anything else.
  3. Activities like cross leg sitting: A table-chair lifestyle must be adopted. The goal of a knee replacement surgery is not about letting patients sit on the floor or sit cross-legged. Such surgeries are only meant to restore the pain-free walking ability.
  4. Regular walk: After 6-8 weeks of surgery, it is important to increase walking pace and distance. This is the best exercise to decrease stiffness and heaviness in joints. Walking ability is purely an individual capacity, and at the end of 2 months one should be able to walk 1-1.5 km every day, which can be increased to 250 meters at the end of 3-4 months, till a 3 km every day mark is achieved.
  5. Activity level: Post TKR, swimming, cycling, golf, badminton (doubles) is allowed. However, contact sports like football, hockey, volleyball and high energy sports like paragliding and mountaineering are not good for artificial joints.
  1. The last to recover after joint replacement are stiffness, heaviness and high flexion activities which happen at the initiation of an activity. Some warm up before initiation of movement is desirable in such case.
  1. Weight reduction: It is desirable to reduce weight before surgery. Decreased mobility due to knee pain can be a big deterrent, and thus requires the patient to have a strong will power and live by strict diet control. Post surgery, patient should continue the diet along with gradually increasing exercises.
  1. Antibiotic prophylaxis: Urine infection, dental problems, skin problems are notorious for producing bacterial seedling’s in artificial joints. Needless to say, prompt and adequate treatment of any infection is a must. Any undergoing dental or urology procedures should be covered by antibiotic prophylaxis.
  1. Yearly check-up: TKR patients must visit their surgeon yearly to keep a check on any loosening in the joint which can be appropriately dealt with on time.
  1. Patients with diabetes or hypertension should regularly measure, monitor and control the ailment. Diabetes patients run the risk of delayed infection, even months after the surgery, and hence should control blood sugar meticulously. Patients having respiratory disorders are advised to do Spirometry orPranayaam to improve lung capacity and thus their walking ability as well.

If these conditions are addressed, joint replacement surgeries may result in long term benefits. In case of any confusion about any point, it is important to seek clarity from the surgeon.

By- Dr. Neeraj Aggarwal

Joint Replacement Surgeon

Narayana Multispecialty Hospital, Jaipur

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