What to Expect Before, During and After Total Knee Replacement Surgery
As total knee replacements become more common, some of our clients have questions about staying active before and after surgery, as well as questions about the surgery itself. Those who are very active want to keep their current lifestyle and activity levels post-surgery. A common misconception is that once you have a total knee replacement, you can no longer be active on that knee. The fact is, you can be active post-surgery, however you have to be cautious about what types of activities you choose. If you are a candidate for a knee replacement who has some concerns about your lifestyle post-surgery, we have some pointers for what you can expect.
4 Types of Total Knee Replacement Surgeries
There are four types of knee replacement surgeries, non-constrained, semi-constrained, constrained and unicondylar.
- Non-constrained: This is the most common replacement performed. The artificial replacements that are inserted into the knee are not linked to each other, which therefore rely on the individual’s own ligaments and muscles for stability.
- Semi-constrained: This replacement has more stability built in to the joint replacement itself and is used more for when there is additional ligament damage in the knee, leading to instability.
- Constrained or Hinged: With this replacement the two components are linked or hinged together, which provides additional stability that the patient’s knee may lack.
- Unicondylar This is the least common type of knee replacement and replaces only one part of the knee. It is used when only half of the knee is damaged and the surgeon doesn’t want to mess with something in good working condition.
In addition to these four main forms, doctors are continually coming up with new techniques and even replacement types to optimize the use of the joint after surgery.
What Happens During Surgery?
The actual surgery itself is as follows: One of your quadriceps muscles (Vastus Medialis) is cut from its distal attachment at the patella (knee cap) and the Anterior Cruciate Ligament is removed so the patella can be moved aside and expose the knee.
The damaged ends of the femur and tibia (two bones that meet to make up your knee joint) are cut and shaped to fit the replacement that will be coming in. The replacement is cemented in place, the patella is returned to its proper position and voila, you have a new knee!
Exercising Pre and Post Knee Replacement Surgery
Exercise Pre Joint Replacement
Pain may be a factor in terms of keeping up with exercise, but it is important to strengthen the muscles in both legs to help you after the surgery. Strengthening the muscles surrounding the joint will cut down on recovery time.
You will have more strength and endurance to move the new replacement. Not only that, you will be relying more on your non-operative leg for support so it is equally important to strengthen that side as well.
Given the variability of pre-surgery health history for each person, there is no set recovery time. During the first six weeks post-surgery, you won’t be bed-ridden but you will be using assistive devices such as crutches or a walker to get around.
Physiotherapists will prescribe various range of motion and flexibility exercises to get the joint moving. From there you will progress to walking with a cane and then to performing various strengthening exercises once range of motion is restored in the joint. After 8-12 weeks of post-surgery physiotherapy you can the be referred to a Kinesiologist.
Age at Time of Knee Replacement
Surgeons recommended waiting until you are older (over 60) to have knee replacement surgery to avoid wearing down the replacement. However, more people are being recommended for replacements at a younger age given how highly active our current population is.
Getting a knee replacement when you’re young doesn’t mean you can no longer be physically active, but the types of activities you do need to change in order to prevent the joint from wearing down. Activities that are off limits are high-impact ones that will lead to wear and tear of the joint.
Knee replacements are continuously being improved in order to allow the individual to have more function in the joint. If you are in the market for a new knee, check out some of the up and coming replacements that may perhaps be better for you in the long run.
What Role Do Kinesiologist Play in Rehab?
Our Active Rehabilitation program helps you both pre and post surgery. Before surgery our Kinesiologists teach you the right exercises to help strengthen your leg muscles and improve flexibility to facilitate an easier recovery.
After surgery and after completing your physiotherapy, we work towards integrating you back into an active lifestyle and helping you return to work or recreation activities. We communicate with your medical team to make sure we are creating an optimal plan for you.