My Personal Experience of a Total Knee Replacement
What is Knee Replacement?
Total knee replacement (TKR) or total knee arthroplasty is a surgical procedure where the worn areas are removed and artificial materials are used to replace those worn out parts. Some people may only need a partial knee replacement; the surgeon would be the one to decide which would be best for the patient. Some times, the patient may opt to have both knees replaced at the same time; however, this calls for careful planning and much thought. Also, not everyone is a candidate for bilateral (both) knee replacement at the same time. Osteoarthritis (inflammation of the joint from wearing down or destruction of the cartilage) is one of the main reasons why someone has a total knee replacement.
When arthritis prevents an individual from functioning at the level that is necessary for everyday life and when that person lives in such pain that it is unbearable, then it is time to take action. Understand, everyone heals at a different rate; also, everyone responds differently to pain. The important thing is that anyone planning to do that surgery prepares by finding out as much as possible regarding what the whole process involves. Following the surgeon’s order and complying with the entire treatment team recommendation, will help to ensure success. One member of the team, the physical therapist, plays a vital role in helping the individual to get better.
I began experiencing knee pain when I was a teenager. I found out that several members of my family had a history of joint pain but since I was young, I did not worry about it. However, over the years the pain in my knees became progressively worse and I was diagnosed with arthritis. Despite various interventions including oral medications, supplements, and injections, I continued to suffer. My joints deteriorated to where there was no cartilage left; I was in constant agony and was unable to perform many of the activities that I had been doing before. Consequently, surgery was recommended and the implants used were metal and plastic. My surgery took two hours and I was up and walking in the hallway with the use of a walker the day immediately after my surgery. The physical therapist also applied the CPM (Continuous Passive Motion) machine on the leg that had the surgery. The CPM machine was used to assist the knee through range of motion while I lay and relaxed in bed.
After being discharged from the hospital, I spent ten days in rehab where I received more intensive physical therapy. I was also placed on antibiotics, blood thinner, pain medication, and stool softener (may experience constipation because of the pain medication). Upon arriving home, I received two weeks (3xs per week) of therapy at home then I went to outpatient therapy (3xs per week). After using the walker for a while, I began using the cane. At this time (3months after surgery), I am still using a cane and I am still getting physical therapy. I still have to take pain medication but I do so less frequently than a month ago. I am still experiencing stiffness and I am also applying creams and oils (including Vit. E) several times a day to the surgery site to aid in skin care, and to fight tissue scarring. I continue to apply ice to the area and also follow the exercise plan that my therapist gave me to do at home.
While in the rehab facility, I began going to my surgeon’s office where they checked my incision and removed the staples when it was time. X-rays were done in the early stage following the surgery; blood work was also completed. They pretty much checked for any signs of infection, progress (or lack of progress) or any unusual symptoms. I continue to visit the surgeon’s office and I usually meet with his PA who knows my case and also has a lot of experience in this field.
Well, five months after y surgery, I am finally done with physical therapy. I have had to get a knee manipulation three and a half months after the surgery as my knee was still not bending enough. I continued with therapy the very next day after the manipulation. My therapist tailored my program to suit my needs and that really worked in my favor. I also had to rent a flexinator for home use for one month after the manipulation; this equipment is covered by some insurance but if your insurance does not pay for it, you may be able to rent it. It really helped with breaking up the scar tissues. Now that I no longer receive therapy, I use my recumbent bike and exercise the knee. I also still take pain pills but the frequency has decreased markedly. I find that my knee gets very stiff when there is rain or cold in the forecast. I keep a positive attitude and continue to take it one day at a time. It is amazing how well I am beginning to feel now that it is five months after the surgery.
Wrapping It Up:
Everyone’s journey is different as there are many factors that affect the outcome of the surgery. Some patients experience more pain than others; also, individuals have different levels of pain tolerance. Your surgeon will give you the pain medication that is best for you and will monitor you to decrease chance of over dependence. Some people will walk with a walker/crutch just for a few days then they will begin using a cane; others may have to use the walker/crutch for longer periods. Complying with physical therapy and completing exercises at home will help to prevent tissue scarring and will speed up the healing process; applying ice is also necessary to decrease swelling and discomfort. Frequent applications of creams/ointments will also help with preventing skin discoloration and will also help to decrease tissue scarring. It is important to eat healthy foods as this will aid in the healing process, as well as prevent weight gain.
Sometimes a patient may have to have the knee replacement again because of complication to the originally replaced joint. For example, a patient who is overweight stands the risk of having this surgery repeated because of the pressure of so much weight on the new knee; however, being overweight is not the only reason. Fortunately, a second surgery is an infrequent occurrence. We have to know ourselves and have an understanding of what we want out of this surgery. We also need to understand that we might not heal at the same pace as someone else. We each have our care plan and we just need to comply with the instructions so that we may achieve the best results.
Although I had a total knee replacement of the left knee, I still needed treatment for my right knee as I have osteoarthritis in that knee as well. I was still taking pain medications, was applying heat and cold alternately and was exercising (recumbent bike) but was still experiencing a lot of pain, and was still having much difficulty walking. After reviewing my treatment plan, my doctor decided to give me injections in the knee. I received one cortisone shot in my right knee as there was so much inflammation there. After a few weeks following the cortisone shot, I began the Euflexxa* therapy (three injections in the series – given over a three-week period).
*Euflexxa: a synthetic form of hyaluronic acid (HA) that is injected in the knee to aid in relieving the pain/discomfort caused by osteoarthritis. Hyaluronic acid (HA) is in the synovial fluid which is the fluid that cushions and lubricates the knee, much like the oils that are needed to make the car (engine, etc.) move smoothly. People with osteoarthritis lose their synovial fluid (it thins out) so the knee is dry and creaky like a door hinge that needs to be lubricated. Euflexxa is given as the HA and it works to restore some harmony in the knee, providing cushioning and protection so movement becomes easier.