Neighbor News
Knee Replacement Health and Wellness
Recovering from Knee Replacement Surgery: What you rarely hear, and how to prepare for it - my friend Dr. Freeman wrote this article.
How about some real insight in to how to recover well from knee replacement surgery. Some excerpts below - click the link for the full article.
Your body cannot tell the difference between surgery and trauma—and responds to surgery exactly as it would if your body had experienced traumatic injury. Consequently, your body sends inflammatory cells to the site of injury to help heal it, and the damaged cells and blood vessels leak fluid —creating swelling in, and around, your knee.
The single most important thing you can do is to pump the fluid out of your leg (into the lymph—then to the blood, and finally out of the body in the urine). Pumping requires that you bend your knee and flex your leg muscles—which, as I have just discussed, is difficult. Because you cannot do this effectively, someone else, usually your physical therapist (in standard therapy) will bend your leg for you. To do this they usually push or pull on your leg, to bend it, as far as you can stand it; for as long as you can stand it. This bending really hurts– because it adds pressure to an already swollen joint. Therapists typically repeat this pumping process three to five times at each physical therapy visit— (three times a week). Sometimes, they push too hard and damage your knee causing more swelling and pain. In other cases, they don’t push hard enough and little fluid is pumped out of your knee.
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What is commonly discussed is the range of motion, which encompasses both your ability to straighten your leg (extension) and bend your leg (flexion). You need to be able to straighten your leg, and bend your leg to about 110-115 degrees. Unless, you achieve these benchmarks, you won’t be able to engage in many activities of daily living (ADLs). You must regain an adequate range of motion—if you don’t your surgeon will likely perform either a manipulation under anesthesia or a second surgery called an arthrolysis. The latter is used when scar tissue formation is extensive—usually more than 2 months after surgery. Either procedure causes you to start your rehabilitation over again. So, therapists work extremely hard to gain range of motion. But, having achieved a range of motion that should allow you to engage, say ski, does not mean you have the strength to go skiing. It merely means you can adequately bend your leg.
Following knee replacement surgery, you are in pain, and the last thing you want to hear is how urgent it is that you get rid of the fluid—which will increase your range of motion and mitigate the adverse consequences discussed above. But, the truth is that you are in a race to gain range of motion and break up the scar tissue before it forms fibers. Once fibers have formed you can no longer increase the flexibility of joint beyond what it has– without medical intervention.