Life After Knee Replacement: What to Expect

For many people with worn-out knees, a knee replacement is the start of a more active life. It is not a quick fix. The weeks after surgery take real effort, and the result depends a great deal on the exercises you do at home. This guide explains what the operation involves and what life is typically like in the days, weeks and months that follow.

What a knee replacement is

In a knee replacement, the damaged surfaces at the ends of the thigh bone and shin bone are removed and covered with metal and plastic parts. The new surfaces glide smoothly, so the grinding pain of arthritis stops. A total knee replacement resurfaces the whole joint. A partial knee replacement resurfaces only the worn side, when the rest of the knee is healthy. The operation usually takes one to two hours under a spinal or general anaesthetic, and a typical hospital stay is two to four days.

Who it is for

A knee replacement is usually considered when knee pain is severe, limits walking, stairs or sleep, and has not improved with painkillers, physiotherapy, weight loss or injections. X-rays usually show the joint worn down. There is no fixed age. The decision rests on how much the knee affects your life and on your general health. Many knees improve without surgery, so it is worth trying other treatments first when they have a fair chance of helping.

The first days and weeks

Most patients stand with help on the day of surgery or the next day. Physiotherapists teach you to walk with a frame or crutches and to manage stairs before you go home. At home, expect swelling, bruising and tiredness. Pain usually eases week by week. Keep up the bending and straightening exercises several times a day, even when they are uncomfortable; this is the most important thing you can do for how well the knee will bend. Use ice and keep the leg raised when resting. Remove loose rugs and clutter, and ask family to help with shopping and cooking for the first few weeks.

Six weeks to three months

Many people walk with a stick or without support by about four to six weeks. Driving is usually possible once you can bend the knee well and brake hard without pain, often around six weeks; check with your surgeon and your car insurer first. Desk work often resumes at around six weeks, and more physical work later. By about three months, most people are back to most daily activities. Swelling and warmth around the knee can take up to a year to settle completely, and that is normal.

Activity, kneeling and prayer

Walking, swimming, cycling and golf are generally encouraged once you have recovered. High-impact activities such as running and jumping sports put more strain on the new joint, so ask before taking them up. Many patients can kneel after recovery, though it may feel strange or uncomfortable at first. Deep bending, such as sitting cross-legged on the floor or the full positions of prayer, varies from person to person. If this matters to you, say so at your first consultation, so your goals are part of the plan from the start.

Warning signs and when to call

Call the clinic the same day if the wound becomes hot, red or starts to leak, if you develop a fever, or if your calf becomes swollen and painful. Sudden breathlessness or chest pain needs emergency care: call 999 or go to the nearest emergency department. Most knee replacements keep working for 15 to 20 years or more. If your knee pain is limiting your life, a consultation is a good place to start. Dr. Subhash Ushakoyala trained in hip and knee replacement on a fellowship in 2016 and can explain whether a replacement, or another treatment, suits your knee.