Total Recovery Time for Total Knee Replacement Surgery

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Article featured on Arkansas Surgical Hospital

If your doctor has suggested total knee replacement surgery, it’s crucial to know what to expect after the procedure. Recovery from a total knee replacement surgery takes about three months and depends on how well you follow your surgeon’s instructions. Understanding the timeline will help you prepare for the downtime you’ll need while your knee takes time to heal and rebuild strength.

Understanding Total Knee Replacement Surgery

Knee replacement surgery is usually suggested when you experience severe, unrelenting pain that hasn’t been alleviated by other means. If there is loss of motion, a lot of grinding in the joint, or misalignment of the knee, a knee replacement can help.

What to Expect After Total Knee Replacement Surgery

Recovering from a knee replacement is a lengthy but worthwhile process. Here’s what to expect when you recover from your knee surgery at Arkansas Surgical Hospital.

The Day of Surgery

After your knee replacement is complete, you’ll be taken to the post-anesthesia care unit, where a nurse will carefully monitor your vital signs and incision. When your pulse, blood pressure, and breathing rate are normal, you’ll be transferred to your private suite in our patient care unit. In most cases, you’ll stay overnight. You’ll be given pain medication to keep you comfortable after your surgery.

Postoperative Care

You will meet with a physical therapist on the day of or the day after your total knee replacement. Your therapist will develop an exercise regimen to help you with mobility, which will start as soon as possible after surgery to prevent stiffening of the knee joint.

While you’re in the hospital, your physical therapist will take you through various exercises designed to strengthen and stabilize the knee. By the time you leave the hospital, you should be walking independently with an assisted device. Most patients discharge home from the hospital after 1-2 nights. Your surgeon will decide which is appropriate for you.

The First Six Weeks

Before you return home, make sure you have safety features installed. These may include a shower seat in the tub or shower, grab bars where needed, and other mobility aids recommended by your surgeon or physical therapist.

During the first six weeks at home following a total knee replacement surgery, the focus is on healing. You may take over-the-counter medications for pain, which your doctor can recommend.

Eat lots of iron-rich foods to promote healing and keep your strength up. At the six-week point after your surgery, you should be able to stand, sit, walk, and use the stairs unaided.

Returning to Work & Activities

Most patients can return to work after six to eight weeks. If your job involves manual labor or long stretches of time spent walking and standing, it may take you longer to return to full-time work. Your doctor can advise you on when you’re ready. It’s essential to pace yourself and not put too much stress on your knee joint before it’s strong enough to handle the load.

Exercise is vital for proper recovery from total knee replacement surgery. During the first several weeks after your procedure, walking and gentle exercises may be appropriate in addition to your physical therapy. Sports, jogging, and other high-impact activities need to be postponed until about two to three months after your surgery to give your joint time to heal and strengthen. Avoid lifting anything over 40 pounds during the first three months after your total knee replacement surgery.

Getting Back to Normal

Your body and your knee joint will continue to gain strength for several months after your surgery. There shouldn’t be any pain after the first four months. If you continue to feel pain, be sure to talk to your surgeon.

If you’ve participated in activities that are hard on your knees in the past, talk to your doctor about how to return to jogging, skiing, and other activities while protecting your new knee implant. There may be some activities that aren’t advisable.

Most patients fully recover within six months to a year of total knee replacement surgery. While this may seem like a long time, the knee replacement itself can last as long as 15-20 years, giving you many years of comfort and mobility.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Partial and Total Knee Replacement: How are they different?

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From Noyes Knee Institute
Strong, healthy knees are important for your mobility. Unfortunately, the knee joint is easily injured and is susceptible to damage from arthritis. Any damage or injury to the knee is painful and may limit your daily activities. Depending on which part of your knee is damaged, you may have the option of either a total or partial knee replacement.
Learn more about the difference between partial and total knee replacement to decide which is right for you.

Parts of the Knee

The knee joint consists of four bones: the femur, tibia, fibula, and patella. Four ligaments — two collateral and two cruciate — stabilize the connection of the bones while allowing movement. Menisci, or cartilage, minimizes the trauma of the femur and tibia sliding across each other, and small sacs of fluid between bones allow for smooth movement.
The knee is also divided into three distinct compartments: The medial compartment is the section of knee on the inside of the leg, the lateral compartment is on the outside of the leg, and the patellofemoral compartment is the area directly under the kneecap. A partial knee replacement is done when only one of these compartments is damaged.

Total Knee Replacement

A total knee replacement involves resurfacing the ends of the tibia and femur to remove all the damaged tissue. The damage could be deteriorated bone, cracked bone, or calcified bone as well as the damaged cartilage. Once the bad tissue is removed, metal caps are placed over the bones to recreate their original shape and size. These caps may snap on snugly or be glued in place.
With the bones recreated, the doctor determines whether the kneecap has been damaged or not. If there is damage, the underside will be cleaned, and then a plastic disc will be fit into place. Finally, plastic pacers are placed between all parts that may rub or slide against each other during movement.
Either or both of the cruciate ligaments of the knee may be removed during a total knee replacement if they are damaged. The collateral ligaments are not removed. When a cruciate ligament is taken out, the metal caps over the bones have a ridge or locking mechanism to ensure your bones do not move too far or slip out of place.

Partial Knee Replacement

A partial knee replacement requires the same resurfacing and metal caps but involves either the medial or lateral compartment. If both compartments have damaged tissue, or if the problem is within the patellofemoral compartment, a different treatment is needed.
If your knee is unstable and the bones slip to the side, forward, or backward, partial knee replacement is not an option. In addition, the anterior cruciate ligament must not be damaged for this procedure to work. No ligament is removed during a partial knee replacement.
When only one compartment needs repaired, you may consider a partial knee replacement. If your doctor deems you a good candidate for this procedure you will experience a few benefits over a total knee replacement. One of the most important benefit is that your knee will still function the way it always has because less of the joint is removed and replaced.
With a partial replacement, you may require more surgery and a total replacement in the future. One reason for this is that a partial replacement does not last as long as a total replacement. The other reason is that the remaining natural parts of the joint may become damaged as you age and require replacement too.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

7-Things-to-Know-About-Your-New-Knee

7 Things to Know About Your New Knee

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From WebMD

Congrats on your new knee! You’re one of 600,000 Americans who get the joint replaced every year. You may be thrilled to walk again without pain or no longer face staircases with dread.

But don’t expect superhuman powers just yet. Here are seven things to know about your newest body part.

  1. You can do (almost) everything as before.

You can usually expect huge improvements in pain and mobility after knee replacement. But if you never ran a mile in your life, you won’t win races with your new knee. In fact, most surgeons recommend you stay away from high-impact exercises like jogging or jumping rope, even if you did them before. The sheer force can loosen or break your implant or make it wear out faster. Skiing, mountain biking, and even kayaking also may be off-limits because of the chance that you could fall and the break bones around the implant.

You’ll still have lots of other ways to stay active. You can walk, swim, bike, do light hikes, and even play doubles tennis. Weight training will give you stronger muscles and bones. Be sure to ramp up by doing more reps instead of adding heavier weights.

  1. It won’t feel exactly like your old knee.

You’ll have less pain, for one. You also may notice other strange differences. For example, your new knee may click and pop. That’s the sound of the metal and plastic in your implant rubbing against each other. If it doesn’t hurt, you don’t need to worry. You might have trouble kneeling. Bending down won’t harm your new joint. But about half of all people who have knee replacement surgery say they don’t like the feeling when they kneel.

  1. Your new knee will be with you for a long while.

Almost nine out of 10 people find that their new body part holds up for at least 20 years. Even 2 decades after their surgery, people who’ve had their knee replaced tend to be more physically active than their same-age peers with natural knee joints. You can save wear and tear on your new knee by keeping a healthy weight.

  1. You may need extra time at the airport.

Chances are, your knee implant will almost always set off the airport metal detector. That can trigger a hand pat-down screening by a Transportation Security Administration (TSA) agent. If the security checkpoint has a full-body scanner, you can go through that instead. You may still be searched a second time if the agents think they see something suspicious on the screen. You can print and carry a small TSA notification card to let the agent know you have an artificial knee, but this will not always stop them from searching you again. You also can speed things up by wearing clothes that easily let you reveal your surgical scar.

  1. You needn’t worry about visits to the dentist.

For years, both orthopedic surgeons and dentists recommended that people with artificial knees or hips get a shot of antibiotics before any dental procedures, including simple cleaning, that might make gums bleed. They worried that bacteria in the mouth could get into your bloodstream and reach the site of the implant. In 2015, the American Dental Association said it was no longer routinely needed. People with knee implants whose immune systems are weak or who may be prone to infections may still need antibiotics before a dental procedure.

  1. You may need new habits for your knee.

Even if you’re able to return to full normal after your surgery, you’ll need to mind your artificial knee for the rest of your life. Avoid lifting anything more than 20 pounds. That can stress the joint too much. Don’t jerk the leg with the implant. Turn by taking small steps. Pivoting sharply — your toes pointed in one direction and your thigh and upper body in another — can damage the implant and wear it out sooner.

  1. Sometimes, you have to have repeat surgery.

Nearly one out of 10 people end up needing to repair or replace their artificial knee. More than two-thirds of these operations are done within the first year, usually because the joint gets infected. Repeat surgeries that happen later more often involve a loose implant, which can be painful or can leave your knee unstable. Always keep a watch on your artificial joint. If you suddenly have pain, swelling, and trouble moving, call your surgeon.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

3 Trends That Are Disrupting the Total Knee Replacement Market in 2020

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By Amanda Pedersen | Jan 16, 2020 MDDI (Source)

Big changes lie ahead for knee replacements in 2020 and beyond. MD+DI recently spoke with an expert at DePuy Synthes for insight into how three key trends are impacting the market.

In recent years MD+DI has reported on a number of ways emerging technologies such as artificial intelligence (AI) and machine learning (ML), surgical robotics, and 3D-printing are impacting a number of different sectors in medtech. In 2020, we expect these technologies to become even more relevant in the industry, particularly in orthopaedics.

MD+DI recently spoke with an expert at DePuy Synthes for insight into how key trends are impacting the total knee replacement (TKR) market, and how emerging technologies can be part of the solution. Rajit Kamal is vice president and global franchise leader of the knee business at Warsaw, IN-based DePuy Synthes.

Outpatient Is No Longer Just a Niche

“We are seeing a very persistent shift toward outpatient or ambulatory surgical care centers and we think that shift makes sense, Kamal said, pointing out several benefits of this trend, including faster recovery and a lower cost of care.

“We think anything that makes sense for the patients clinically and economically is the right thing to do,” he said.

While outpatient will never be right for every patient, Kamal said up to 70% of TKRs could eventually be handled in outpatient settings such as ambulatory surgical centers (ASCs).

“Outpatient is not a niche,” Kamal emphasized. “Outpatient is the site of care of the patient. So when we develop our portfolio, when we drive innovation, it is with outpatient in mind.”

What that means from an R&D perspective is that companies in the TKR space like Depuy Synthes need to keep in mind the fact that ASCs are smaller than in-patient hospital settings.

“We are making sure we are developing the portfolio that is enabling our customers to be able to operate in this site of care and that means developing products that are portable, smaller, and cost effective,” Kamal said.

Kamal sees opportunities to address these and other unmet TKR needs with emerging technology such as AI, ML, robotics, and 3D printing.

“We think technology has the potential to transform total knee replacement, and we are at the leading edge of that transformation,” Kamal said. “Technology has unlocked a lot of constraints that we had.”

Here are three examples of how technology can play a role in TKR trends:

1. Enhancing Patient Selection and Optimizing Pre-Operative Care

Today, one in five patients who undergo total knee replacement surgery are not fully satisfied but surgeons are perplexed by this problem. Sometimes a patient will come in for a follow-up appointment and everything looks perfect from the surgeon’s perspective, yet the patient is not happy with the outcome of their procedure. Other times, a surgeon may expect a particular patient to be unhappy with their TKR results but the patient will surprise them.

The solution, according to Kamal, is to drive personalization, automation, efficiency, and connectivity. All of these together can really transform total knee replacement, he noted.

“Today, if you go to five different surgeons and ask them which patient is the right patient for surgery you will get five different answers,” Kamal said.

For example, some surgeons will not operate on a patient whose body mass index (BMI) is 35 or higher, while other surgeons are willing to operate on patients whose BMI is 50 and those surgeons say their BMI 50 patients are their most satisfied TKR patients, Kamal explained.

Kamal says this is where AI and machine learning tools could go a long way toward enabling surgeons to not only make the right decision on patient selection, but also help them optimize their pre-operative care pathway.

“So if a patient is not the right patient today, the surgeon can work with them and get them in the best shape before they go through surgery,” he said.

2. Enhancing Efficiency with AI and Robotics

Today, if two different TKR patients go to the same surgeon they are likely to get a similar procedure based on that particular surgeon’s training and clinical experience. Surgeons tend to perform the same procedure on all of their patients because it makes them more efficient, Kamal said.

Once again, AI can help surgeons develop a very personalized surgical plan that analyzes each case based on dynamic motion of the knee and other variables, without costing the surgeon any efficiency.

Surgical robotics also comes into play here.

“We think the right robotic solution should be easy to use, it should be portable, and it should be cost effective,” Kamal said.

Technology also enables surgeons to better monitor their patients remotely.

“Five years ago a patient would be sent home after surgery and come back six weeks later and that’s the first time they saw the surgeon post-op. Or you would end up in the ER if you had a problem,” he said. “Sometimes six weeks might be too late. Technology has unlocked that constraint.”

3. Taking Implant Design to the Next Level with 3D Printing

The emergence of 3D printing in medical device manufacturing has benefited companies like Depuy Synthes not only in terms of cost but in terms of design.

“3D printing enables us to develop designs that we couldn’t do with traditional manufacturing,” he said. “So we are actively investing in all of these technologies because we truly believe that it has the potential to take a very successful procedure to the next level.”

Bringing It All Together

DePuy Synthes recently unveiled its Velys Digital Surgery platform, which will consist of connected technologies that leverage data insights for patients, surgeons, and healthcare systems across the continuum of care. Today, the new platform will focus on joint reconstruction including existing technologies like the Kincise System and the Joint point System, the company noted. Over time, DePuy Synthes plans to add new technologies like its orthopedic robotic solution, patient selection tools, advanced visualization, sensors, and mobile apps. Read more about the Velys Digital Surgery platform here.

At New Mexico Orthopaedics, we like to post articles we think our patients will find interesting. While these posts occasionally contain brand names or product manufactures, etc., we would like to note that we are not necessarily endorsing or recommending these products, brands or techniques.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Combined Knee Ligament Injuries

Combined Knee Ligament Injuries

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Article Featured on AAOS

The knee is the largest joint in your body and one of the most complex. It is also vital to movement. Your knee ligaments connect your thighbone to your lower leg bones. Knee ligament sprains or tears are a common sports injury.

Read more

Common Knee Injuries

What to do if you think your joint replacement is infected

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Article Featured on AAOS

Knee and hip replacements are two of the most commonly performed elective operations. For the majority of patients, joint replacement surgery relieves pain and helps them to live fuller, more active lives.No surgical procedure is without risks, however. A small percentage of patients undergoing hip or knee replacement (roughly about 1 in 100) may develop an infection after the operation.Joint replacement infections may occur in the wound or deep around the artificial implants. An infection may develop during your hospital stay or after you go home. Joint replacement infections can even occur years after your surgery.

This article discusses why joint replacements may become infected, the signs and symptoms of infection, treatment for infections, and preventing infections.

Description

Any infection in your body can spread to your joint replacement.

Infections are caused by bacteria. Although bacteria are abundant in our gastrointestinal tract and on our skin, they are usually kept in check by our immune system. For example, if bacteria make it into our bloodstream, our immune system rapidly responds and kills the invading bacteria.

However, because joint replacements are made of metal and plastic, it is difficult for the immune system to attack bacteria that make it to these implants. If bacteria gain access to the implants, they may multiply and cause an infection.

Despite antibiotics and preventive treatments, patients with infected joint replacements often require surgery to cure the infection.

Total knee implants

Examples of total knee implants. Joint replacement implants are typically made of metal alloys and strong, durable plastic called polyethylene.

Cause

A total joint may become infected during the time of surgery, or anywhere from weeks to years after the surgery.

The most common ways bacteria enter the body include:

  • Through breaks or cuts in the skin
  • During major dental procedures (such as a tooth extraction or root canal)
  • Through wounds from other surgical procedures

Some people are at a higher risk for developing infections after a joint replacement procedure. Factors that increase the risk for infection include:

  • Immune deficiencies (such as HIV or lymphoma)
  • Diabetes mellitus
  • Peripheral vascular disease (poor circulation to the hands and feet)
  • Immunosuppressive treatments (such as chemotherapy or corticosteroids)
  • Obesity

Symptoms

Signs and symptoms of an infected joint replacement include:

  • Increased pain or stiffness in a previously well-functioning joint
  • Swelling
  • Warmth and redness around the wound
  • Wound drainage
  • Fevers, chills and night sweats
  • Fatigue

Doctor Examination

When total joint infection is suspected, early diagnosis and proper treatment increase the chances that the implants can be retained. Your doctor will discuss your medical history and conduct a detailed physical examination.

Tests

Imaging tests. X-rays and bone scans can help your doctor determine whether there is an infection in the implants.

Laboratory tests. Specific blood tests can help identify an infection. For example, in addition to routine blood tests like a complete blood count (CBC), your surgeon will likely order two blood tests that measure inflammation in your body. These are the C-reactive Protein (CRP) and the Erythrocyte Sedimentation Rate (ESR). Although neither test will confirm the presence of infection, if either or both of them are elevated, it raises the suspicion that an infection may be present. If the results of these tests are normal, it is unlikely that your joint is infected.

Additionally, your doctor will analyze fluid from your joint to help identify an infection. To do this, he or she uses a needle to draw fluid from your hip or knee. The fluid is examined under a microscope for the presence of bacteria and is sent to a laboratory. There, it is monitored to see if bacteria or fungus grow from the fluid.

The fluid is also analyzed for the presence of white blood cells. In normal hip or knee fluid, there are a low number of white blood cells. The presence of a large number of white blood cells (particularly cells called neutrophils) indicates that the joint may be infected. The fluid may also be tested for specific proteins that are known to be present in the setting of an infection.

Treatment

Nonsurgical Treatment

In some cases, just the skin and soft tissues around the joint are infected, and the infection has not spread deep into the artificial joint itself. This is called a “superficial infection.” If the infection is caught early, your doctor may prescribe intravenous (IV) or oral antibiotics.

This treatment has a good success rate for early superficial infections.

Surgical Treatment

Infections that go beyond the superficial tissues and gain deep access to the artificial joint almost always require surgical treatment.

Debridement. Deep infections that are caught early (within several days of their onset), and those that occur within weeks of the original surgery, may sometimes be cured with a surgical washout of the joint. During this procedure, called debridement, the surgeon removes all contaminated soft tissues. The implant is thoroughly cleaned, and plastic liners or spacers are replaced. After the procedure, intravenous (IV) antibiotics will be prescribed for approximately 6 weeks.

Staged surgery. In general, the longer the infection has been present, the harder it is to cure without removing the implant.

Late infections (those that occur months to years after the joint replacement surgery) and those infections that have been present for longer periods of time almost always require a staged surgery.

The first stage of this treatment includes:

  • Removal of the implant
  • Washout of the joint and soft tissues
  • Placement of an antibiotic spacer
  • Intravenous (IV) antibiotics

An antibiotic spacer is a device placed into the joint to maintain normal joint space and alignment. It also provides patient comfort and mobility while the infection is being treated.

Knee Implant Compressors

(Top) These x-rays show an original knee replacement from the front and from the side. (Bottom) An antibiotic spacer has been placed in the joint during the first stage of treatment for joint replacement infection.

Spacers are made with bone cement that is loaded with antibiotics. The antibiotics flow into the joint and surrounding tissues and, over time, help to eliminate the infection.

Patients who undergo staged surgery typically need at least 6 weeks of IV antibiotics, or possibly more, before a new joint replacement can be implanted. Orthopaedic surgeons work closely with other doctors who specialize in infectious disease. These infectious disease doctors help determine which antibiotic(s) you will be on, whether they will be intravenous (IV) or oral, and the duration of therapy. They will also obtain periodic blood work to evaluate the effectiveness of the antibiotic treatment.

Once your orthopaedic surgeon and the infectious disease doctor determine that the infection has been cured (this usually takes at least 6 weeks), you will be a candidate for a new total hip or knee implant (called a revision surgery). This second procedure is stage 2 of treatment for joint replacement infection.

During revision surgery, your surgeon will remove the antibiotic spacer, repeat the washout of the joint, and implant new total knee or hip components.

An antibiotic spacer in a hip joint.

This x-ray shows knee components used in a revision surgery (stage 2). Note that the stems of the implants are longer to help support bone that has been compromised due to infection and removal of the previous implants.

Single-stage surgery. In this procedure, the implants are removed, the joint is washed out (debrided), and new implants are placed all in one stage.  Single-stage surgery is not as popular as two-stage surgery, but is gaining wider acceptance as a method for treating infected total joints. Doctors continue to study the outcomes of single-stage surgery.

Prevention

At the time of original joint replacement surgery, there are several measures taken to minimize the risk of infection. Some of the steps have been proven to lower the risk of infection, and some are thought to help but have not been scientifically proven. The most important known measures to lower the risk of infection after total joint replacement include:

  • Antibiotics before and after surgery. Antibiotics are given within one hour of the start of surgery (usually once in the operating room) and continued at intervals for 24 hours following the procedure.
  • Short operating time and minimal operating room traffic. Efficiency in the operation by your surgeon helps to lower the risk of infection by limiting the time the joint is exposed. Limiting the number of operating room personnel entering and leaving the room is thought to the decrease risk of infection.
  • Use of strict sterile technique and sterilization instruments. Care is taken to ensure the operating site is sterile, the instruments have been autoclaved (sterilized) and not exposed to any contamination, and the implants are packaged to ensure their sterility.
  • Preoperative nasal screening for bacterial colonization. There is some evidence that testing for the presence of bacteria (particularly the Staphylococcus species) in the nasal passages several weeks prior to surgery may help prevent joint infection. In institutions where this is performed, those patients that are found to have Staphylococcus in their nasal passages are given an intranasal antibacterial ointment prior to surgery. The type of bacteria that is found in the nasal passages may help your doctors determine which antibiotic you are given at the time of your surgery.
  • Preoperative chlorhexidine wash. There is also evidence that home washing with a chlorhexidine solution (often in the form of soaked cloths) in the days leading up to surgery may help prevent infection. This may be particularly important if patients are known to have certain types of antibiotic-resistant bacteria on their skin or in their nasal passages (see above). Your surgeon will talk with you about this option.
  • Long-term prophylaxis. Surgeons sometimes prescribe antibiotics for patients who have had joint replacements before they undergo dental work. This is done to protect the implants from bacteria that might enter the bloodstream during the dental procedure and cause infection. The American Academy of Orthopaedic Surgeons has developed recommendations for when antibiotics should be given before dental work and for which patients would benefit.  In general, most people do not require antibiotics before dental procedures. There is little evidence that taking antibiotics before dental procedures is effective at preventing infection.

    Antibiotics may also be considered before major surgical procedures; however, most patients do not require this. Your orthopaedic surgeon will talk with you about the risks and benefits of prophylactic antibiotics in your specific situation.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Knee Replacement Surgery for Arthritis

What Can I Do After Knee Replacement Surgery? When to Return to Normal Activity

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Article Featured on AAOS

After having a knee replacement, you may expect your lifestyle to be a lot like it was before surgery— but without the pain. In many ways, you are right, but returning to your everyday activities takes time. Being an active participant in the healing process can help you get there sooner and ensure a more successful outcome.

Even though you will be able to resume most activities, you may want to avoid doing things that place excessive stress on your “new” knee, such as participating in high-impact sports like jogging. The suggestions here will help you enjoy your new knee while you safely resume your daily activities.

Hospital Discharge

Your hospital stay will typically last from 1 to 4 days, depending on the speed of your recovery. If your knee replacement is performed on an outpatient basis, you will go home on the same day as surgery.

Before you are discharged from the hospital, you will need to accomplish several goals, such as:

  • Getting in and out of bed by yourself.
  • Having acceptable pain control.
  • Being able to eat, drink, and use the bathroom.
  • Walking with an assistive device (a cane, walker, or crutches) on a level surface and being able to climb up and down two or three stairs.
  • Being able to perform the prescribed home exercises.
  • Understanding any knee precautions you may have been given to prevent injury and ensure proper healing.

If you are not able to accomplish these goals, it may be unsafe for you to go directly home after discharge. If this is the case, you may be temporarily transferred to a rehabilitation or skilled nursing center.

When you are discharged, your healthcare team will provide you with information to support your recovery at home. Although the complication rate after total knee replacement is low, when complications occur they can prolong or limit full recovery. Hospital staff will discuss possible complications, and review with you the warning signs of an infection or a blood clot.

Warning Signs of Infection

  • Persistent fever (higher than 100 degrees)
  • Shaking chills
  • Increasing redness, tenderness or swelling of your wound
  • Drainage of your wound
  • Increasing pain with both activity and rest

Warning Signs of a Blood Clot

  • Pain in your leg or calf unrelated to your incision
  • Tenderness or redness above or below your knee
  • Increasing swelling of your calf, ankle or foot

In very rare cases, a blood clot may travel to your lungs and become life-threatening. Signs that a blood clot has traveled to your lungs include:

  • Shortness of breath
  • Sudden onset of chest pain
  • Localized chest pain with coughing

Notify your doctor if you develop any of the above signs.

Recovery at Home

You will need some help at home for several days to several weeks after discharge. Before your surgery, arrange for a friend, family member or caregiver to provide help at home.

Preparing Your Home

The following tips can make your homecoming more comfortable, and can be addressed before your surgery:

  • Rearrange furniture so you can maneuver with a cane, walker, or crutches. You may temporarily change rooms (make the living room your bedroom, for example) to avoid using the stairs.
Home recovery center

Prepare a “recovery center” by placing items that you use frequently within easy reach.

  • Remove any throw rugs or area rugs that could cause you to slip. Securely fasten electrical cords around the perimeter of the room.
  • Get a good chair—one that is firm with a higher-than-average seat and has a footstool for intermittent leg elevation.
  • Install a shower chair, gripping bar, and raised toilet seat in the bathroom.
  • Use assistive devices such as a long-handled shoehorn, a long-handled sponge, and a grabbing tool or reacher to avoid bending over too far.

Wound Care

During your recovery at home, follow these guidelines to take care of your wound and prevent infection:

  • Keep the wound area clean and dry. A dressing will be applied in the hospital and should be changed as often as directed by your doctor. Ask for instructions on how to change the dressing before you leave the hospital.
  • Follow your doctor’s instructions on how long to wait before you shower or bathe.
  • Notify your doctor immediately if the wound appears red or begins to drain. This could be a sign of infection.

Swelling

You may have moderate to severe swelling in the first few days or weeks after surgery. You may have mild to moderate swelling for about 3 to 6 months after surgery. To reduce swelling, elevate your leg slightly and apply ice. Wearing compression stockings may also help reduce swelling. Notify your doctor if you experience new or severe swelling, since this may be the warning sign of a blood clot.

Medication

Take all medications as directed by your doctor. Home medications may include opioid and non-opioid pain pills, oral or injectable blood thinners, stool softeners, and anti-nausea medications.

Be sure to talk to your doctor about all your medications—even over-the-counter drugs, supplements and vitamins. Your doctor will tell you which over-the-counter medicines are safe to take while using prescription pain medication.

It is especially important to prevent any bacterial infections from developing in your artificial joint. Some patients with special circumstances may be required to take antibiotics prior to dental work to help prevent infection. Ask your doctor if you should take antibiotics before dental work. You may also wish to carry a medical alert card so that, if an emergency arises, medical personnel will know that you have an artificial joint.

Diet

By the time you go home from the hospital, you should be eating a normal diet. Your doctor may recommend that you take iron and vitamin supplements. You may also be advised to avoid supplements that include vitamin K and foods rich in vitamin K if you taking the blood thinner medication warfarin (Coumadin). Foods rich in vitamin K include broccoli, cauliflower, brussel sprouts, liver, green beans, garbanzo beans, lentils, soybeans, soybean oil, spinach, kale, lettuce, turnip greens, cabbage, and onions.

Continue to drink plenty of fluids and avoid alcohol. You should continue to watch your weight to avoid putting more stress on the joint.

Resuming Normal Activities

Once you get home, you should stay active. The key is to not do too much, too soon. While you can expect some good days and some bad days, you should notice a gradual improvement over time. Generally, the following guidelines will apply:

Driving

In most cases, it is safe to resume driving when you are no longer taking opioid pain medication, and when your strength and reflexes have returned to a more normal state. Your doctor will help you determine when it is safe to resume driving.

Sexual Activity

Please consult your doctor about how soon you can safely resume sexual activity. Depending on your condition, you may be able to resume sexual activity within several weeks after surgery.

Sleeping Positions

You can safely sleep on your back, on either side, or on your stomach.

Return to Work

Depending on the type of activities you do on the job and the speed of your recovery, it may take from several days to several weeks before you are able to return to work. Your doctor will advise you when it is safe to resume your normal work activities.

Sports and Exercise

Continue to do the exercises prescribed by your physical therapist for at least 2 months after surgery. In some cases, your doctor may recommend riding a stationary bicycle to help maintain muscle tone and keep your knee flexible. When riding, try to achieve the maximum degree of bending and straightening possible.

As soon as your doctor gives you the go-ahead, you can return to many of the sports activities you enjoyed before your knee replacement.

  • Walk as much as you would like, but remember that walking is no substitute for the exercises prescribed by your doctor and physical therapist.
  • Swimming is an excellent low-impact activity after a total knee replacement; you can begin swimming as soon as the wound is sufficiently healed. Your doctor will let you know when you can begin.
  • In general, lower impact fitness activities such as golfing, bicycling, and light tennis will help increase the longevity of your knee and are preferable over high-impact activities such as jogging, racquetball and skiing.

Air Travel

Pressure changes and immobility may cause your operated leg to swell, especially if it is just healing. Ask your doctor before you travel on an airplane. When going through security, be aware that the sensitivity of metal detectors varies and your artificial joint may cause an alarm. Tell the screener about your artificial joint before going through the metal detector.

New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.