A few weeks ago, Channel 5 aired a documentary called Operation Live: Total Knee Replacement. Did you catch it?
It caused quite a stir, mainly due to its no-holds-barred content. As the title implies, the programme featured live coverage of a patient (his name was Howard) undergoing a total knee replacement at the Royal London Hospital. You can see it on catch-up here (free My5 account required), though do exercise viewing caution, for obvious reasons.
For anyone who works with Total Knee Replacements (TKR) or is considering one, Operation Live was a fascinating watch. It wasn’t for the squeamish. But that was the key take-home point: for all its great benefits, TKR does take significant recovery time. More than many patients realise.
So what does that look like in practice? Keep in mind that recovery times vary from person to person, but here is a general guide.
Right before your operation, you’ll be given an anaesthetic to send you to sleep. This is usually done by injection into the spine, and its pain-relieving effects last for about 24 hours. When you wake up, you’ll see your surgeon. Medical staff will be coming in and out to check your progress. Even on Day 1, you’re likely to be practising with crutches and getting in and out of bed. By Day 2, you might venture into the corridor. Your new knee will be fully weight-bearing from the start, though the area will feel very painful.
Day 3 (or sometimes four) is when most people are able to leave hospital. To be sent home, we need to tick four key boxes: your wound will be dry, your knee can bend to 90 degrees, you can walk with crutches and you can get yourself up and down stairs (again, with crutches). Here and at the Pre-Assessments, you’ll be getting help and tips from the physiotherapy team. They will also give you exercises to do at home over the coming weeks.
On leaving hospital, you’ll be given a two-week supply of pain relief to take home. This is normally a simple analgesic like Cocodamol, taken every six hours or so. By two weeks, however, most people have already stopped taking them. At this point you will come back to the hospital to meet the physiotherapy team again. They will want to know about your progress. They’ll check that you can bend and straighten your knee. They will also give you some more exercises to work on.
At six weeks, we expect life to be returning to something like normality. You won’t be entirely pain-free. The knee will still feel sore. But by now you should be feeling more familiar with your new joint, and you should be going for short walks – ideally without crutches. Six weeks is also the point that most patients are able to drive again. You need to be certain that you can remain in control of the vehicle at all times. (If you’re still unable to drive after three months, you’ll need to inform the DVLA.)
6 months +
For many knee patients, six months is the first key horizon for a full recovery. This is the point where you should feel the benefits of surgery in daily life. That means different things for different people depending on age, fitness and inclination, from pottering about the house to going for three or four-mile rambles in the countryside. Even then, however, there’s scope for progress. The Oxford Knee Score, a questionnaire that tests pain and function after knee replacements, demonstrates that patients often continue to improve for up to two years after the operation.
Interested in finding out more about Knee Replacement and how you can improve recovery times? We are always happy to meet with patients to offer advice, direction and support. Why not get in touch? We’d be delighted to hear from you.