According to the CDC, 32.5 million adults in the US are affected by osteoarthritis and The American Academy of Orthopedic Surgeons reports that more than 750,000 knee replacements are performed in the US each year. Joint replacement surgeries are becoming more advanced with better and longer lasting material and some surgeons are even using fully customized replacements allowing for an easier recovery. However, no surgery is without a recovery process. Physical therapy is a key part of this process and, while not always pain free, helps patient return to a more active and comfortable lifestyle. It is important to remember that while the arthritis related pain is resolved, functional activities typically take 6 months to a year to be regained. If you have decided on this route, here’s what to expect during your recovery:

Immediately after surgery expect to spend a few days in the hospital where you will receive both nursing and physical therapy care. Typically you will be able to walk with the use of an assistive device such as a walker the same day of the surgery with some assistance from physical therapy or nursing staff. While in the hospital physical therapy is focused on functional activities such as moving in bed, transitioning from sitting to standing, getting on and off the toilet and going up and down steps/stairs all in preparation for returning to home safely.

Post-surgical recovery after leaving the hospital 

Depending on your individual circumstance such as home layout, if you have assistance, and how fast you recover, some will return home after their hospital stay to continue their recovery while others will need higher levels of assistance and supervised rehab before it is safe to return home. In that case most people who need extra help will spend a week or two at a rehab hospital. One could receive up to 3 hours of physical and occupational therapy focusing on functional activities in preparation for a safe return to home. Once at home, you will transition to home health physical therapy or outpatient clinical therapy. Work on functional activities will continue in addition to exercises with goals of regaining knee range of motion and leg strength.

Goals of total knee replacement post-surgical rehab

In post-surgical therapy, the goals are to improve knee range of motion, prevent or limit scar tissue formation, reduce swelling and get a person moving safely. Multiple approaches can be used but at this point in recovery, a hands on approach is particularly appropriate. Massage and soft tissue mobilization are effective at reducing edema, addressing muscle and fascial restrictions, and providing pain relief, while joint mobilizations and aggressive stretching help patients achieve functional knee mobility faster. The treatment should be individualized and goal centered striving for balance for safety, gait training to improve ease of walking, functional strengthening and return to a great quality of life.

At each phase of rehab it is important for the patient or designated care givers, physical therapists and the surgeon to have good communication in order to achieve the best outcomes.