Total Knee Replacements…What you “Knee” to Know
Written by: Matt Ehler – Managing Partner – Steindler Physical Therapy
Cracking and grinding. Giving way. Pain. These are common complaints of people with knee pain.
Afraid of falling. Can’t sleep at night. Unable to enjoy normal activities. These are some reasons why people decide to have a knee replacement.
As a physical therapist, I have worked with many people after their surgery as they regained their flexibility and strength to get back to walking the dog, playing with their grandkids, or return to work. In my current location, I also have the opportunity to talk with people before they have their surgery to help them plan for their recovery, and understand the impact this will have on their lives.
Knee replacement surgery is not new, (it was first performed in 1968), and it’s not uncommon, as over 700,000 knee replacements are performed each year in the United States. For many, it is the best solution for what has become a significant limiting factor in their quality of life. Here is a picture of a healthy knee, and one that has been damaged by arthritis and “wear and tear”:
The decision to have a knee replacement surgery is a serious one that should involve the patient, their family members, and an orthopedic surgeon. The process involves several days in the hospital after surgery, and weeks/months of outpatient physical therapy to help restore normal joint range of motion and strength. The end result is a reduction in pain, restoration of mobility, and a return to activity. The orthopedic surgeons at Steindler Orthopedic Clinic in Iowa City perform about 400 knee replacements each year. Dr. Cory Christiansen cites the main reasons for performing knee replacement surgery as pain that prevents a person from activity they want to perform after other conservative treatments have failed. He estimates that most people are able to resume prior activities within 3-4 months after surgery, but total healing can take 6 months up to 1 year.
The procedure involves replacing the worn out cartilage on the ends of the bones with metal components to prevent further bone deterioration, with a plastic spacer between the components. Here is picture of a knee pre and post surgery:
What can people with knee pain do who are experiencing limitations in their activities or are considering knee replacement?
1 – Maintain your mobility. Many people experience a gradual loss of joint range of motion and flexibility that affects the way the knee normally moves during walking and activities of daily living. Over time people start to compensate and may begin to experience hip or low back pain. Many people can no longer walk for regular exercise, try stationary or recumbent biking to keep up cardiovascular conditioning. Try to keep the knee flexible by bending up toward your chest as far as you can, and prop your foot on a chair to let gravity stretch the muscles on the back of the knee.
2 – Keep your knee and hip strong. The more strength you have in the muscles around your knee the more you are able to protect the joint from further damage. Many activities, like descending stairs, are largely dependent on hip strength to avoid excess workload on the knee. Performing leg lifts and standing leg swings can help keep these muscles in shape.
3 – Eat right, drink water. Losing just 5-10 pounds can have a significant impact on the amount of pressure through your knee with walking, and may help decrease pain. Try to cut out foods/snacks that are high in sugar or processed wheat. Drinking plenty of water will help to keep your muscles and joints hydrated for activity during the day.
4 – See your physician, improve your general health. If you haven’t had a physical in a while, this would be a good time to consult with your doctor to ensure that your heart and other body systems are healthy enough for the surgery. If you are a smoker, there is extra incentive to quit. Quitting smoking will improve circulation for healing tissue, lessen the chances of a post-operative infection, and improve cardiovascular function for exercise and walking.
If you need some assistance with any of these activities, consult with a Physical Therapist at Progressive Rehabilitation Associates or Steindler Physical Therapy. We can help design an exercise program that meets your needs and matches your ability level. We can also use massage, manual stretching, electrical stimulation, and ultrasound if needed to relieve pain and improve mobility. We also offer Wellness Classes that are individualized and conducted by a certified Athletic Trainer/Wellness Coach if you would like guidance along the way.