What should I expect after a knee replacement?
Getting a new replacement can be an intimidating proposition. A lot of the fear or anxiety related to this procedure comes from the unknown. It is true that there can be a lot of variety in how an individual recovers following a knee replacement. In general the most talked about outcomes are what I term the MIRACLE stories and the HORROR stories. The miracle stories sound a little like, “The surgery was a breeze, I had no complications, I flew through physical therapy and I was back on the golf course golfing the best round of my life within 4 weeks!” The horror stories sound a little different, with people saying, “This was the worst decision I’ve ever made. I had an infection, physical therapy was brutal, the surgeon had to go back in and move my knee for me to get my range of motion, and now it has been a year and I still feel like I’m worse than when I started!” Although I have heard these two types of stories, they are the rare exception and I don’t expect either to happen.
Much more often, the outcomes following a knee replacement follow a more predictable trajectory. The timeline looks a little like the bullet points below.
- Surgical date → 1-2 days of feeling “out of it” as you recover from surgery
- 4-5 days after surgery → Start outpatient physical therapy, usually pretty painful and probably more-so than before surgery (you have a lot of healing going on!)
- 2-3 weeks after surgery → Regaining range of motion/strength and walking without an assistive device. Still sore and swollen. Likely not yet sleeping great.
- 2-3 months after surgery → Physical therapy is wrapping up and you will feel like you are getting back to function (walking pretty smooth, in/out of chairs, going up/down stairs again), but not fully better
- 6-8 month → Really happy you had your knee replaced and getting back do things you had been dreaming of before surgery (hiking, pickleball, exercise than challenges your knee)
- 1 year → Vast majority of healing has by now occurred and you are thrilled with your results.
This timeline is not the same for everyone, but on average, it matches the recovery I typically see. There are steps you can take to reduce the risk of being a HORROR story and improve the chance of recovering as expected, if not a bit quicker.
- Practice your pre-operative exercises consistently
- Set up your home in such a way that important areas will be easy to access
- Attend PT consistently and follow instructions/home exercises faithfully
- Keep your surgeon informed about your progress or of any issues that arise
- Keep your expectations realistic – mindset plays a big role in recovery