Measuring Progress After a Knee Replacement at Home
Obviously, when you go home after your knee operation, you’ll be watching to see what progress you are making. My specialist pointed out to me that every patient is different. So it is important to remember as you read this that these are the steps I saw as part of my progress to getting back to as close to normal as the synthetic knee would allow me to get.
All that I write here will be steps towards the recovery for most people. The rate of progress and the order in which the various items improve will be a personal to each patient.
Here I shall discuss problems I had to overcome to show progress.
Area 1- Dressing:
You will have problems dressing, initially. I found putting on briefs, slacks, socks and shoes difficult. To put these on, I needed to sit down on the bed to begin the process. With my right shoe I had to use a shoe horn to get it on my foot.
Area 2- Activities at home:
Getting in and out of bed will become easier as time goes by.
Sitting in comfortable lounge chairs is not possible initially. You need a stout upright plastic chair to begin with. This chair can also be used in the shower if you still require balancing support.
Walking up and down steps will test you out. The physiotherapist would have taught you how to use your crutches on the stairs. Remember going up and down requires a different procedure. You may need to verbally tell you knee to bend when going down the steps i.e. by saying ‘bend’ you are telling your brain to tell the knee to bend. In other words you have to retrain your knee to do the job.
Continue to use your crutches around your home. When you feel confident, try using one only. The next progression, obviously, is to try short distance without the crutch.
Your exercise program will continue at home. The exercises will different from those you did in hospital. They will be designed to correct your walk, add flexibility and strength to your knee. The amount of bend you can achieve with your knee will be a measure of your progress. It seems that a bend of around 120 to 130 degrees is a sign of great progress. (This came for me after 10 weeks.)
When you leave hospital, you will be given instructions about how and when to use your medication. Some of the medication you will take until it runs out. The pain medication continues especially if your pain is still severe. In my case I reduced the use of the strong medication to half the original suggestion and replaced it with my usual paracetamol. Obviously, this meant the pain was going. What also disappeared was my feeling of nausea as I came off the strong pain medication.
Icing my knee and leg continued on a reducing basis and the pressure bandage was no longer required after my 5th week consultation with the specialist. I also found that the pain associated with the sciatic nerve in my right leg had disappeared and I was less troubled by restless legs if I ensured I continued to use paracetamol 4 times a day.
The healing of the wound created by the operation and the colour of the scar were signs of recovery as well. The skin of the lower inside leg was red and the whole leg was always warmer than my left leg. This is normal and part of the healing process.
The swelling of your leg from the upper thigh to the ankle slowly reduces from the ankle upwards. (The swelling in my ankle remained for about 20 weeks.) Some knee swelling may remain permanently. There was a spot on the middle inside of the thigh that remained sore for over 20 weeks. This was where a tourniquet was placed during the operation to prevent blood loss. So the soreness is to be expected.
Area 3 – Outside activities:
Getting in and out of the car is a problem because you can’t bend your knee. So you need to put the seat back as far as possible and recline the back of the seat as far as possible, too, to ease yourself into the car. The same process is required to get out of the car.
I began driving an automatic car after 4 weeks. It was still difficult to get into and out of the car. I found I could only drive for 30 minutes at a time. After 6 weeks, I drove a manual car for short times only. Gradually, the length of time I could drive increased.
Kneeling in church was an issue. I could not knee enough to kneel until after 16 weeks and then for only short periods at a time. Gradually the time I could knee comfortably increased.
I played 4 holes of golf after 6 weeks; 9 holes after 7 weeks and 18 holes after 10 weeks. I felt pain only towards the end of each game and was physically tired.
My physiotherapist advised me to begin riding a stationary bike after 6 weeks and I began riding a road bike after 8 weeks. With the stationary bike, I was to ride with the seat up and to both bend the leg and stretch the leg to increase mobility.
Lastly, the physiotherapist reintroduced new exercises as weeks went by that increased my flexibility, mobility and balance as well as correcting my walking pattern. At each consultation, he measured the degree of bend that I could get with my knee.