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Knee replacements become more common with age. For an indication of that, take a quick look at the NHS chart below:
If you’re in your 60s or 70s, in other words, the chances are you know someone who’s had knee replacement surgery. In fact, you may have even quizzed them about it yourself. “How bad was their pain beforehand? What was it like afterwards? Are they glad they went for it?” And so on.
The flipside, of course, is that it’s hard not to use that friend as a measuring stick once you’ve had the procedure yourself. Mrs B went on a rambling expedition six weeks after her op. You’re still hobbling around on crutches at week 7. Why the disparity?
If you find yourself in this position – or if you’re waiting for knee surgery and worried you might – here are some things to bear in mind.
3 things that affect recovery after a knee replacement
The most important thing to remember about replacement surgery is that everybody responds differently to it. Just as no two knees are exactly the same, neither are two operations – nor two recovery periods. But there are some general underlying factors will make a significant difference to your progress.
Context – age, as you’d expect, has a major bearing on recovery times. The older you are, the longer it will take for the joint tissues to recover, and for your surrounding muscles to rebuild their strength. But your health and fitness may well be a bigger factor overall. The more you can do to strengthen yourself before and after your operation, the greater the chance of a smoother recovery (see below)
Damage – your progress will also be affected by the extent and severity of arthritis in your joint. Is the lost cartilage mainly confined to one compartment of your knee? That might mean a partial knee replacement rather than a total knee replacement, which generally means a faster recovery. Longstanding, severe arthritic damage across the whole joint will likely take longer
Complications – some replacement operations are more involved than others. If your knee is very stiff and hard to bend, for example, the surgeon may need to work on the surrounding ligaments in order to loosen it up. That means more soft-tissue impact during the op, which will naturally affect your recovery afterwards
3 ways you can improve your chances of a faster recovery
Those things being said, however, there are some things every knee replacement patient can do to boost their chances of a strong recovery.
Prehabilitation – think of “prehab” as the image of rehab: it’s essentially about improving strength and fitness before you go into theatre. By doing this, you give your body a stronger platform for the recovery period. This may not be easy. Few people want to think about an exercise regime when their knees are in constant pain. But the little things you do to improve strength and flexibility will pay off after surgery. For more detail on this topic, see Why “prehab” is vital for ACL surgery
Exercise – unlike prehab, exercise is something you can work on, and improve, after your knee joint has been fitted. Here we’re talking about simple routines such as “straight-leg raises”, “quadriceps sets” and supported knee bends. Your physio will show you which ones to use, and how to do them properly. But studies show it’s worth the effort. Even when the effort is hard, at least at first
Psychology – though it sounds fanciful, mentality has a big part to play in strong physical recoveries. Research has found that staying optimistic actually reduces both physical symptoms and even the intensity of pain. Sustaining a positive mental outlook is easier said than done, of course. But it’s more achievable when tackled with others. Initiatives like the ESCAPE-pain course, which link you with fellow knee-replacement patients, show that group-based recovery can be extremely powerful
Interested in reading more about recovery from knee replacement? You may find these articles helpful…
The 60-second guide to knee replacements
How long does it take to recover from a total knee replacement? A surgeon’s timeline
Knee surgery checklist: 12 things to do before your operation
Total knee replacement: 5 ways to improve your recovery time
* Table source: Patient Reported Outcome Measures (PROMS) in England for Hip & Knee Replacements, April 2018 – March 2019
