In this article, Dr. Lawrie discusses the average rate of recovery to help guide patient expectations.
Total knee replacement is often associated with a challenging recovery, especially in the first few weeks after surgery. Patients often are frustrated by the pace of return to their desired activities. While recovery rate depends on many factors, including severity of arthritis, age, preoperative function and others, most patients recover their ability to perform activities on a similar timeline. In this article, we discuss the average rate of recovery to help guide patient expectations.
Walking aids are important after surgery to help offload weight from the operated leg. They can help patients recover without a limp faster when used appropriately. They are also important for preventing falls. Most patients use a walker for two weeks and then a cane for two weeks. On average, patients have stopped using their cane by 4 weeks and are able to walk around their house, a grocery store, or neighborhood by themselves with minimal to no limp.
Riding an exercise bicycle is an excellent form of physical therapy after knee replacement surgery. At least 90 degrees of knee motion is required to perform a full revolution of the pedals, so most patients are able to ride a standard stationary bike around 2-4 weeks. Special rehab cycles may be available that can be ridden sooner. Riding a cycle outside requires more strength and balance and usually is possible by 6 weeks
Patients undergoing left total knee replacement may return to driving as soon as they are off narcotic pain medication and able to comfortable sit in the driver seat. This can be as early as one week after surgery. However, after right total knee replacement, driving occurs much later. Driving an automatic transmission car requires good strength, speed and flexibility of the right knee. Most patients prefer to wait 4-6 weeks before getting back behind the wheel after right knee replacement surgery.
Working at a desk all day may seem like an easy task but proves difficult for many in the first few weeks after knee replacement. Sitting for long periods of time may be challenging for the first 2-4 weeks due to discomfort in the knee. Furthermore, surgery leaves most patients feeling fatigued with low energy, making focusing for long periods of time challenging. Most patients prefer to wait 4 weeks before returning to the office. For those working from home or on flexible schedules, they may return to their job as early as 2 weeks.
Many jobs are strenuous and require tasks like walking long distances, standing for long periods of time, climbing ladders and lifting heavy objects. For activities like these, more time is needed to build strength and stability in the knee to allow for these higher demand activities. Patients usually return to these types of jobs 8-12 weeks after the procedure.
For more active patients, returning to sports is an important goal for their recovery. Most patients can return to less strenuous sports, like golf, around 3 months after surgery. Jogging short distances is also possible around 3 months. For more demanding sports like tennis, basketball or snow skiing, patients may need 6 months to one year to return to their desired level of performance.
Yoga and pilates deserve special attention as they place high demand on knee motion and may involve kneeling. Most patients find kneeling on the operated knee challenging and sore, even long term. Expected knee motion for most patients is around 125 degrees of knee flexion, and knee replacement designs are not able to go beyond around 140 degrees of flexion. Therefore, these activities may be performed with appropriate modification as early as 1 month after surgery. Patients will likely have to modify their practice of these exercise types due to the limitations of knee replacements.
Overall, most research has shown that the majority of patients are able to return to their desired level of activity and sports. This article should serve as a rough guide to help set expectations for patients undergoing total knee replacement. It is important patients talk with their surgeons to discuss their own specific timelines of activity restrictions as well as long term activity recommendations.