According to the Centers for Disease Control and Prevention (CDC), there were just over 1 million combined total hip/total knee replacement surgeries performed in 2010 in the United States alone. Many people are very anxious about deciding if they “need” a joint replacement. To help you better understand what you can expect with these surgeries, I’ve done a two-part series on the topic.
In my previous post (What to Expect After Total Knee or Hip Surgery), I talked about some of the things you can expect following your surgeries. Now, I’ll answer some of the most common questions I receive as a physical therapist about these surgeries.
When can I drive?
In order to drive, you should have full control of your operated leg and demonstrate good quadriceps strength. Also, you should no longer be taking pain medications. Ultimately, you and your surgeon will decide when it’s best for you to drive, but it’s typically 4-6 weeks after surgery. Also, when you do return to driving, I recommend practicing in an empty parking lot to practice switching from gas to brakes and vice versa and work on your reactions in a safe environment.
Can I kneel after a total knee replacement?
This has been a gray area since I’ve graduated from school. And in my research, I have not found anything that says you cannot kneel. However, I have found that kneeling should be avoided for a minimum of 6 weeks. If/when you decide to kneel, I recommend kneeling on a soft surface. Also, kneel on both knees before kneeling only on your new knee to understand better how this will feel. Ultimately, this is a good conversation to have with your surgeon and will likely be based on your own physical condition and comfort with kneeling.
Why do I need a TED Hose?
TED hose help keep swelling down in your legs and will prevent blood from pooling in your lower legs. Essentially, they will help prevent blood clots. Your surgeon will most likely give you instruction on how long and when to wear the TED hose. Usually, wearing them day and night initially, then discontinuing wearing them at night. You will probably be wearing these for 1-3 months depending on your activity level, amount of lower extremity swelling, and other risk factors.
Should I rub my incision with Vitamin E or other oil?
No, we want to see a dry, healthy scar following surgery. Once the incision is closed, this can be reconsidered.
What are the signs of infection?
Only 1 in 100 patients may develop an infection following a total joint replacement. The following are symptoms that would lead to a follow up with your surgeon:
- Increased pain/stiffness or swelling to the joint
- Warmth (Note: you will have some increased warmth to the joint to begin with as your body heals)
- Redness around the joint/incision (If you start noticing redness around the incision, keep a note of the area, if it becomes larger call the surgeon)
- Drainage from the incision
- Increased fatigue
- Night sweats, chills, and fever
When can I go swimming?
Once the incision has fully healed; usually 8-12 weeks after surgery.
How long do I need to do my exercises?
Health care is ever changing, and will continue to change. Rehab visits are becoming reimbursed less and less so as a physical therapist (PT) we have to really focus on educating our patients and being efficient with each visit we see you. I suspect in the next five years (likely less than that), a patient will only have 4-8 visits with a PT (currently we see patients for 6-18 visits, and sometimes more following a joint replacement).
With that being said, do the exercises that have been given to you 1-2 times per day for the first 4-8 weeks. Then it is likely safe to perform exercises 3x per week for an additional 8 weeks. It will take 3-6 months for you to return to most daily activities and can take 6-12 months before you feel “normal.” Remember, if you start noticing weakness in everyday activities or difficulty with certain tasks, resume these exercises as needed!
I hope this post answers some of the questions you may have regarding total hip and knee replacements. Have a question of your own? Ask in the comments below!
Bryon Renwand, PT, DPT, CSCS, works with ProMedica Total Rehab and received his Bachelors of Science in Exercise Science from the University of Toledo, where he also received his Doctorate of Physical Therapy. For his full bio and other articles, please click here.