What are the key issues with knee replacement?

September 24, 2023

How far you can bend your knee and how far you can straighten it!

Those are obviously essential for movement, but, are much more important post knee replacement surgery. Lots of things happen when you have knee replacement surgery as this is a complex joint with 4 major ligaments for support and 7 tendons for muscles the surgery team have to navigate.

The primary reason for knee replacement is wear and tear with osteoarthritis. This means the cartilage wears away so the joint is bone on bone and very painful. The knee replacement is metal plates inserted where the cartilage would normally be and attached. The surgery has a excellent success rate 99% and the majority after recovery are largely pain free.

The issue is movement, specifically range of movement!

Surgery varies depending on the wear and tear of the knee and can be operated on more in a straight position, or bent as required and this can have a impact on movement post-surgery. If it was operated on in a straight position standing and straightening knee is easier. If it was more bent when operated on bending tends to be easier.

This most evident in the initial 6 to 8 weeks of recovery with stiffness and swelling in some cases lots of swelling. So standing, sitting and walking has to be modified and the added issue of using crutches and progressing to one crutch then no crutches. The focus is zero and 90 degrees. This is usually ok with a bit of pushing to 90 degrees and zero is approximate so closer to 8-10 degrees so nearly straight. 6-8 weeks after surgery this is fine as people are still recovering as its major surgery and the inflammation will still not have fully gone.

The issue for knee replacements tends to start now.

You have usually stopped using crutches or sticks now and can move around home and do normal things getting in and out of bed, walking short distances, in and out of a car as you can drive, so able to go out. At this point you may consider to return to work and you feel great as the pain has gone swelling down and life is getting back to normal.

If you are in this situation right now or have had a knee replacement for some time try these two things:

Firstly stand up using something for support and standing on your non operated leg raise your ankle behind you bending your knee aiming for 90 degrees. Have someone look if you cannot see, how does it feel easy or awkward?

Secondly sit on the floor with your legs out straight in front of you. Now most people have tight backs of the legs the hamstrings, how do they feel behind the knee? After only a short period it will feel uncomfortable and your knees will want to bend upwards.

The reason for this is you have not recovered or specifically rehabilitated properly. You will probably have done the exercises regularly initially but not as much now and your body is still healing.

I have been helping people recover from Knee Replacements over the last 12 years if you want to give me a call on 01789 220123 or you can book a conversation below

About the author

Stephen Grinnell MSc Health and Rehabilitation
Pain and Physical Rehabilitation Specialist
Stephen has had his own Pain and Rehabilitation Clinic for over 11 years where he has treated well over 2500 people with lots of different pain and injury issues. Stephen’s personal physical rehabilitation journey started with a serious injury while on active service with the Royal Marines 25 years ago. This injury resulted in a long journey of complementary rehabilitation and two replacement hips. Stephen has developed his own bespoke treatment protocols using a variety of medical devices to help pain and inflammation resulting in accelerated recovery. Expert areas of focus are Plantar Fasciitis Treatment, Back pain issues particularly Lower Back and Sciatica and hip and knee replacement rehabilitation. Stephen previously had a successful academic career lecturing at a variety of Colleges and Universities in the Sports Science, Rehabilitation and Training areas. Stephen has also worked in The Queen Elizabeth Hospital Physiotherapy department during the Covid 19 Pandemic helping the recovery of COVID patients. In 2022 Stephen has been extensively researching and trialling protocols to treat plantar fasciitis. His Expertise has resulted in the successful treatment of 103 people and counting with a current success rate of 93%

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