Knee arthroplasty is a surgical procedure in which the diseased joint is replaced with an artificial prosthesis, made with materials such as titanium or plastic. The most common problem that requires this type of surgery is severe osteoarthritis (usually due to wear and tear). At least 600,000 knee arthroplasties are performed every year in the United States. Due to its particularly invasive nature, this surgery causes severe post-operative pain, therefore it is very important to learn how to manage it.
Steps
Part 1 of 3: Dealing with Pain at Home
Step 1. Rest and lift the limb
Once you are discharged from the hospital, you will be told to rest and raise the affected leg during the first few days to reduce swelling, inflammation and thereby also relieve pain. When sitting on the sofa or chair, put pillows under your leg, but try not to hyperextend the knee and risk straining it - do a few push-ups with the joint when you rest. Also consider putting a pillow under your knee when sleeping on your back.
- It is not a good idea to stay in bed all the time after the surgery, because some movements (even in the surrounding joints such as the hips and ankles) are needed to stimulate blood circulation and help the healing process.
- Another effective way to reduce pain, swelling and prevent possible emboli is to wear graduated compression stockings. At first you will have to wear them day and night, but after a few weeks they will only be needed when you sleep.
- There are two types of knee replacement surgeries: full or partial arthroplasty. The rest needed in the case of total replacement is obviously longer: 3-5 days of hospitalization and a subsequent convalescence of at least 1-3 months.
Step 2. In the early stages, apply ice to the knee
When the knee is still in the acute phase (still inflamed and sore) it is important to put ice on. This remedy is effective for all types of acute injuries affecting the musculoskeletal system. Doing so reduces swelling and pain, especially in the muscles. Apply it to the affected area every 2-3 hours for a couple of days, then reduce the frequency of the compresses as the swelling improves.
- Compress the ice on the knee using a band or elastic support to control inflammation, but do not squeeze too tightly, to avoid interrupting the blood flow which would cause further damage to the knee and lower leg.
- Always wrap the ice or gel pack in a thin towel to prevent cold sores on the skin.
- If you don't have ice or gel packs, you can use a bag of frozen vegetables that you can take straight from the freezer.
Step 3. Use crutches to move
During the first few weeks after the operation, it is important to use this support (which is not provided by the hospital) for walking, so as not to further inflame the knee. It is a good idea to move the joint a little after surgery, but you should avoid putting all your weight on the limb for at least a week or two, until the muscles surrounding the knee begin to recover their functions. and their strength.
- You should be able to resume your normal daily activities (including walking and bending over) within 3-6 weeks of surgery.
- It is normal to experience some pain for several weeks when walking or doing other movements with the knee.
- If you have had surgery on your left knee, you will only be able to drive cars with automatic transmission until you are completely healed, which may take a few months.
Step 4. Take medications as directed
You will likely be given pain relievers (by mouth or intravenously) during your hospital stay and your doctor will prescribe other strong medications to take at home. These could be strong opiate pain relievers, such as morphine, fentanyl, or oxycodone, which you will need to take for a few months. Medicines are a great help in pain management, so follow your doctor's instructions closely, but be aware that their abuse is addictive.
- Alternatively, your doctor may prescribe non-steroidal anti-inflammatories in stronger formulations than those available for sale, such as ibuprofen, naproxen, or pain relievers such as Tachipirina. After a few weeks, you can independently switch to the less concentrated over-the-counter versions.
- Be careful not to take any medications on an empty stomach, as this could irritate the stomach lining and increase the risk of ulcers.
- There are also topical cream pain relievers containing capsaicin, menthol and / or salicylate that can relieve discomfort.
- Your doctor may decide to prescribe you a short course of antibiotics to reduce the risk of infections.
Step 5. Once the acute phase is over, consider applying moist heat
When the inflammation and pain in the area around the knee has subsided considerably, you can start putting heat on the injured area. The heat helps to dilate the blood vessels a little and relieve any form of stiffness. Microwaved pouches of medicinal herbs are also effective and are often infused with aromatherapy products (such as lavender), which have relaxing properties.
- If the doctor has nothing against it, you can immerse your leg in a warm bath with Epsom salts, which are great for reducing swelling and pain, especially in the muscles; moreover, the magnesium present in the salt contributes to muscle relaxation.
- However, avoid soaking the wound in water until it is completely healed and dry.
Part 2 of 3: Medical Treatments
Step 1. See a physical therapist
Physical therapy is extremely important in the post-surgery rehabilitation process and can begin as early as 48 hours after the operation. The physical therapist can show you specific and targeted stretching, motility and strengthening exercises to facilitate recovery. Knee braces are also often used to stabilize the knee during treatment.
- To get positive results after the operation it is important to undergo physiotherapy about 2-3 times a week for 6-8 weeks. This should also include a gradual return to walking program and strengthening exercises for the knee.
- If necessary, the therapist can also stimulate, contract and strengthen the weakened muscles of the leg with electrotherapy, for example with electrostimulation.
- To manage pain, the practitioner can also use TENS (transcutaneous electrical nerve stimulation), a complementary technique for the knee.
Step 2. Use a continuous passive motion machine (CPM)
This device can help you speed up the recovery process and reduce knee stiffness. The machine is attached to the operated leg and automatically moves the knee to different positions for about an hour while the patient relaxes. This type of passive movement improves circulation and reduces the risk of soft tissue scarring / contractures around the knee.
- Exercises in this machine also help prevent blood clots that might form in the leg.
- Some therapists, such as the occupational therapist and the physical therapist (who deal with rehabilitation), have this tool in their office, but not all of them.
Step 3. Consider infrared therapy
Low-energy (infrared) light waves are known to speed up the wound healing process and reduce pain and inflammation. It is believed that infrared rays (sent via a portable device or a special sauna) can penetrate deep into the body and improve circulation because they create heat and dilate blood vessels.
- In most cases, a noticeable reduction in pain begins as early as a few hours after the first treatment.
- Getting rid of the pain is a long process that takes weeks and sometimes even months.
- The professionals who use infrared therapy most often are chiropractors, osteopaths, physiotherapists and massage therapists.
Part 3 of 3: Alternative Treatments
Step 1. Try acupuncture
This therapy consists of inserting very fine needles into specific energy points within the skin / muscle in order to reduce pain, inflammation and stimulate healing. Acupuncture is generally not recommended for managing pain after surgery and should only be considered as a secondary option, although there is anecdotal evidence that this practice helps for many types of musculoskeletal injuries. If your budget allows it, it's worth a try.
- This therapy, based on the principles of traditional Chinese medicine, reduces pain and inflammation by releasing a variety of substances present in the body, such as endorphins and serotonin.
- It is practiced by various health professionals, such as doctors, chiropractors, naturopaths, physiotherapists and massage therapists; however, be sure to hire a certified and qualified professional.
Step 2. Undergo a deep tissue massage
Surgery inevitably also involves partially cutting the muscles surrounding the knee, in order to clean and reshape the surfaces of the bone ends. For this reason, the muscles undergo severe trauma that causes post-operative inflammation and spasms. A deep massage of the muscle tissues is very useful and should be practiced a few weeks after the operation, in order to reduce spasms, fight inflammation and promote muscle relaxation. Start with a 30-minute leg massage, focusing on the anterior and hamstring muscles. Let the therapist go as deep as possible without causing you pain.
Always drink plenty of water immediately after a massage, in order to expel inflammatory substances and lactic acid from the body; otherwise, you may experience a headache or mild nausea
Step 3. Try vibration massage therapy
This is an interesting alternative for managing musculoskeletal pain. The frequencies of the vibrations are believed to be able to relax the muscles while stimulating the nerves in order to reduce pain. As for specific knee pain, you can apply vibrations to the specific area or to the whole body; in both cases positive results were found.
- It is difficult to find devices in clinics or medical centers that allow full-body vibration therapy and are probably very expensive to purchase for home use, so consider using a small vibrating tool for your feet and / or legs.
- A portable vibration massage device can be just as effective for stimulating and reducing pain in the muscles around the knee.
Advice
- Avoid squatting, twisting, jumping, or kneeling on hard surfaces in the first few weeks after surgery.
- Most people use crutches for 3-4 weeks and then use a cane for another 2-3 weeks before returning to normal walking.
- Almost all patients manage to achieve 90 ° flexibility (right angle knee flexion) from the second week after surgery and eventually manage to flex it to a 110 ° angle.
- Among the most suitable exercises and activities to perform after knee surgery are swimming, water aerobics, cycling and dancing; But know that first you will have to give your leg a few weeks of rest.
