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How Long Does It Take To Heal From A TKR?

One of my readers (you know who you are..:) ) let me know about this interesting article written for tkr patients that I – in turn- wanted to pass along. The information on this Guest Post is as follows:

Total Knee Replacement: How Long Does It Take To Heal
Written by Richard Haynes.
http://physictherapy.blogspot.com

When you finally decide to go ahead with a knee replacement, you can get bombarded with a lot of information from friends, family, and hopefully the surgeon. When it comes to friends and family, most of the information you will get are opinions though they mean well you get very little fact. The time it took for their knee to heal can vary and unless they had the knee operated on within the last 4-6 months the information you get may be inaccurate.

Your surgeon may or may have not discussed with you some of the experiences you will encounter when, it comes to the actual amount of time it will take for the knee itself to be completely healed.

During the healing process your knee will go through what I consider three phases from a rehabilitation standpoint. The phases are the acute phase, the post-acute phase, and the long term healing phase.

These are phases that I have discovered are important for a patient to understand. The time I feel to discuss them with the patient is not only prior to surgery but, again after surgery as there will be information during the pre-operative briefing that will not be retained.

In general the phases mentioned above tend to play out for the patient in the following way:

1.Acute Phase: This is without question the most painful. It lasts from the day of surgery out to week six.. This time can vary from patient to patient but by week five there is a noticeable decrease in pain. The knee will go through the swelling phase and “throbbing phase” when it comes to pain. It is vital that your understanding and compliance with pain control measures are followed. The use of ice before and after rehabilitation are recommended along with foot elevation to keep the swelling to a minimum. Sleepless nights are generally in store and are not unheard of due to pain. The best measure found to relieve the pain you will encounter during sleep is to move or pump the knee back and forth five to ten times as the knee gets stiff and the spasms occur.

2.Post-Acute Phase: This phase kicks in from roughly week seven to week twelve. Here is where you begin to get a better handle on how to control the swelling and you also have learned as well how temperamental the knee can be. In other words as you become more active the knee will fool you. You will be tempted to do more then the knee is ready to handle physically. if you take on more then the knee is prepared for, the next day you will pay the price in increased pain and swelling. The use of pain medication though not as frequent is still advised. You should at this point be up on a single point cane and away from the walker which with the new found freedom add to the subtle ability to overwork the leg.

3.Long Term Healing Phase: This is the phase that most orthopedic surgeons will tell you will take close to a year for the knee to be totally healed. You will be able to however to do most anything within reason at this point unless it involves a high-impact activity like constant running and jumping. Pain, swelling, and muscle spasms at this point have completely subsided. You will have obtained all the range of motion of the knee that you will get. Your strength gains however can always be improved in the muscles surrounding the knee. Your walking pattern has now been established and the knee can and will endure most anything you ask it too.

There will always be some differences among patients when it comes to set time frames with pain and recovery. Having a total knee replacement is considered a major surgery and the advances made in surgery have shorten the time frame by weeks if not by months with some.

The key to joint replacement recovery is patience. By having some patience you develop a stronger more pain free recovery instead of pushing yourself to the edge of suffering from chronic pain and overall physical breakdown.

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15 Responses

  1. I am about two years post-op. It has taken that long fully to heal. But I was impatient and tore into rehab and perhaps I overdid it. Now I can ride a bike and walk for miles and miles. I do squats in the gym, do personal training and lead a yoga class. I’m seventy years old and I am relatively pain-free.
    After my TKR (left knee) I got certified in personal training since I’d always been interested in fitness. I am not a yoga adept per se but the people I train wanted one day a week for yoga and so I teach what little I know and which I have made my own.
    I can’t do yoga with as much flexibility as I once had, nor can I go fully down – or lift as much – with my squatting as I could before the TKR. But given my age there are many things I can’t do as I once used to! Having the TKR was a great thing for me. Now I have to learn to pull back a bit and accept the limitations as well as the positives of my new knee.
    I would do it again…. and I may have to some day. It has been a great thing for me.

  2. That is what I needed to know BEFORE I had my surgery, and what my doctor and the people I talked to, did NOT tell me.

    I had a rude awakening along about week 4……It would have been nice to know this beforehand.

    I guess I am now in the “Post-acute phase”…….but at least I am back at work…….(and my bank account will be happy!)

  3. I am 3 weeks post TKR. I was becoming frustrated with the slowness of the rehab, but after reading this I have realigned myself to expect less. What kind of daily excersise is best?

  4. At three weeks, the best exercise for me was isometrics and an upright exercise bike.

  5. I think the daily exercise depends on where you are in the healing process, what you need to work on the most, and your ROM. It seems my PT recommended several things after 4 weeks including the recumbant bike, a towel stretch, quad sets, deep knee bends, and knee bends using a pillow to support my replaced knee along with some walking.

  6. Not that I’m impressed a lot, but this is a lot more than I expected for when I stumpled upon a link on Furl telling that the info here is quite decent. Thanks.

  7. 9 Weeks ago yesterday, I had my TKR. I’m sporadically using my cane, have just started doing a 4 inch stair exercise, and having good days and bad for sure. Finally, I got up to 103 degrees of flexion, but with much bullet biting.
    Narcotic pain meds and tylenol are used but not so freely. My liver took a beating from heavy pain med and tylenol use earlier in my recovery. But, really I had no choice with the amount of pain I was in. Now, I am really picky about when I take the meds – and fortunately, my liver enzymes are coming back to normal – almost. Still – the pain is there and I do piss, moan, and groan about it – it’s frustrating. I can totally agree with the post acute phase comment. Doing too much always comes at me the next day and kicks my butt.

    I did have some good news today, though. My long term disability insurance called today to say they would approve my case – and agree with my surgeon that I should be out 6 months from my surgery date – on account that I have a very physical job with lots of lifting and saying on my feet all day. I feel grateful I have this as I am sure others have not been so fortunate to have this resource.
    I’m also grateful for this site, Booktoots! It’s been such a support.

  8. Hi all. I am 8 wks out. I am definately in phase 2. Dr visit this past Tuesday, Dr. says your doing great!! Now no dancing, or running yet. I THOUGHT I WOULD PEE MY PANTS LAUGHING AT HIM!!!! 1. I never have been a runner not starting now. 2. I COULDN’T DO ANY OF THAT IF I WANTED TOO. He must be nuts……
    I will be glad when I get to the point where I can dance or run if I WANTED to. He has obviously never had this surgery performed on his knee!!!!
    Thanks for all the info. It has truely been helpful to me.

  9. i tkr for 2mth and 3week.left.leg.because i walking limp.and pain and diffcuit walking .can you help to reduce pain and how to do walking better limp.sorry my english not good

    • Hi Rose,
      No need to apologize about your English. You speak better than some living in the United States.
      Anyways, there are a variety of exercises you can do to strengthen your tkr leg. That sure helped my limping. Look though my blog and you’ll find some that worked for me.
      About your pain…we’ve all been there. I found icing while elevating my tkr to work best.
      Good luck and keep in touch!

  10. I am 3 weeks out from TKR, and was feeling like it might not be doing as well as expected. I did not expect to still have so much pain and swelling, or have to take so much pain medication. Talk about sleepless nights, as soon as my head hits the pillow, the pain level goes up unbelievably! My knee is just as big as it was when I left the hospital, but I have pretty good motion in it. Looks like I just have to endure this for another couple of weeks at least, I won’t be trying to avoid the pain meds as much now…seems like it must be normal to still be on them. Thanks for the info!

    • Hi Becky,
      I have been reading quite a few posts this evening and I haven’t read of anyone having been on a CPM (Constant Passive Motion)
      machine during recovery. I don’t know what I would have done without it. For those of you who are still only a few weeks out from
      TKR, maybe your doctor would consider prescribing one for you.
      It helped me immensely and kept my knee from getting too stiff
      and helped with the paid too. In fact, it felt better when on the machine than any other time. I used the CPM for 6 weeks and my
      ROM (range of motion) got to 110 by that time. Hope this info helps someone out there and good luck!

  11. I had a TKR in July 2009, a couple of days later they opened it again to get blood out of the area. My doctor blamed it on the coumadin. Whatever the reason, I’m sure it contributed to my slow recovery. It has been eight months and I still have a lot of swelling and sleepless nights. I have stayed off the pain pills most of the time, however after I return from the YMCA I find I need to take one that night. I had a tremendous amount of anxiety and depression. At times overwhelming. I may need to have the right knee replaced some day, but right now I know I will put it off as long as possible.

  12. my tkr 4 mth but i got my walking still limp cannot still be fast.

  13. I had my tkr done on my right knee Jan.17…over 4 months ago. I have constant swelling….when I stand on it for over 30-45 minutes, I feel it getting bigger and bigger. I have discovered that it is about 1/2 inch longer than my other knee. The doctor says hr can give me a lift for the other foot to put in my shoe…this has not helped enough to see any change. He says when they do a second knee replacement on my left knee ( they used to say it would probably get better after I had my right leg done) then they can make it the same length. The doctor says it is normal to have swelling and pain for 6 month…but my knee is so much larger than my other knee, you can see it with my jeans on! This does not seem normal to me…can anyone share if they have had swelling and pain this long? I did not have it with my first knee replacement and it never grew to my to my bone…so who knows what is normal????

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