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Guest Post on TKR Healing- Part I

Hello everyone! As this blog progresses, I will be adding Guest Posts written by individuals who can share expertise about tkr issues.

Today, I am honored to share with you a guest post written by one of my readers, a nurse. Here is Karen’s post..Enjoy!


This article is the first in a series dealing with Healing after Knee Replacement (KR). In this article, I will describe the process of normal wound healing in general terms, and moreover how the body heals itself. Whilst acknowledging all types of healing, this article deals specifically with the physiological healing of wound tissue. Once you have grasped the basics of normal wound healing, you will be in a better position to recognize any deviation from the norm and take steps to avoid or correct its development.

Future articles will deal with:

healing as it relates to knee replacement surgery,
delayed healing and what causes it,
what you can do to promote optimum healing,
a first-hand account of the post-operative period.

Whether you are preparing for a knee replacement, or are already in possession of a new knee, after reading this series of articles you will have gained some idea of what to expect in the post-operative period and how you can influence the outcome. The aim of this series of articles is to equip you with the information needed to fulfill your role in your body’s healing, confidently and without fear.


Injury can occur in any part of the body. It can occur internally, as in the case of a ruptured appendix, fractured tibia, or burst aneurysm, and externally, as a result of sunburn, a penetrating wound or a venous ulcer. Injuries do not arise spontaneously, they are the consequence of a causative agent, whether it be externally applied, internally generated or the outcome of a combination of degenerative factors. So if we refer back to the previous examples, a ruptured appendix will often result from an infection, a fractured tibia from a blow to the lower leg, and a burst aneurysm from a progressive weakening of part of the wall of an artery.

Operative procedures inherently injure the body, and are tolerated on the understanding that they are ultimately performed with the altruistic aim of removing or altering conditions which are harmful to the body. However, whilst operative procedures and post-operative practices may differ from country to country, healing the world over (and throughout the animal and plant world) conforms to one universal property: it is programmed into the cells and tissues of the body of every living entity. The body has foreseen the need to protect itself against the vagaries of existing in a hostile environment fraught with many potentially hazardous encounters. Healing is one in a vast array of physiological self-protective mechanisms and whether you’re a bird, a bee or a sycamore tree, one of the things you share with humans is the capacity to heal after injury.

Naturally, it goes without saying that there are limits to the body’s capacity to heal. In the same way as no one would expect a pile of wood shavings to restore itself to a tree, likewise no one would imagine the body capable of reassembling its scattered constitutive parts after an explosion and subsequently establishing a process of healing. But as in the case of our ruptured aneurysm, in the presence of skilfully applied medical intervention, it is certainly conceivable for the body to recover from injuries, which left to its own devices, it would be incapable of overcoming.


Healing is a physiological process which contains a number of stages. The process, each of the four phases and every aspect of the process are programmed. Each phase is programmed to take a certain amount of time and healing can be delayed in any of the stages. Thus a wound can appear to be healing well and then suddenly appear to stagnate for some time. At each stage, different physiological factors intervene, each with their own essential functions to perform, and combined, they result in the injury being healed. Each stage succeeds and naturally occurs as a result of the previous one, so that each has to be completed successfully before the next stage can be engaged. However, in order for the process of healing to run a normal course a number of predetermined factors have to be present. If some hindrance exists, or if the components of the process are lacking, healing will be delayed. Interference to healing will be dealt with as a separate topic in a subsequent article, but an obvious cause might be the interruption of the blood supply to the area needing to be healed. Less obvious, but more commonly encountered, might be the absence of essential nutritional elements.


Karen Newby is a district nurse (also known as visiting or home nurse) with a practice in Paris, France. In her words…I specialize in the care of patients in the post-operative period, and in particular, the care of their wounds. However, I also speak as someone who has experienced the satisfaction of putting her 30 years professional experience to use in a personal context. Last year, I had the pleasure of accompanying my mother, a very active and highly motivated 85 year-old, from her first consultation with the orthopaedic surgeon, throughout her post-operative period to her six-week check up. Her recovery was rounded off with a well-deserved holiday in the sun, during which, under the guidance of an experienced yoga teacher, she overcame an understandable fear of kneeling. Later on that day, absent-mindedly standing up after waking from a snooze on the beach, she knelt on her prosthetic knee for the first time………. without complaint and without any after effects, other than surprise.

(Another guest post by Melanie, mom’s yoga instructor, will follow.)


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