Post-Operative Concerns After Knee Replacement Surgery: What to Know

Postoperative Issues After Total Knee Arthroplasty

It has been almost a year since my surgery, and there is not much time left before I return to work.
I am using a knee joint covered by health insurance, and my doctor advised that I should do office work.
However, my job requires a lot of walking and jumping.
If I opt for self-paid options, would the most durable ones allow me to run and jump? Is it advisable to have another surgery using self-paid options?
For my second question, if my family and I go to visit an old street and walk for more than two hours, would that be too long? The weather is getting colder, and my joints are painful.
Are there any foods or medications that can help improve this condition? I have tried heat therapy, but it hasn't been very effective.
I apologize for having so many questions.

A-Kai, 50~59 year old female. Ask Date: 2019/11/06

Dr. Chen Yongxue reply Orthopedics

Hello, artificial knee joints have a lifespan.
Generally speaking, individuals with higher body weight, greater activity levels, and younger age tend to have a shorter lifespan for their knee implants.
This is due to the wear and tear of the polyethylene insert in the knee joint, which has led to the development of wear-resistant inserts.
If it has been a year since your surgery, I recommend against undergoing another surgery just to replace the insert, as damage to the soft tissues can worsen knee function, ultimately being counterproductive.
You should engage in activities within the limits of your muscle endurance and not restrict yourself out of fear of wear, as that is not worth the joint pain.
Heat therapy can help alleviate discomfort.
Additionally, please gently press on the painful area; it is generally caused by ligament inflammation, which can be relieved with heat and massage.
If necessary, you may use pain relievers.
If needed, please visit an orthopedic clinic for further evaluation.
Thank you.

Reply Date: 2019/11/06

More Info

After undergoing knee replacement surgery, it is common for patients to have various concerns regarding their recovery and the functionality of their new joint. As you approach the one-year mark post-surgery, it’s essential to address your questions and provide insights into your situation.

1. Concerns About Returning to Work and Activity Level
You mentioned that your job requires a lot of movement, including walking and possibly jumping. While your doctor has recommended a desk job, it's crucial to understand that the type of prosthetic knee you use can significantly impact your activity level. If you are considering a self-funded prosthetic that is more durable and designed for higher activity levels, it may allow you to engage in more dynamic activities, including running and jumping. However, it’s essential to consult with your orthopedic surgeon about the specific type of prosthetic that would be best suited for your lifestyle. They can provide guidance on whether a more advanced prosthetic is advisable based on your overall health, activity level, and the condition of your knee.

2. Walking Duration and Joint Pain
Regarding your concern about walking for over two hours while visiting an old street, it’s essential to listen to your body. While many patients can walk for extended periods after knee replacement surgery, individual tolerance varies. If you feel discomfort or fatigue during or after such activities, it may be a sign to adjust your pace or take breaks. Gradually increasing your walking duration can help build endurance without overstraining your knee.

3. Managing Cold Weather Joint Pain
Experiencing pain in your knee during colder weather is not uncommon among individuals who have undergone knee replacement surgery. Cold temperatures can lead to increased stiffness and discomfort in the joints. While you mentioned that heat therapy has not been very effective, you might consider other options such as:
- Topical Pain Relievers: Over-the-counter creams or gels containing menthol or capsaicin can provide temporary relief.

- Oral Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can help reduce inflammation and pain. However, consult your doctor before starting any new medication.

- Supplements: Some patients find relief with glucosamine and chondroitin supplements, although scientific evidence on their effectiveness is mixed. Omega-3 fatty acids, found in fish oil, may also help reduce joint inflammation.

- Physical Therapy: Engaging in physical therapy can help strengthen the muscles around your knee, improving stability and potentially reducing pain.

Conclusion
In summary, as you approach the one-year mark post-knee replacement surgery, it’s vital to have open discussions with your orthopedic surgeon regarding your activity level, the type of prosthetic knee that may suit your lifestyle, and how to manage pain effectively, especially in colder weather. Each patient's recovery journey is unique, and personalized advice from your healthcare provider will be invaluable in ensuring a successful return to your desired activities. Remember to take things at your own pace and prioritize your comfort and safety as you navigate your recovery.

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