Two Years Post-Knee Replacement
Yesterday marked the second anniversary of my Total Knee Replacement surgery so I thought I’d provide an update on my recovery for anyone facing a TKR. Keep in mind, this is my experience and won’t necessarily reflect the same experience for everyone but hopefully it provides a general idea of the healing process two years out.
My recovery from TKR was pretty easy. I didn’t experience a lot of pain, after the first 24-hours, the discomfort I experienced was primarily due to stiffness and swelling. Since I’ve covered my rehab previously, I’ll just touch on this past year and where I am today.
Within the first year I had regained most of my flexion and measured at about 130 degrees at my one year check-up. My surgeon described my range-of-motion as 95th percentile, meaning better than most, and I attribute this to a few things:
1) I was pretty fit prior to surgery and worked diligently throughout my rehab process to regain my mobility and maintain fitness.
2) I had age on my side given that I was only 53 when I had my surgery. This made the surgery, recovery and rehab easier. I also didn’t have balance issues which can sometimes slow the rehab in older patients.
3) I’d been through several knee surgeries before, including a very painful tibial plateau fracture with complications in my other knee. This made the TKR surgery and recovery seem a lot easier by comparison. It was a lot less painful than my other surgeries which included multiple surgeries for the tibial plateau, meniscus repair and ACL replacement.
4) Pilates. Hard stop. I believe my Pilates training gave me an advantage going into surgery (fitness and mobility) but it gave me tools so that I could start my rehab immediately after surgery (from my hospital bed in fact) and build as I recovered. I was well equipped to manage my rehab and not just rely on once or twice-a-week PT sessions and a few PT exercises to rebuild my strength and stamina. Don’t get me wrong, PT is essential and I had a great therapist who helped me tremendously but I’m so grateful that I had other options. Pilates gave me a program to move safely and effectively from day one and allowed me to recover ROM much quicker than relying on PT exercises alone.
Today my flexion is closer to 135-140 degrees which allows me full function including stair climbing, kneeling and squatting. It also allows me to comfortably do all of the Pilates mat exercises and most of the apparatus with very few modifications (only those requiring greater knee flexion like Mermaid, Knee Stretches, Thigh Stretch/Backbend). I walk most days, hike a lot in the summer and have recently started to return to riding (this delay the result of the injury to my other knee, not the TKR).
As far as riding is concerned, in my opinion once you’re fully healed a knee replacement shouldn’t be an obstacle in returning to the saddle. My biggest takeaway is that when you return to riding you should consider what range of motion is tolerable for you, i.e. knee flexion, because you may need to make some adjustments. Think about mounting, dismounting, length of stirrup and the width of your horse.
Personally, post-TKR I feel more comfortable on a narrower horse and one that is a bit smaller (under 16 hands). There’s probably a psychological aspect being closer to the ground but it’s obviously easier to get on and off and my knees are less stiff and sore after riding. Mounting a shorter horse doesn’t require as much knee flexion and even if you use a mounting block, you may need to lengthen your stirrup to get on a taller horse.
I also found the width of the horse affected my knee comfort - the wider the horse, the more pressure or torque it put on both of my knees especially when posting. This resulted in more knee soreness after I rode than when I rode narrower horses. You can make adjustments to your stirrup length and opt to go a little longer than before surgery or, if you ride English, consider using a dressage saddle. That said, although I personally have chosen to give up jumping, the TKR would not prevent me from the ability to be in a half-seat or jumping seat using a slightly longer stirrup for comfort. These considerations will depend on your range-of-motion, the degree of flexion you regain and how much discomfort you’re willing to tolerate. Another reason why PT and Pilates are so important for your recovery!
Other questions I get about knee replacement and the healing process:
What’s it like getting used to having a new joint? To be honest, I don’t really notice that I have an artificial joint and it certainly feels better than before! However, the skin still feels odd around the scar especially on the lateral side of the the joint where it still feels a little numb. It doesn’t really bother me other than feeling odd when I touch it but I am extremely careful shaving! I still feel a little numbness on the knee cap and it takes me a few seconds to adjust my weight over it when kneeling. But this is hardly noticeable and it’s not uncomfortable to kneel. I have knocked my knee cap a time or two and that can be painful - a little sharper sensation than prior to surgery but the pain recedes quickly and I don’t notice that it bruises any more than prior to surgery.
Does it cause any trouble going through security screening? No, I haven’t had trouble going through security at airports (although I highly recommend TSA Pre-Check for expediting the airport security lines!).
How does it feel in the morning? I don’t notice it to be terribly stiff in the morning, although my other knee (non-TKR) is stiff first thing. I do have to be careful not to sit for long periods as it will stiffen up but it loosens up easily with just a little movement. My other knee is much worse which makes me realize how much the TKR improved my quality of life after suffering for years with a painful joint. As with many TKR patients, I won’t hesitate when the time comes to have my other one done.
Does cold weather affect it? Not any more than a typical knee in someone over thirty! I probably get stiff a little quicker when the temperatures drop below freezing which happens a lot here in Maine, but who knows if this is age, a result of my surgery or due to the pain I have in my other knee. Whatever the cause, I’ve found that movement is definitely medicine when it comes to achey joints. Or as my PT friends say, “Motion is the Lotion!”.
I hope this helps anyone considering knee replacement, or at least gives you a better idea of what to expect. I’ve found it was really worth it and consider the short-term pain and inconvenience of surgery and rehab a small price to pay for the long-term benefits I’ve experienced. Please share this if you know someone considering knee replacement and feel free to email me if you have any questions.
Keep moving!
