Most people with osteoarthritis of the knee won't require surgery. However, if you fail to see improvement with the conservative treatments, or your arthritis is causing you constant pain and/or interfering with your daily living your physician may recommend a surgical option. Knee surgery is generally used to relieve continual pain and inflammation, to slow down or prevent the destruction of your knee joint, or to restore the use and function of the deteriorated areas. Sometimes seriously damaged joints need to be replaced with artificial ones.
There are always some risks associated with any surgery, which include but are not limited to possible anesthesia reactions, thrombophlebitis (blood clots) infection, allergic reaction to medications, nonunion of the bones, loosening of the new parts, and damage to surrounding nerves or blood vessels. However, modern techniques have significantly minimized the occurrence of these problems.
Although surgery is often successful at repairing damage and/or relieving pain, it does not necessarily return strength to your knee. Tenderness, pain, stiffness, scar tissue development and weakness are very common after surgery. This is why a strong commitment to rehabilitation utilizing the conservative treatments mentioned earlier is essential!
Most of these surgeries will require rehabilitation utilizing conservative treatments. Rest and the application of a Cold Compress or Ice Pack can begin soon after surgery once the incision has healed up to quickly address post surgical inflammation. Your surgeon should provide a treatment plan to help you regain normal use as soon as possible. Healing and recovery time really depend on the degree of damage done to your knee, the type of surgery, your age, pre-injury level of function and your rehabilitation.
This surgery involves making tiny incisions around your knee joint and inserting a pencil-thin, fiber optic camera with a small lens and lighting system in one hole, and small surgical instruments in the other holes. The surgeon will take a look inside your joint to investigate all your soft tissues and bones. These images will then be transmitted to a TV monitor, which allow the doctor to make a diagnosis and/or perform the surgery under video control. At the end of surgery, your incisions are closed, and a dressing is applied.
There are a number of different arthroscopic surgeries that can be performed to help relieve pain and inflammation in the early stages of osteoarthritis:
If you have arthroscopic surgery you will generally be under some type of anesthesia, most are completed in day surgery and do not require an overnight stay. Generally you will be able to your start rehabilitation soon after surgery and return to normal activities within 6 weeks - 4 months after surgery. These surgeries do not cure osteoarthritis of the knee, however they will permit you to maintain and participate in an active lifestyle.
Although arthroscopic surgery has been a popular treatment for osteoarthritis, a study completed at the University of Western Ontario and the Lawson Health Research Institute in Canada challenges its effectiveness. In the study, published in the September 11, 2008 issue of The New England Journal of Medicine, researchers treated 2 groups of osteoarthritis patients with medication and physical therapy. 1 of these groups also underwent arthroscopic surgery. Patients of each group reported comparable improvements in pain, movement and function suggesting surgery had no additional therapeutic value over non-surgical methods. Although arthroscopic surgery may be useful for patients with ACL or meniscal tears, researchers recommend osteoarthritis patients pursue conservative treatment methods before resorting surgery.
Tibial Osteotomy surgery involves:
In both surgeries a pin is used to bring the edges together, and the leg is placed in a padded splint. A tibial osteotomy is considered a major surgery that requires a walker or crutches, stitch removal after 2 weeks, a brace for approximately 6 weeks and extensive rehabilitation.
The goal of this surgery is to shift the pressure on the cartilage from the damaged side to the healthy side of the knee, with the hope that the new positioning will help your cartilage regenerate and grow. This surgery is performed to reduce pain and delay degeneration of your knee joint. It is often recommended for people under 60 years of age who want to maintain an active lifestyle, or those who have osteoarthritis on only one side of their knee. It is recommended for those who suffer from bowleggedness or knock-kneedness. It is not always a successful surgery, however it generally allows you to buy time before a total knee replacement (lasts about 5 - 7 years).
There are 2 types of knee replacement surgery:
A partial or full knee replacement is considered a major surgery that requires anywhere from a few days to a few weeks in the hospital, followed by minimal weight-bearing for 5-6 weeks, and an intensive rehabilitation period. It helps to relieve discomfort and improve your movement, permitting you to live a more active life.
Knee replacements are used on patients who have exhausted other treatment types and suffer from advanced stages of osteoarthritis. It is most recommended for people 60 years or older, who will participate in low impact activities like swimming, biking, golfing and/or walking. It is not generally recommended for younger patients or those who participate in active and impact loading sports like skiing, basketball, squash, jogging or impact aerobics. These activities tend to put too much stress on the artificial joint causing it to loosen and/or crack; in turn requiring revision surgery to fix the damage. Once you have a knee replacement, talk with your physician about our Circulatory Boost products to see if they should be a part of your knee replacement surgery rehabilitation.
Knee Fusion (Arthrodesis) is a salvage procedure that is often used after a failed total knee replacement and/or if a knee replacement can't be done. It involves cutting off the bony ends of the femur and tibia, and stripping out the ligaments, menisci and synovial joint lining so that the 2 bones can be fused together with pins, plates or screws in a straight position (with a slight bend). The hope is that the ends of the bones will eventually grow together. It is another major surgery that requires extensive rehabilitation. Your surgeon or physical therapist may find the Circulatory Boost to be a very effective tool during post surgery rehabilitation. to see if they should be a part of your knee replacement surgery rehabilitation.
This surgery provides a stable and pain-free, though stiffer and shorter leg; most people will be able to bear weight better, however they will walk with a slight limp. The success of this surgery is really dependent on your bone stock, your age and your health prior to surgery. Generally surgeons prefer to perform this surgery on younger and/or more active individuals; although it is not used as frequently as in the past.
If you have had or will be having knee surgery, remember that proper post-surgery rehabilitation is very important, perhaps even more important than the surgery itself. Activities should set out to promote healing, increase flexibility in the knee and strengthen surrounding muscles.
An important point for knee osteoarthritis patients to remember after surgery is that every effort must be made to increase strength in the knee joint. Weakness in the knee can usually be eliminated by extra strengthening exercises, but increased stiffness can become a problem if physical therapy and Circulation Boost are not done. Just be sure to talk with your therapist before beginning any knee stretching routine to ensure it is the right time to start.
Rehabilitation and PT after an arthroscopic or open knee surgery will first focus on protecting your knee and initiating simple movement. Directly after your surgery has been completed, your knee will go through Step 1 of the healing process by stopping the bleeding that has started because of the incisions and work done inside of your knee. Depending on the type of procedure you have just had, your tissue may be sutured together, reconstructed or removed to fix your underlying condition. In any case, as with any injury to your tissue, the tissue in your knee will be bleeding again. Depending on the type of injury you have, your surgeon may even stimulate bleeding during your surgery to trigger the healing process.
Typically your body will have begun to stop the bleeding as soon as your surgeon has completed your surgery. This means that the veins carrying your blood will close off, and your blood will coagulate (condense to seal the bleeding off) in order to reduce the amount of blood loss in your body. Your body knows to do this automatically because blood is so vital to the healing process. Blood is basically the vehicle for oxygen and nutrients that travel directly to the injury in your knee - where these things are needed most.
If you have undergone an arthroscopic surgery, you may have less blood loss and your doctor or surgeon will check before you leave to make sure your bleeding at the incisions has stopped. If you have undergone an open knee surgery, your doctor and/or surgeon will check your incisions periodically over the next few days of your hospital-stay to ensure that your body has stopped the bleeding on its own and also make sure that your incisions are starting to heal.
After your incisions and repaired/removed tissue has stopped bleeding; your knee will become tender, swollen, red and hot to the touch. These are all symptoms of inflammation (Step 2 of the healing process). At this point you will be home if you have had arthroscopic surgery, or you may still be in the hospital if you have had open knee surgery. In order to reduce pain, swelling and inflammation your doctor will prescribe an anti-inflammatory drug to be taken during the first week or 2 after your surgery. Your surgeon will also recommend a treatment for dealing with inflammation, like R.C.C.E. (Rest, Cold, Compression, Elevation). You can use a Cold Compress or Ice Pack often (as prescribed), several times a day, to control your inflammation and reduce your pain.
Rest at this point is vital to your rehabilitation plan depending on the surgery you have undergone. If you have had arthroscopic surgery with minimal work from your surgeon, you may be encouraged to start movement early or as soon as possible. Walking with the aid of crutches and a knee brace will be required in most cases after the surgery. If you have had an invasive open surgery, then you may be encouraged to rest longer at first before starting movement with you knee brace and crutches.
Your doctor or surgeon will advance you to the next Phase of rehabilitation when there is no evidence of inflammation or swelling in your knee. If you have had arthroscopic surgery, your doctor may expect that you are able to walk around pain free (with the aid of crutches or a knee brace if needed) before moving onto the next Phase of rehabilitation.
After the initial healing of your knee injury (when Step 1 and 2 of the healing process is done), temporary tissue will start to grow to replace any veins, nerves and tissue that were damaged during your injury or the surgery (Step 3: Temporary Tissue Growth). This temporary tissue will also pull together the two sides of your tissue tear, and strengthen any area where you will have sutures. This tissue will lay the foundation for stronger, healthier tissue to come, but it will be soft and not as strong as regular healthy tissue. This is why you really need to be on "re-injury watch" and make the most of your home therapies for the rest of your rehabilitation. After all, it would be devastating for you if over-doing it at any point during the next few weeks or months of rehabilitation will send you right back into the operating room.
Once your new tissue has begun to grow you will be encouraged to gain back some of your range of motion (ROM) and increase the stability of your knee. Your doctor or surgeon may also introduce regular PT appointments. You may still be expected to wear your knee brace to reduce the amount of stress you are placing on your knee during movement (reducing your risk of re-injury).
You will start gradual movement of your knee in a free (non-forced) way with very low impact exercises. Your knee may be stiff at first, and you should expect simple and easy movement to be a bit more difficult for you to master and painful. Exercise of any kind is a method of increasing blood-flow in your knee to increase the amount of oxygen and nutrients that travel to your injured tissue. You can increase your blood flow before exercise to warm up your tissue and increase your ease of movement. Use of the Knee TShellz Wrap® for approximately 15 to 20 minutes (finishing 15 minutes before exercise) will warm up your knee, relax your muscles and encourage tissue elasticity.
Some of the basic exercises you will start with may include controlled flexing (bending) of your knee by sliding your heel away from your body then back toward your body. Other exercise and strengthening may focus on the use of a stationary bicycle, or stretching of the leg muscles surrounding your knee (quadriceps, hamstrings, thighs and calves) to increase the overall stability of your knee joint.
Controlling post-exercise swelling and inflammation is crucial during this Phase. Any sign of swelling or inflammation after exercise may be an indication of minor re-injury to your knee or to the surrounding tissues and muscles. Controlling your inflammation immediately after exercise for at least 15 to 20 minutes with cold compression or an icepack may help reduce risk of re-injury to the knee. If you are not careful to treat your swelling or inflammation immediately after exercise you can experience a set-back in your recovery.
Your doctor, surgeon or physical therapist will advance you to the next Phase of rehabilitation when you show measured improvement of range of motion (ROM), strength, stability and flexibility of your knee. The level of improvement will depend on the severity of your injury and the type of surgery you have had. For example, if you have had a relatively simple arthroscopic repair of tissue, you may be expected to walk normally (no limping) before moving to Phase 3 of your rehabilitation.
After temporary tissue has grown in Step 3 of the healing process, this temporary tissue will go through different stages of conversion into healthy, normal, flexible tissue during Step 4 (Complete Tissue Re-Growth). Before converting into healthy tissue, temporary tissue will often become tough, dense, fibrous scar tissue. Scar tissue has a weak and unorganized tissue structure, which makes it brittle. Scar tissue will provide your injury with more long term fusing together, but will also stick to surrounding healthy tissue in your knee. The growth of this scar tissue is what stiffens your knee, restricting movement and flexibility.
This Phase of your rehabilitation will focus on an increase in activity level in order to regain full range of motion (ROM) and muscle strength in your leg. Continued exercise and activity will break up and soften scar tissue. Your doctor of physical therapist will increase your activity by introducing regular use of a stationary bicycle (or other cardiovascular exercise), and additional stretching exercises (lunges, hamstring curls, quadriceps stretching and movement of your hip and lower leg). A continued stretching regimen will minimize the growth of scar tissue and also increase the elasticity and strength of your knee joint. After a consistent stretching regimen (as prescribed by your PT), your knee joint will be better prepared to handle higher and higher loads.
You will probably be able to stop using your crutches at this point as long as you focus on walking slowly and normally. Limping during rehabilitation should be avoided at all costs, because abnormal walking could result in re-injury of your knee, or even injury to your opposite leg, feet, hip or your back. If you have been limping to speed up your recovery, you will probably start to notice compensation pain in your opposite leg, hip or back. You can easily treat compensation pain with your doctor of physical therapist during your regular appointments, and can even further reduce this pain at home with a TShellz Wrap®. TShellz Wraps® are intendend to help relax your soft tissue, effectively getting rid of any stiffness and aching caused by compensation pain.
Continued use of cold compression after exercise and activity may still be recommended by your doctor. Like we mentioned before, controlling your pain and inflammation will go a long way to reduce your risk of re-injury. If you are noticing any recurring inflammation, you can continue applying ice packs 2 to 3 times per day for 15 to 20 minutes at a time, or as recommended by your doctor.
Your doctor or physical therapist will advance you to the next Phase of rehabilitation when they feel that you have regained full ROM (range of motion) without pain in your knee. You may also have to pass clinical exams or tests of your muscle strength, balance, stability and flexibility in order to be cleared for Phase 4.
When your overall condition and range of motion has improved your doctor or physical therapist may clear you for a return to work or athletic activity. In many cases, they may recommend that you continue muscle strengthening and stretching instructed during your rehabilitation in order to maintain healthy ROM of your knee. Additional cardiovascular exercise will also be encouraged. If you are an athlete or have a job that requires extensive physical capability, your doctor or physical therapist will likely advise a very gradual return to previous activity.
Scar tissue may plague you for weeks, months and maybe even years after your surgery depending on your level of activity and the amount of conservative therapy you have undergone during your rehabilitation. Scar tissue will be a major problem, especially when it comes to re-injury of your knee. Even if you have been cleared to get back to activity you still must be careful with the activity you take on. You need to keep in mind that your knee won't be back to 100% for some time (if at all) and so continued stretching and treatment with Knee TShellz Wrap® will maintain good health of the knee and significantly reduce your risk of re-injury during recovery.
Living with pain is never easy as it affects your entire lifestyle. Living with pain during or after an intensive surgery and lengthy rehabilitation period can be even harder! Nothing is more important than making the proper decision when it comes to treating your knee pain after your surgery. Rehabilitation at-home while attending regular PT or doctor appointments is vital for your overall recovery. Consistent exercise and conservative treatment on a daily basis during your rehabilitation while working with your doctor, surgeon or physical therapist is key!
MendMyKnee stands out in this regard as our goal is to help you recover for the long-term during your post-operative rehabilitation and beyond.
The bottom line is, you are welcome to try our products for a 60 day period after your surgery, during your rehabilitation. Discuss our products with your doctor and ask your medical professionals if integrating these therapies into your daily life is right for you! If you do not receive the benefits that countless of our other customers have experienced, simply return your purchase back to us and we will issue a prompt & full refund. There will be no hassle and no hard feelings.
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To prevent further deterioration in your knee joint, it is recommended that you gradually increase the intensity of any exercise or activity when you begin and to be aware of the movement of the knee during activity.
A knee that is supported by strong leg muscles is less prone to injury and deterioration because there is less load on the knee. If your knee is unstable or weak, wearing a brace during exercise and activity can reduce the pressure on your knee joint and reduce your pain and inflammation.
Knee Osteoarthritis: Quick Links | ||
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Symptoms Causes Diagnosing |
Treatment Conservative Treatments Alternative Therapy
Medications |
Surgery Prevention |
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Learn more about Knee Surgery and Post-Surgery Recovery
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Learn more about Ice vs Heat Treatments for Knee Strain
During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort at the location of your soft tissue injury until the pain and inflammation settle. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!
Please be aware that this information is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider before using any of our outstanding products to make sure they are right for you and your condition or if you have any questions regarding a medical condition. Always see your doctor for a proper diagnosis as there are often many injuries and conditions (some very serious) that could be the cause of your pain.
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