Below is a step by step guide of what to expect before, during and after knee replacement surgery. Firstly this blog comes with a caveat – that there is no precise timeline when it comes to knee replacement surgery and recovery.

So I will start with the variables of the time it takes to recover, and these are just some of many.

• The extent of the patients injury or condition.
• There may be other injuries within the knee – either existing injuries or those discovered in surgery.
• Your overall health is a factor that may determine the length of time you will recover.
• Your fitness levels, and to what point you want to get back to will have a strong importance in your recovery. You may have a goal of returning to walking, or building up strength to return to professional sports.
• Whether or not you have physiotherapy.

While there are many determining factors, I can of course give you the process with approximate timeframes:

INITIAL APPOINTMENT AND FOLLOW-UP APPOINTMENT
The need for a knee replacement will be discussed with you at either your first appointment with your orthopaedic surgeon, or at a follow-up appointment if tests such as a Radiograph, MRI or CT scan have been requested to determine more about your injury or condition. Your surgeon will explain the procedure and give advice for your recovery, such as medication and rehabilitation.

If you are having your surgery privately and you have medical insurance, you will need to speak to them after your appointment to check that your operation is covered by your insurance policy, and to find out what information they need you to provide. You can speak to someone from your surgeons team if you need assistance with your insurance claim.

PRE-REHABILITATION
There are several things that you may be told to do before your surgery that could help with your recovery. Pre-rehabilitation is often helpful before surgery to strengthen your muscles and to improve the flexibility of the knee.

PRE-SURGERY APPOINTMENT
You may be asked to attend a pre-op appointment either at the hospital or over the phone. This is usually the day before your surgery. This is to discuss…

THE DAY OF SURGERY​
You will be given a time to arrive at the hospital. Upon arrival, you will be directed to go to the ward where your surgeon will come and speak to you about your operation, and answer any questions you have. You will also be visited by your anaesthetist, who will discuss anaesthetic options including general or regional anaesthetic. Your nurses will then prepare you for the operation.

SURGERY
You’ll be taken to theatre, given anaesthetic and then your operation will be performed. The knee replacement will take approximately two hours. Near the end of the operation, the knee will be injected with local anaesthetic to reduce the pain experienced once you come round from your anaesthetic.

A nurse will take you to recovery and you will stay there until you have safely recovered from the anaesthetic.

RECOVERING ON THE WARD
The patient will then be moved to the ward, where they will be until discharged from hospital. Once the patient has recovered from the anaesthetic, and the sensation and motor function has returned, the rehabilitation process will start. This may include carrying out simple exercises such as ankle pumps and leg lifts. A physiotherapist will often come and see you on the ward to start the rehabilitation process. You will be encouraged to do heel slides while sitting on a chair and you will try and walk.

MEDICATION
Patients will be given antibiotics at the time of surgery to prevent infection, and these may need to be continued afterwards for several doses. You will be given blood thinners following surgery which will need to be continued following discharge. As the local anaesthetic that you were given in surgery wears off, there will be an increase in pain. This may be whilst you are still in hospital, or when you have returned home. It is important that you take your painkillers.

GOING HOME
Returning home is specific to each patient. If recovery is going well, the patient will go home on the same day as their surgery, or if the operation is later in the day, the patient will be discharged the following day. It may be decided that you will need to be in hospital for 2-3 days to recover in some circumstances – such as if you have health issues. Your surgeon will discuss this with you at your appointment before surgery. Patients will need to arrange for a family member or friend to take them home.

THE FIRST WEEK AT HOME
At home you will need to look after your wound. This will include protecting it with a dressing and keeping it dry for approximately 2 weeks. You will experience some pain so you will need to keep up with your painkillers. This pain will improve over time.

You will be advised to continue to do your exercises in the weeks following surgery. The exercises will really help with your recovery and help you to achieve a good range of movement and strength in your knee.

THE SECOND WEEK AT HOME
Your wound will be reviewed two weeks after surgery to ensure that it has healed without complication. If you are concerned about the wound at any stage of your recovery, it is important that you book an appointment for the wound to be checked by your surgeon.

It is recommended to plan for physiotherapy after discharge as this will help with improving the range of motion and strengthening the muscles around the knee. It normally starts 2 weeks after surgery when swelling has settled. Most major private medical insurers cover physiotherapy on your policy, so if you have medical insurance you should check this before you have your surgery.

A MONTH AFTER SURGERY
You may be able to return to driving 4 to 6 weeks of surgery. This will depend on whether the knee is comfortable and if you can bend the knee and have enough strength to control your vehicle. You must be safe, so if you cannot do these things, you will need to wait longer to drive.

A follow-up appointment is often required six weeks after surgery to assess your progress. At this stage you will then be discharged if you are doing well.

This is around the time you will start to feel more confident to walk again without a walking aid.