5 Tips to Make Your Knee Replacement Successful

Your doctor may have recommended you talk to an orthopedic surgeon about knee replacement surgery. If they suggest you consider having this type of knee surgery to reduce pain and improve mobility, make sure you consider these important factors from Alejandro Gonzalez Della Valle, MD, an orthopedic surgeon who specializes in hip and knee replacement at HSS.

1. Make sure you really need it.

Before deciding on knee replacement surgery, it's crucial to determine if it’s the best option for you. As Dr. Gonzalez Della Valle explains, "you should discuss whether successful knee replacement surgery would address the needs for pain relief and function you have before surgery."

For example, if you have severe knee pain that affects your daily activities, like walking and climbing stairs, and this pain is confirmed to be from your knee joint as shown on X-rays, then knee replacement will likely be very beneficial, Dr. Gonzalez Della Valle says. On the other hand, if your knee pain is mild and only affects activities like running marathons, surgery may not be necessary. Have honest conversations with your surgeon about what your expectation of a successful outcome should be with total knee replacement surgery, he suggests.

2. Prepare your body and mind.

Proper preoperative preparation can significantly lower the risks associated with surgery and enhance your recovery. "Patients should work on reducing modifiable risk factors before surgery," Dr. Gonzalez Della Valle advises. These include:

• Your weight. Obesity increases the risk of surgery complications, though strict BMI cutoffs are now questioned. Aim to get to a healthier weight to improve your outcomes.
• Chronic conditions. If you are a person with diabetes, try to get it under control before surgery. Keep your blood sugar levels in check to reduce infection risk.
• Your smoking status. Heavy smoking can lead to complications like pulmonary problems and wound infections. Set yourself up for a successful surgery by working on quitting.

Just as important as physical preparation is getting in the right mindset before surgery. Mentally preparing oneself for a major operation like total knee replacement surgery might not be easy, but there are a few steps that might help. 

“The more informed you are, the more likely that your outlook will be optimistic,” says Dr. Gonzalez Della Valle. “Going into surgery looking forward to future of pain relief and better function is an important psychological state of mind to have when preparing for an operation.”

3.  Stick to your post-surgery rehab plan.

Recovery involves a structured postoperative plan to ensure your knee heals properly. Dr. Gonzalez Della Valle emphasizes, "The plan is based on your specific needs and should be followed closely." 

Take medications as they are prescribed and communicate any issues with your healthcare team in the days and weeks following your total knee replacement surgery.

Your care management team will set goals for you to reach, like working on bending your knee to 90 degrees within the first two weeks and straightening your knee, or having the swelling go down. It’s also important to stay on top of pain by applying cold therapy to your incision and by using pain medication as prescribed by your surgeon. Let your healthcare team know if you don’t feel well on the pain medication, if the swelling isn’t going down, if there isn’t a progressive reduction of pain, or if something else doesn’t seem to be going to plan. 

Once you’re ready and cleared for physical therapy, attend all of your sessions and do prescribed exercises at home. As you feel better, gradually increase your activity as advised by your doctor. Avoid high-impact activities initially.

4. Be realistic about your activities. 

Once you’ve recovered, it’s important to enjoy the benefits of your new knee while understanding its limitations, Dr. Gonzalez Della Valle says. "Patients often feel a significant improvement in their quality of life, but it’s essential to have realistic expectations." This most likely won’t feel like the healthy knee you had in your 20s or be a perfect knee. It’s a mechanical device.

Be active and engage in your favorite physical pastimes with loved ones, but don’t sign up for a marathon. You should notice big improvements in mobility and pain which can greatly impact your quality of life.

When in doubt, Dr. Gonzalez Della Valle recommends being protective of the knee over aggressive with activities and training. Once you’ve been cleared, you should be able to bike, swim, walk, play tennis, hike, and enjoy many beloved activities.

5. Practice good long-term care habits.

You have a mechanical device in your leg. Regular “service” check-ups are necessary to ensure the longevity of your knee replacement, Dr. Gonzalez Della Valle says. "Think of it like taking your car for regular maintenance." See your knee surgeon every few years—most recommend every five—so they can make sure everything is working optimally.