After undergoing knee replacement surgery, it is important to try to return to as active a lifestyle as possible. At The Stone Clinic, we work with our patients to set goals to return them to activities and fitness better than they have been in years.

Driving
You may resume driving as soon as you have good muscle control of the leg which varies in patients from 2-6 weeks. In any case you must be able to move the leg easily from the gas pedal to the brake.

Walking and Stairs
You will be progressed during your physical therapy program rapidly and be encouraged to climb stairs step over step immediately. In most cases, patients begin with smaller height steps and gradually progress to standard height steps.

Work Activities
Determining the date you return to work will depend on the type of work you do. Some individuals may require modifications of their job, while others may easily return to their previous activities. Those engaged in heavy manual labor requiring strong impact stresses or stop-start movements, jobs requiring moving heavy objects, or tasks requiring excessive squatting or climbing steep stairs may have to modify their work load.

Leisure and Sport Activities
In general, the more impact the activity, the higher the risk of damaging the implant, increasing the wear and tear on the implant, or increasing the risk of loosening of the implant.

Three major categories of activities should be avoided. These include:

• Activities causing high impact stresses on the implant.
• Activities with potentially high risk of injury.
• Activities that may result in falling or getting tangled with opponents risking dislocation of the joint itself or a fracture of the bone around the implant. These types of activities include competitive racquet sports (such as singles tennis, squash, and racquetball), high impact aerobics, high intensity jogging, and rough contact sports (such as football, soccer, lacrosse, basketball, baseball, handball, and volleyball).

Encouraged are:

• Lower stress activities such as golfing, hiking, walking, biking, snow and waterskiing, stationary skiing (e.g. Nordic Track®), and swimming are excellent forms of exercise for individuals with a knee replacement. Others that may also be considered for long-term sports or leisure activities include cross-country skiing, table tennis, rowing, Tai Chi, bowling, doubles tennis, calisthenics, low impact aerobic exercise, horseback riding, and canoeing.

After total knee replacement, we inject a long-acting numbing medication into the knee joint, which can work for 12-18 hours. In the recovery room, intravenous pain medication will also help ease the pain. In most cases, a patient controlled anesthesia or PCA pump or intraarticular pain pump is used. This allows the patient to control the timing and dosage of the medication. After a few days, the PCA pump is replaced with a combination of injections, pain pills, and anti-inflammatory medications as needed. Almost everyone is given a prescription for pain medication when they leave the hospital. Within a few weeks most patients use the medicine only to sleep at night or after physical therapy.