Every patient after an artificial joint replacement should have functional exercises. In particular, a certain amount of time should be spent on rehabilitation after artificial knee arthroplasty. The functional exercises have a direct impact on the future use of the joint. Some patients are not prepared for some of the normal occurrences that often occur after total knee replacement, and they often mistake some of the normal occurrences in the postoperative rehabilitation process for “something wrong”, which adds to many unnecessary worries and in some cases even directly affects the patient’s desire for rehabilitation and delays the normal conduct of rehabilitation training, which is detrimental to Some of them even directly affect the patients’ desire for rehabilitation, delay the normal progress of rehabilitation training, and are not conducive to the maintenance of the improved joint function after surgery, which further affects the improvement of quality of life. Therefore, we have summarized some regular phenomena that occur during the rehabilitation process for patients after total knee arthroplasty. These signs are normal phenomena that are bound to occur and will definitely get better gradually. Recognizing this can help patients to put down their “baggage” and ensure normal rehabilitation training.
1.Why is there a “numbness” or an “electrical” pain around the wound?
This is due to the regeneration of the neurocutaneous branch that governs the skin on the outside of the surgical incision. When the nerve regeneration process breaks through the scar, it will produce a “running electric-like” pain sensation, which does not affect the patient’s daily life and rehabilitation training, and often disappears on its own after six months.
2.Why does the affected knee joint feel swollen and hot? How long does it take to recover?
This is due to the inflammation caused by the body’s reaction to the prosthesis or the stimulation of the knee joint activities during functional training. This inflammation is not caused by bacterial infection, but it is also characterized by redness, swelling, heat and pain. These symptoms can gradually disappear and return to normal. If there is significant swelling, heat, redness or fluid in the affected knee, it should be brought to your attention and you should consult with a medical professional to determine if a late postoperative infection exists.
3. Why do I have pain or swelling in the knee at night and stiffness when I wake up in the morning?
During the post-operative rehabilitation process, as the intensity and frequency of training increases, some patients may experience soreness in the knee at night and stiffness in the knee when they wake up in the morning, especially after a high level of activity during the day. This is a normal reaction during the rehabilitation process after total knee replacement. The degree of pain is related to the patient’s preoperative knee function status, and the lower the knee and function score, the more pronounced the pain due to training may be. If daytime activities and exercise are more intense, an oral tablet of a non-steroidal anti-inflammatory drug such as Fotarine or Cilpro can be taken after dinner, or a topical analgesic and anti-inflammatory drug Fotarine emulsion can be used to inhibit soft tissue edema and pain. On the basis of excluding other complications, patients should build up confidence to overcome the disease and achieve the best functional rehabilitation through active exercises.
4. Why do patients with more severe preoperative anxiety and insomnia have greater difficulty at night in the early postoperative period?
Patients who have been suffering from osteoarthritis for a long time may have varying degrees of anxiety and insomnia. In the early postoperative period, the increased sensitivity to pain at night, combined with insomnia, can seriously affect the patient’s subjective perception of postoperative pain, and these patients are often in great pain at night in the early postoperative period.
5.Why do I always feel tightness around the affected knee joint?
Within 6-8 weeks after surgery, patients often feel “tight” around the surgical incision, like a metal brace. This feeling will be eliminated after gradually “pulling apart” through functional exercises.
6. Why is it stiff or unnatural when I walk?
After artificial knee replacement, as long as the patient can take care of daily activities without joint pain and the joint flexes and extends to the expected degree, it can be considered to have achieved the desired effect. Early post-operative stiffness is normal and is usually relieved to varying degrees in 6-8 weeks, with knee mobility returning to normal by 3 months after surgery. In addition to soft tissue scar formation and unrecovered soft tissue edema, there are many causes of postoperative knee stiffness, including the incomplete recovery of the muscles surrounding the joint, which is often most apparent in the morning when walking on the ground. Whether or not the stiffness of the joint is relieved can be used as an indicator to assess the effectiveness of rehabilitation, and it is normal for the above-mentioned time to occur.
7.Why is there a “gurgling sound” during post-operative knee activities?
This sound is usually due to the fact that the soft tissue around the newly installed prosthesis is still lax and the muscles are weak, lacking sufficient strength to maintain balance. This sound occurs during the post-operative activities of the prosthesis, especially when there is a collision between the patella and the femoral condyle prosthesis. This ringing is rarely accompanied by clinical symptoms, but can cause tension in the patient. Over time, after the soft tissues have repaired and balanced themselves, the rattling of these patients’ joints will gradually disappear and no special treatment is needed. If the symptoms are very pronounced, a doctor should be consulted to exclude problems such as slipped patella.
8, joint flexion and extension exercises need to be continued for more than six months straightening exercises.
You can use sandbags to press your legs for 20-30 minutes three times a day; flexion exercises should be trained 8-10 times a day, each time for more than 90 degrees. If trained properly, it is possible to achieve 120 degrees of flexion of the knee. Some discomfort may occur during functional exercise, including swelling, mild pain, fever, etc.; as long as the degree is not serious, it is within the normal range.
9.When there is any phenomenon, must I go to the hospital to see the doctor immediately?
Late post-operative infection is the most serious complication after artificial joint replacement, and in severe cases, the prosthesis even has to be removed, thus easily leading to complete failure of the artificial joint. Symptoms of infection are usually marked localized warmth, redness, or a high volume of fluid in the affected knee. When a patient has a cold or other acute infection, antibacterial agents should be given to prevent infection; if local redness, swelling or a “red bag” is found in the affected knee, antibacterial agents should be administered and the patient should be seen immediately at a hospital, never at a non-professional clinic, to avoid delay or incorrect treatment.
In conclusion, the above phenomenon is a normal reaction to post-operative rehabilitation and functional training of total knee arthroplasty, and patients should not be overly worried about it, which may cause loss of courage and confidence for further rehabilitation and affect the recovery of post-operative joint function. In addition to taking advantage of outpatient review opportunities to receive professional advice on the prosthesis and functional recovery of the affected knee after discharge, patients should consult with a medical professional to identify any other problems that arise during the late rehabilitation process.