Knee Replacement Recovery - Smooth Sailing

I wanted to create this post to give some encouragement for folks who haven't gone through this yet. The testimonials vary widely. I think it's been pointed out that on boards such as this, one's more likely to see the stories highlighting more difficulty, so I wanted to provide some balance.

I'm a 65yo female, who hadn't exercised in a year, that is, gym, pool, long walks, though I was still doing all my own chores, running errands and so forth. Prior to this last year, I was always active, but I wouldn't say I was ever very athletic, activities being confined to swimming 3+ hours a week, walking, and ballet or Pilates 3 hours a week. Besides the knee being bone on bone with low-grade constant pain and swelling, I'm in very good health, but about 20 pounds overweight. I've known I've needed this surgery for ~15 years, but have been putting it off. It wasn't really bad until this last year when it was too painful to meaningfully exercise anymore. I should mention that the knee issue was caused by osteoarthritis, and that I have it in both knees. Knee two surgery coming up in December '26.

I had an excellent surgeon here in San Francisco (Derek Ward at UCSF.) I think getting the best surgeon possible is terribly important. It was not robotic.

The operation itself took 1.5 hours on my left knee. I was surprised at how much smaller my knee was after the surgery! Hospital staff immediately kept me on the icing machine 24/7, which also applied compression. I think this was also key in my recovery. All of my surgeon's patients are kept over-night in the hospital, which I think is a sound idea.

The day after surgery the hospital PT person came and showed me how to use stairs, get in and out of a car, walked with me up and down the hospital aisles, and was sure that I could get up by myself from the toilet.

After getting home, I only did light PT work (ankle flexion and circles, light quad engagement.) I immediately had 0 degrees extension, but not much flexion (far less than 90), mostly, I think, due to swelling, but also because the muscles are somewhat traumatized from the surgery itself and just won't work as they should.

I can't say I was ever in much pain. I was surprised that I could stand, no problem, without pain, and that walking slowly with the walker wasn't painful either. The walker is there for stability, which I really needed at first. I did feel pressure from the swelling, however, and again, the muscles felt "achey-hurty" in a way that's similar to when one works out too hard and then pays for it later. There were some times when there were sharper pains, but I learned quickly that there were certain movements that couldn't be done yet - you'll figure this out for yourself. The worst day was day three, as I think others have mentioned, when I had to double down on the pain meds. I'm not sure that it's due to the nerve block wearing off, as some have metioned - this happens pretty quickly after surgery, but due more to the added movement one is doing, getting up back and forth out of bed. Too, as other's have said, nights are more difficult, probably for the same reason.

I was up and walking at home without the walker or cane after the first day, much to my care taker's consternation! I also found that a lot of the equipment I'd purchased, I didn't need: the shower chair, the raised toilet seat. Frankly, I felt like I'd be better equipped to actually stand in the shower, rather than trying to stand up and down from a shower seat. As for the toilet seat, I was able to use the side of the bathtub and edge of the cabinet on the other side of the toilet to help push myself up from a sitting position, carefully sliding my surgery leg forward as I did so - no problem.

I was anxious to shower, but put it off longer than I probably needed to. I was able to get my leg in and out of the shower (tub shower) after the first week, but refrained for my caretaker's sake more than anything. I took my first shower nine days after surgery.

I live alone, but had a friend there with me for the first three nights. I was VERY prepared, and had cooked/frozen individual portions ahead of time, and had everything I might need next to my bed. I was able to do for myself with everything, but having my friend there with me to swap out the frozen water bottles in my ice machine a few times in the middle of the night made all the difference. I did, however, hire someone to come look after my cats for me for that first week. It's challenging, but doable.

Every day you'll see small signs of improvement. The in home PT person told me to take it really slowly and only gave me the most rudimentary exercises to do. After the first week, I could bed my knee to 90 degrees, just from working at my flexion while using the toilet on my own. I also quit using the ice machine, started looking after my cats myself, and started to take small walks in my apartment building: down to get the mail, in the hallway back and forth, nothing too strenuous, just to get the blood moving and something to work up from.

I was two weeks out yesterday, and had my first outpatient PT appointment. I'm told I'm doing very well. I'm now at 110 degrees flexion and have maintained the 0 degree extension. He's given me more challenging PT, which I would have laughed at in my ballet days (ha ha), but humbly find somewhat difficult after the surgery. I'm walking normally, but taking it slowly, and today found that I could get up and down off my rather low and squashy couch without using the couch arms - yay! I've also gone back to work today, but must let you know that I work 100% from home - It is doable after two weeks! If I start feeling sore or stiff, I get up and walk around for a bit, which is what one should be doing every hour anyway! I also got a bed desk, so if I need to, I can move to the bed with my legs straight, propped up with the laptop.

I'm off the Tylenol and on Advil now, since I'm able to stop my prescription anti-inflammatory at this point. I think the Advil is much more adept at blocking the muscular pain, and of course the swelling - it's really made a significant difference. At night I take a couple of oxy's to help me sleep, but I want to stop these ASAP, but am waiting for the night "discomfort" to abate. I didn't need them for PT, by the way. If you need oxy's for PT, I suspect the PT is too draconian!

That's about it. When I checked my progress against the expected TKR recovery timeline, it seemed to jibe closely. I'm looking forward to the day when I won't need any pain relief at all. My PT seems to think this will come at week three, so keeping my fingers crossed. The incision isn't bad at all. My surgeon used internal stitches which are absorbed by your body - no staples and no glue that I can detect - I was able to remove the bandage to air exposure after one week, which was such a relief. The incision is about as wide as a hair.

And oh yes, after surgery, you'll no longer feel that same pain you felt BEFORE surgery - it's gone!

Happy to answer questions if you have them.