Knee replacement surgery- The straight scoop on the first 6 weeks

I am a 51 year old guy who had a bad knee due to an auto accident when I was 18 years old. The knee finally was so deficient that replacement was the only option. This is the story of my surgery and recovery through the first 6 weeks.


Prior to the surgery, one must arrange for a couple units of blood to be given, just in case you need it. I did not need it. Most everyone also attends a series of training classes to tell you what to expect from the surgery and the various things that will go on after the surgery. I found these educational classes very good and really dropped the pre-surgery anxiety levels.

The day of the surgery, we arrived at the hospital on time and waited around to be called. The anesthesiologist showed up in the pre-op area about 10 minutes before the surgery and inquired if there was anything he needed to know. I did not find this comforting. He then proceeded to prep my IV’s, gave me a shot of something to relax me and then insert a spinal block to be activated after the surgery for pain control.

We were transported to the operating room and I went to sleep.

When I woke up in recovery, I was in a great deal of pain because the spinal block did not work. They tried to insert another, and it did not work. Then they gave me some big shot of pain killers and my heart rate dropped very low and off I went to ICU.

In ICU they put in the morphine “drug buddy” and the pain was controlled very well. This ends day one.

From day two until day four when they send you home, you are in pain or you are out of it from the drugs. There is a lot of pain and the pain control is not very good. Sometime during day three, they take out your catheter and the morphine drug buddy, and change you over to oral Oxy-cotton and Percoset. This takes the edge off the pain, but you still have sizeable discomfort. You get PT in the hospital and this hurts a lot and you must keep your leg as straight as you can to gain extension.

Then, after day four, you take your discomfort and go home. It is good to be home and you have about 10 days to two weeks worth of Percoset and oxy-cotton prescribed. When this runs out, you get a milder pain reducing drug. During that time you have physical therapy at home daily and sometime after 14 days post op, you change over to outpatient PT.




During week three and week 4 things begin to improve, but the pain is not really reduced significantly until after 4 weeks. During this time, it is important to do your PT with as much vigor as possible to gain strength in the quads and the knee. It is only after you get this strength that the pain of walking and moving about decreases. It is really quite remarkable the progress that you make in PT as the bone pain from the surgery diminishes and the stretching and tearing of scar tissues begins. This scar tissue pain is not nearly as bad as the bone pain and is easily controlled with Hydrocodone and/or Tylenol.

Week 5 and 6 are much better as you get off the narcotics and your head, bowels and physical abilities begin to return.

Final comments-

This surgery is brutal. The recovery period is 6 weeks. You will be out of commission for 4-6 weeks and may not be able to work. PT is the most gratifying part of this process. Your body is greatly traumatized by this surgery. You are weak, depressed and homebound for a long time. This was new to me and I did not suffer it gladly. Day-time TV sucks pretty badly and unfortunately for 4 of the 6 weeks the drugs made me unable to write or read very productively. I was tired most of the time and did not begin to feel better, really, until week 5.

This is surgery that changes people’s lives. I can tell that my new knee will be better than my old worn out one. However, this is major surgery and should not be taken or entered into lightly.

Doctor’s and hospitals are making millions of dollars from this surgery and performing many of these procedures every week. The attention to post-op pain control was not what it should have been for me. My patient care was not as good as I had experienced in the past, and this may be mostly due to the inability to adequately control the post-op pain. The latter stages of pain from PT, are not so bad because you can see progress every day. The first two weeks post-op are pretty bad and you will need some good care during this period.

If I were to do this again, hindsight being 20/20, I would demand a premeeting with the anesthesiologist, not on the day of the surgery, and I would make clear my demands for as much pain control as is necessary. There is still too much triage by experienced nurses on the floor not allowing for adequate pain control. If my post-op pain had been in better control and I had not had the additional trauma caused by inadequate care, my experience with this would have been better. All’s well that ends well is OK, but find a hospital and a surgeon that understands the care needed and get some feedback from someone that has been through the procedure at that facility. I had a great surgeon and a mediocre hospital, which provided for a less than satisfactory surgical experience.