Talk with Your Knee Replacement Doctor Today!
Choose Dr. Morton to Help You Get Back to Sports After a Knee Replacement Doctor Today!
- Board-certified, Fellowship Trained Knee Surgeon
- Experienced Orthopedic Surgeon
- Nonoperative and operative treatments available
- High success rate in treating total and partial knee replacement
- Minimally invasive surgery
- Well-versed with modern techniques such as total and partial knee replacements and robotic-assisted joint replacements.
- Fellowship-trained and specialist in knee surgery
- Takes care of revision knee replacements and complex operations
- Trauma Surgeon at Level 1 Trauma Center – Queen’s Medical Center
Many patients ask about the return to sports after a total knee replacement. Total knee replacement surgery is an excellent procedure to address knee arthritis. The surgery is designed to restore function, address alignment, and relieve pain.
Total knee replacements are mechanical devices created from metal and plastic. While there have been significant improvements in implants and techniques since the first one was performed in 1968, the implants may not withstand the higher forces sustained when playing sports or high-impact activities. We hope that the knee replacement we implant will last a patient’s lifetime and minimize the requirement for a revision knee replacement.
Patients undergoing knee replacement today are much more active compared to prior generations. Older patients desire to continue their prior levels of activities. In addition, surgeries are now being performed on younger and more active patients.
There has been NO large-scale study that has compared the longevity of total knee replacements in active versus inactive individuals. There are some small studies in active patients with specific partial knee replacement implants and total knee replacements that are able to resume their prior active lifestyle.
Know your limitations
If you have any doubts, use common sense when playing sports on your new knee implants. The greater the impact from sports, the higher the risk of damage to your implants. Your ability to return to sports will be affected by your general health. The healthier you are, the more likely you are to return to playing sports after surgery. Many people who participated in high-impact sports prior to a total knee replacement are able to resume medium to low-impact sports after surgery.
Level of Activity
Total knee replacements are the best way to continue to maintain an active lifestyle. Below are some recommendations for different activities:
Low-impact sports – There are no limitations with low-impact activities.
Intermediate-impact sports – If you have prior experience, you may resume these activities.
High-impact sports – High impact sports are more likely to lead to wear-and-tear on your knee implants.
Be Active! Sports You can Play after a Knee Replacement
We want you to continue to be active after your total knee replacement. There is no doubt that a continued active lifestyle leads to better health and personal satisfaction. Most hip and knee doctors recommend that you can continue to play sports such as the following:
- Swimming – A great way to exercise without putting stress on your artificial knee. Most patients can resume swimming once the incision over their knee replacement has healed
- Cycling – Excellent way to regain strength after a total knee replacement. Begin by pedaling backward on a stationary bike while you gradually regain strength in your knee before progressing to regular biking
- Weight lifting – A great way to build strength and minimize pain. Use appropriate weights and consider the advice of a physical therapist or personal trainer.
- Elliptical machines – An excellent substitute for running as you can move faster than walking without the impact of jogging.
- Walking – Low impact activity. Start with shorter, smaller steps as you work your way up to longer distances
- Downhill skiing or surfing – If you have previous experience in this area, you may resume water and winter sports. Be cautious and avoid extreme sports.
- Yoga – Great way to improve the flexibility and health of the knee. There may be limitations.
- Calisthenics – Many gyms offer calisthenic classes. Avoid high-impact exercises.
- Golf – Excellent way to get your walking miles in and exercise your upper and lower body. Spend time warming up at the driving range and consider using a golf cart when going out.
- Doubles tennis – Much less requirement for movement compared to singles tennis. Avoid high-impact running.
Higher impact activities that you may want to avoid include: running, basketball, jogging, soccer, football, power-lifting, and skydiving.
The above-discussed recommendations are in alignment with those of the American Association of Hip and Knee Surgeons. If in doubt regarding activities you would like to resume – schedule an appointment with Dr. Morton.
Read more about Knee Replacements:
Frequently Asked Questions About Knee Replacements
Your surgeon will evaluate your medical history and see if you are a good candidate to return home on the day of surgery. With modern medicine, anesthesia, and surgical technique, many of our patients are able to return on the same day as their knee replacements.
Your medical history will be carefully evaluated to ensure that you are a good candidate to return home on the same day after your knee replacement. After a discussion with your physician, we will decide if you can return home safely. We make sure that all of our patients work with a physical therapist to ensure that they can safely navigate the obstacles in their home before being discharged.
Long-distance travel should usually be avoided until at least after your initial post-operative visit with your surgeon. The concern with long-distance travel is the possibility of the development of a blood clot, or missing a postoperative complication.
Once you are on a long trip, Dr. Morton recommends that you get up to stretch or walk at least once per hour during a long trip. Taking 81mg of aspirin daily is a useful adjunct. Dr. Morton recommends starting aspirin 2 days before your trip, and 2 days after your trip to avoid blood clots. You may want to talk with your primary care physician if you have a history of stomach ulcers, allergies, blood clots, or bleeding disorders. Usually, patients will desire an aisle seat or a lay-flat seat for long distances during their initial recovery.
Modern knee replacements have made a drastic improvement with the invention of highly cross-linked polyethylene. Polyethylene is the plastic component within your knee replacement. Traditionally, these plastic components are expected to last up to 20 years in 90% of people. With newer plastic components, we are hopeful that knee replacements will last even longer.
There are newer knee components including those made from Vitamin E or ceramic, which may reduce the wear of the plastic component.
The length of time that a knee replacement will last is variable. While the current generation of knee implants are expected to last most of our patient’s lifetimes. Orthopedic surgeons worry that high levels of activity, weight, or other complications such as infection or loosening could lead to the need for revision.
Traditionally, knee replacements were reserved for patients who were elderly with severe knee arthritis. Concerns regarding patients who undergo knee replacement at a younger age are focused on the wear of the knee replacement components. Any patient who is in their 40’s and 50’s is considered “young” for a knee replacement. However, they may still be a candidate for a knee replacement if they understand the limitations of the implant and have failed non-operative treatment.
The average age of patients today undergoing a knee replacement is 65 years old. While patients under the age of 50 are the fastest-growing segment of the population undergoing knee replacement surgery, many orthopedic surgeons have reservations.
Running can put a tremendous amount of stress across your new implant. I would be very careful before starting a heavy-exercise program on your new knee replacement. Despite this, you can still be an athlete and do certain types of activities. The American Academy of Orthopaedic Surgeons (AAOS) recommends the following activities with a total knee:
– Low-resistance rowing
– Gentle Skiing
– Walking & Hiking
– Low-resistance weightlifting
Similarly, the AAOS advises against high-impact activities:
– High-impact aerobics
– Running and Jogging
Even if you feel fit and healthy, you may be asked to lose weight before knee replacement surgery if you are heavier. Much of the research on complications following knee replacement surgery has been focused on patients with a high body mass index (BMI). In fact, Queen’s Medical Center will not allow the scheduling of any surgery of patients with a BMI greater than 40. This is because patients who are heavier are at higher risk for the following complications:
– Component loosening
– Poor wound healing
– Blood clots
– Pulmonary embolism (blood clot travels to the lung)
Typically, we ask patients to aim for a BMI that is less than 40 prior to surgery. We would prefer patients to obtain a BMI less than 35 as this will significantly lower your risk profile.
Infections in your mouth are a significant risk factor for a knee replacement infection. We recommend that any evidence of a dental or gingival infection be addressed prior to surgery. Some clinics even require mandatory dental clearance prior to surgery. After surgery, we will often provide patients with antibiotics prior to deep cleaning or any major dental work.
Some patients find that once they lose a significant amount of weight after bariatric surgery, they do not need to see an orthopedic surgeon for a knee replacement. If you are able to successfully lose enough weight before surgery, you may also reduce the chance of a complication after your surgery. Obtaining a healthy weight should be your goal.
Tobacco use is known to be a significant risk factor for loosening, infection, or wound healing problems. Minimizing your tobacco use or quitting before surgery will make a significant impact. If you are able to quit for life, you will significantly reduce your risk of other complications to your overall health as well. Learn more about tobacco effects on joint replacements here.
I usually recommend that people wait three months prior to having any dental work done. Please ask for antibiotics, especially within the first year of your surgery.
Partial and total knee replacement surgery have excellent track records. There are risks and benefits to both operations. Partial knee replacements often leave patients with a more “natural feeling” knee, while total knee replacements are able to provide the longest term result with lower risk of re-operation.
Robotic joint replacements are a hot-topic in hip and knee replacements. While you may not need a robot to perform your surgery, robotic knee replacements are able to provide a much more accurate positioning of your knee replacements and personalize the implantation to your anatomy. Much like anterior hip replacements are able to position our implants better and improve outcomes, I believe that robotic joint replacements can make the same improvements for knee replacements.
While the science is conflicting on whether injections are associated with infected knee replacements, many insurance companies have made limitations on joint replacements after injections. If you have an injection, most insurance companies will not support payment for a knee replacement for 3 months after your injection. This is with the health of our patients in mind. Avoidance of infection is of utmost importance as an infection can have devastating consequences.
Custom implants and customized jigs are a technology that has not demonstrated to have brought significant value for patient outcomes. These devices have not been demonstrated to be more reliable than traditional knee replacements. It is likely because it does not take into account your soft-tissue anatomy at the time of surgery. This is the difference that robotic joint replacements provide.
Modern knee replacements are performed on an outpatient basis. Many patients are able to go home on the same day, and sometimes the following day. This is because our pain control and anesthesia have significantly improved. Some patients who do not have adequate support at home will require a skilled nursing facility to recover until they are strong.
This depends on if you drive a manual transmission car, and if your replacement involves your right or left knee. Patients who undergo a right knee replacement are going to take longer to start driving – sometimes up to 6 weeks.
I allow patients to drive when they reach the following goals: 1. No significant pain while driving, 2. No longer taking narcotics, 3. Able to stop in the event of an emergency such as a small child crossing the road.
Most patients are able to achieve this with a left knee replacement around two-weeks after surgery.
We have our patients walking on the same day. patients who are expected to go home will have a course of physical therapy in the post-op unit to ensure that they are safe to go home.
This is a complex question depending on what job type you are doing.
Desk job: I tell most patients that they will feel well enough to begin working around two weeks after surgery. Some patients who are gung-ho will even start working immediately after surgery.
Light Labor: Light labor that requires frequent walking or light lifting. Some patients may require 6 weeks to 3 months before returning to work. Close monitoring will be needed to help you determine when you are safe.
Heavy labor: Construction and other types of manual labor usually requires at least 3 months of recovery. Some patients will have to change their careers depending on their demands. Talk with your surgeon before returning to work.
During a knee replacement, we cut through the infra-patellar branch of the saphenous nerve. This nerve is responsible for the sensation on the outside of your knee. This usually disappears slightly with time, but you will always have a numb area there. Some patients can develop a painful neuroma. I am happy to talk about any of your concerns about this numbness.
These devices have fallen out of favor in the orthopedic community. We have found that these devices are expensive and have not made a difference in return to motion after a knee replacement. These have not been used for years by most orthopedic surgeons.
Yes. In order to implant your new knee, we have to move the muscles and soft tissue to the side. Cutting the bone can cause a significant amount of blood flow. This will cause a large amount of bruising and discoloration after surgery.
Blistering can be a side effect of the bandages or swelling after your replacement. Blistering is a rare phenomenon. If you have blistering, please call me to make sure that there are no complications to be concerned about.