Knee Replacement Recovery Time

[boulderjohn]

I had a full knee replacement this past August 29. Although I am told that my recovery is going very well, with my range of motion ahead of schedule (107º flex in less than two weeks), I was (of course!) expecting to do better than I am. Sadly, I have no real dive trips planned for the near future, so I have no concerns about being healed in time for the next trip.

Here is my question:

My doctor told me long ago that I could swim 6 weeks after surgery.

I am scheduled to teach the confined water segment of an OW class during the last weekend in October, about 8 weeks after surgery. Can anyone with experience in this surgery and an understanding of the CW requirements speculate as to whether or not I should look for a substitute or plan to teach the class? Please assume I will have an assistant who can do some heavy lifting, and that I will continue to outpace the normal recovery curve to some extent. (I was in relatively excellent condition prior to surgery.)

 

[TSandM]

I would think that, if you can don your gear in the water, you could probably do it. You're likely still to have some reduced range of motion, so it might be difficult to kneel and sit back on your heels. (It's nice that we weigh so much less underwater, so you're not putting as much weight on the knee on the bottom of the pool!) Climbing the ladder out of the pool in gear probably would be a no-go.

People are SO different in terms of their rehab and their pain tolerances, it's always hard to tell someone what they will or will not be able to do at a certain point post-op.

 

[boulderjohn]

I figured that some day someone will have a similar question, start with a search, and run into this thread. I am therefore going to give some updates so that others will know what to expect. At this time, I am just over five weeks after my surgery.

I seriously underestimated the difficulty of rehabilitation. It was much harder and more painful than I expected it to be. The biggest problem was (and continues to be) getting the leg to go straight. Were I to do this over again, I would stretch those hamstrings as much as possible before I had the surgery. For the past few weeks, the pain has been almost exclusively at night, when the knee swells up. Icing it just before bed (and at times during the night) helps.

On the other hand, much of the pain is probably due to the fact that I have been relatively aggressive in my PT efforts. Consequently, when I met with my doctor a few days ago, he said I was making excellent progress. He said that while believing I was in for a normal 6 week checkup. When I told him I would not be around on the 6th week and it was only 5 weeks, he amplified his analysis of my progress. I guess the pain at night is worth a good progress report. Maybe.

Before the surgery, I had thought I would be able to lead some OW dives at 6 weeks. That did not happen for other reasons, and that is a good thing. Although I can and do swim gently with fins now, I don't believe I will be in any shape to do a real OW dive in a week. Perhpas I could do it in gentle conditions with everything going right, but I could not deal with an emergency effectively.

I am still scheduled to do a CW class in three weeks. I should have no trouble with that, especially since I will have an AI with me.

 

[bvmjethead]

Are you in a pool swimming now?

Swimming is the best full body low impact exercise known to man.

After a while don some smaller fins, if you're cool with that don your scuba fins.

Just take it easy.

Just do it.

 

[boulderjohn]

Are you in a pool swimming now?

Swimming is the best full body low impact exercise known to man.

After a while don some smaller fins, if you're cool with that don your scuba fins.

Just take it easy.

Just do it.

I go to my LDS's pool from time to time. I do some walking in the water and some step aerobics on the steps. I swim a little with a snorkel and some really mushy ScubaPro TwinSpeeds. I feel fine doing that.

 

[DocVikingo]

Hi boulderjohn,

No specific time frame can be given as it is entirely dependent upon the individual situation.

Given a successful surgery and rehabilitation, as appears to be the case with you, it is the expectation that the majority of persons undergoing KR will be able to return to scuba.

As you know, rehab after KR is intensive and has much to do with eventual outcome. It is important that the knee can bend least 90 degrees (which you've reportedly already exceeded) and that leg muscles be adequately strong and limber to allow for all daily activities.

While time to return to full physical activity depends upon factors such as age, health & fitness, personal motivation and response to rehabilitation, it typically takes about 3 months for those undergoing KR to reach maximum recovery.

Still, some activities likely will be discouraged, such as contact sports, intense running/jogging and others that place excessive strain on the joint.

The patient and his orthopedic surgeon will arrive at a decision as to when resumption of a particular activity is appropriate based on the specifics of the case.

The diver with KR will want to be cautious not to fall on or twist the knee while on deck/performing shore entries and should doff gear in the water rather than trying to climb the boat ladder/to the shore while kitted up.

Helpful?

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such.

 

[ChuckWagon]

I was going to ask about this, I am scheduled for a left total knee on the 27th of November and the right one to follow as soon as it is feasible.

 

[boulderjohn]

As you know, rehab after KR is intensive and has much to do with eventual outcome. It is important that the knee can bend least 90 degrees (which you've reportedly already exceeded) and that leg muscles be adequately strong and limber to allow for all daily activities.
...

The diver with KR will want to be cautious not to fall on or twist the knee while on deck/performing shore entries and should doff gear in the water rather than trying to climb the boat ladder/to the shore while kitted up.

Helpful?

Thanks. My flexion has not been measured in a while. More than a week ago I measured 125º on my own effort, without the PT pushing it. I have been swimming with soft fins without discomfort.

 

[DocVikingo]

I was going to ask about this, I am scheduled for a left total knee on the 27th of November and the right one to follow as soon as it is feasible.

Hi Chuck,

The various posts in this thread should give you a very good background to the issues.

I would add to mine that conditioning of the legs prior to surgery can help in speeding rehab. Also, if you're a smoker, think about stopping now.

Best of luck.

DocVikingo

 

[boulderjohn]

I would add to mine that conditioning of the legs prior to surgery can help in speeding rehab.

I worked very hard on a stationary bike for months prior to my surgery, and it did me a ton of good. If I had known what I know now, I would have added a lot of hamstring stretches to that plan to get my leg to extend as much and as comfortably as it could.