Total Knee Replacement (TKR) is a major surgery, and the recovery period requires careful attention to daily movements. Sitting is a common activity where patients risk placing undue stress on the new joint or causing a fall if proper body mechanics are not followed. A successful recovery depends on consistently using safe techniques to protect the implant and surrounding tissues. This article provides practical, step-by-step instructions to navigate sitting and standing securely following your procedure.
Preparing the Environment for Safe Sitting
The choice of seating surface directly impacts the effort and knee flexion required for safe movement. Select a chair that is firm and has a straight back, avoiding soft couches or deep recliners that strain the knee joint. The chair height must be high enough to ensure your hips remain level with or slightly higher than your knees when seated. This positioning helps maintain the operated knee angle above 90 degrees to minimize stress on the implant.
A stable chair with fixed armrests is necessary, as these provide a solid base for pushing up or lowering down, transferring weight away from the operated leg. If your existing furniture is too low, increase the seat height using firm cushions or specialized furniture risers. For bathroom safety, a raised toilet seat or safety frame is recommended to maintain the proper hip-to-knee height ratio.
Step-by-Step Guide to Sitting Down
Approaching a chair correctly is the first step in a safe transition from standing to sitting. Back up slowly until the seat touches the back of your non-operated leg, ensuring the chair is directly behind you without twisting your body. Reach back with both hands to grasp the armrests securely. This action allows your arms to bear a substantial portion of your body weight during the descent.
Before lowering, slide the operated leg slightly forward, keeping the heel on the floor to limit knee flexion. Slowly lower your body by bending the non-operated knee, using your arm muscles to regulate the speed. Let your arms and the non-operated leg manage the transfer of weight until you are fully seated. Feel the seat with your buttocks before releasing your full weight, ensuring you do not drop suddenly.
Safe Techniques for Standing Up
Rising from a seated position requires a coordinated effort, placing the majority of the load on your arms and your uninjured leg. Shuffle forward until you are positioned on the edge of the seat. This places your feet directly beneath you, making it easier to shift your center of gravity forward. Position your operated leg slightly forward, keeping the foot flat or with only the heel touching, which protects the knee from taking a direct push-off force.
Lean your torso forward, bringing your nose over your toes, preparing the body for the vertical push. Use both armrests to push your body upward, simultaneously driving down through the heel of your non-operated leg. Push up primarily with your arms and unoperated leg, avoiding force from the operated knee. Once upright and stable, use your walker or cane for support before taking your first step.
Essential Postural Rules While Seated
Maintaining proper posture while seated protects the new joint and encourages healthy circulation. Avoid bending the operated knee beyond 90 degrees, especially when sitting in a low chair, as this places strain on the joint capsule and implant. Ensure your feet are placed flat on the floor for stability and even weight distribution. Never cross your legs or ankles, as this twisting motion affects knee alignment and can hinder blood flow.
Sitting for prolonged periods increases stiffness and the risk of blood clot formation, particularly in the first few weeks after surgery. Limit sitting to intervals of 45 to 60 minutes, taking regular breaks to stand and walk gently. If you experience swelling, use a small footstool to elevate the operated leg slightly, ensuring the knee remains extended and supported. Perform simple ankle pumps and toe wiggles every 15 minutes to promote circulation and prevent fluid pooling.