Knee replacement surgery (arthroplasty) is a widely performed procedure designed to eliminate pain and restore mobility in a damaged joint. While the artificial joint is engineered for long-term function, the success of the operation relies heavily on patient compliance during recovery. Ignoring medical guidelines and physical restrictions can compromise the new joint, delay healing, or lead to dangerous complications. Understanding what not to do is just as important as knowing what precautions to follow.
Movements and Activities to Avoid
The integrity of a new knee joint can be compromised by excessive force or movements that cause the components to twist abnormally. Patients must strictly avoid high-impact activities for the lifetime of the implant, which includes aggressive sports, running, and jumping. Repetitive shock can accelerate wear and potentially loosen the prosthesis.
In the initial recovery phase, deep knee bending must be avoided. Many surgeons recommend not exceeding a 90-degree flexion angle in the first few weeks to protect the soft tissues. Movements that involve twisting or pivoting on the surgical leg should also be avoided entirely, as they carry a high risk of dislocation or damage to the healing ligaments and muscles. When turning, it is safer to take small steps and move the entire body rather than rotating the knee.
Lifting heavy objects places significant strain on the new joint. During the first four to six weeks post-surgery, patients are advised to avoid lifting anything heavier than 10 to 15 pounds. This restriction includes grocery bags, laundry baskets, or small children, as the combined action of lifting and bearing weight on the surgical leg can jeopardize the implant fixation.
Driving must not be resumed until the patient is completely off narcotic pain medications, which can impair reaction time and mental alertness. For a right knee replacement, waiting four to six weeks is typically required before safely operating a vehicle. Patients must ensure they have sufficient strength and reflex speed to perform an emergency stop without pain.
Errors in Medical Adherence
Failing to adhere to the prescribed physical therapy regimen is among the most common errors and can severely limit the long-term outcome of the procedure. Skipping sessions or neglecting home exercises can lead to muscle weakness, joint stiffness, and a permanent loss of the full range of motion. This non-compliance often results in a prolonged recovery period and may increase the risk of chronic pain.
Altering or prematurely stopping prescribed medications without explicit physician approval presents a serious health risk. Blood thinners (anticoagulants) are administered post-surgery to prevent deep vein thrombosis (DVT), a complication that can become life-threatening if a clot travels to the lungs (pulmonary embolism). Stopping these medications too early significantly increases the chance of developing a dangerous blood clot.
Improper incision care can introduce bacteria, which may lead to a periprosthetic joint infection that often requires complex revision surgery. Patients must not soak the wound by taking baths, swimming, or using hot tubs until the incision is fully healed, usually around four weeks post-operation. Applying unapproved lotions, creams, or powders to the incision can interfere with the healing process and should be avoided.
Missing follow-up appointments prevents the surgical team from monitoring the healing process. These visits are essential for checking the incision site, assessing mobility progress, and obtaining timely X-rays to ensure the implant remains correctly positioned. Catching early signs of implant wear or subtle complications allows for less invasive treatment rather than waiting until a major revision is necessary.
Warning Signs Never to Ignore
Patients must immediately contact their surgeon if they observe signs that differentiate expected post-operative discomfort from a serious complication. While mild swelling and warmth around the incision are normal, infection is characterized by a persistent fever above 100.4°F, shaking chills, and a sudden increase in pain that is not relieved by medication or rest. Any new drainage from the wound, particularly if it is gray, yellow, or foul-smelling, requires urgent medical attention.
Signs of a deep vein thrombosis (DVT) in the leg, which typically occur in the first few weeks, must not be dismissed as simple surgical pain. Symptoms include new, persistent swelling in the calf, ankle, or foot that does not improve with leg elevation, or a sudden onset of pain or tenderness in the calf or thigh muscle. The skin over the affected area may also become warm, red, or discolored.
If a DVT travels to the lungs, it becomes a pulmonary embolism (PE), a medical emergency. Ignoring symptoms such as sudden shortness of breath, chest pain, or a rapid heart rate (tachycardia) can have fatal consequences. Any sudden, severe pain in the knee accompanied by instability, clicking, or the inability to bear weight may indicate a serious issue with the implant, such as dislocation or component failure.