Welcome back to our Total Knee Arthroplasty Survival Kit. We have previously discussed why this is Survival Kit is needed and we talked about why sleep is important.
This post we are going to talk about swelling in the knee, post surgery. Why does swelling occur and how to deal with it effectively. This is going to be at least a 2 part blog post as we are going to compare and contrast the circulatory system and the lymphatic system.
Let's start off with a simple question. Why is my knee so sore and swollen post surgery? That is a great question! I will often as my clients if they have watched a video of a TKA being performed. If they say yes, I will tell them that is why. If they say no, I will tell them to watch a video of it, as long as they are not the queasy type.
The surgery for a TKA is quite a violent surgery. The end of the thigh bone, femur, is cut off, the top of the shin bone, tibia, is cut off. The bone are drill out and reamed out. After that the bone are fitted with a fake prosthesis to make sure the fit is good. Then the fake prosthesis is removed and the real one put in place.
After all the trauma, the knee/surgical site is inflamed because of the damage done to the body. Think of a badly sprained ankle, you cannot walk on the ankle/foot, sometimes for days! There are four hallmarks of inflammation; redness, heat, sensitivity (soreness) and swelling. After the inflammation period ends about 24-96 hours (1-4 days) after surgery, it is very easy to start it up again as the bones, muscles, ligaments are very sensitive. However, it is very important to start walking on the TKA leg as soon as you can. The TKA knee can stay swollen and hot for a long period of time after surgery. The redness and sensitivity should calm down relatively quickly, within 10-14 days.
Let's change gears and talk about the circulatory vs lymphatic systems now. The circulatory system has the heart, blood, arteries and veins. The heart is a pump that pumps the blood throughout the body. The average person has about 4-6 liters of blood in their body. The heart pumps the blood through the Aorta artery and the blood gets dispersed throughout the body. When an injury occurs, the body shifts the blood flow to the area of the body. Why does it do this? The body brings the oxygen and nutrients needed to start healing the area, after the signal of inflammation as ended.
The lymphatic system also helps post injury. The lymphatic system has lymph fluid that flows through the lymphatic vessels. There is about 10-15 litres of lymph in the body, about 2-3x the amount of blood. Interestingly, the lymphatic system does not have a pump like the heart for the circulatory system. The pump for the lymphatic system are muscle contractions. The lymphatic system is generally superficial underneath the skin. What does the lymphatic system do? The lymphatic system does a number of functions, it helps to circulate the immune system (have you ever been sick and felt your swollen lymph nodes?), it helps to maintain fluid balance in the body and it is the main waste disposal system of the body. Whenever you injure yourself the body breaks down the dead tissue in the area. The dead tissue then gets put into the lymphatic system for clearing it away from the site of injury so the rebuilding cells can go in and start to rebuild. The majority of the lymphatic vessels are located on the inside aspect of the leg and arm. The lymphatic vessels take the waste in the lymph and drain it back into the circulatory system. The leg drains into the lower tummy area and the arm drains just behind the collarbone. Then the circulatory system works on excreting the dead cells/tissues with voiding or bowel movements.
Why is this important?
By leveraging the lymphatic system, you will be able to help the swelling get out of your knee faster. This is going to enable you to bend and straighten your knee sooner and avoid having complications, i.e. poor bending of your knee.
What is needed to help you get the swelling out of your knee the fastest? This will be covered in more detail in the next blog post.
1) elevation
2) compression
3) knee, foot and ankle movement
4) heat! (not what you were thinking, right!)
To be continued...
If you are getting ready to have a knee or a hip replacement, have a plan in place and call New Leaf Physiotherapy for your at home physiotherapy needs. 250-826-7300 to talk with Lyndsey, a certified Rehabilitation Assistant, to help you book your assessment.
New Leaf Physiotherapy is a mobile physiotherapy service that sees clients in West Kelowna, Kelowna and Lake Country.
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