Total Knee Replacement | The Good, The Bad and The Ugly

Total Knee Replacement

Total Knee Replacement | The Good, The Bad and The Ugly

Growing up, I remember doing class assignments that asked us where we envisioned our lives to be in five, ten, twenty years. Being diagnosed with rheumatoid arthritis (RA) at eighteen and having a total knee replacement at twenty-nine years old was not on my radar.

My life changed fifteen years ago when I was diagnosed and I cannot say it has been an easy ride. This ride has taken me on a path of pain, loss, grief and disability. But it has also shown me on of path of hope, faith, spirituality, healing, acceptance, strength, bravery and purpose. Ironically, the path my RA has shown me is more that I started off with. Through the negativity and darkness of my chronic illness, eventually light and positivity shined through on areas of my life that I never thought would be whole again.

However, the moment of my deepest darkness and despair came over a year ago, with my first ever major surgery. The surgeon’s diagnosis that my knee cartilage was non-existent and that I had a bone on bone knee was not shocking to me. For at least couple of years prior to seeing a surgeon I had been experiencing a limp, bent knee and along pain and swelling. Intuitively, I knew something was seriously wrong and the x-rays confirmed my suspicion.

Because a total knee replacement is considered an elective procedure, I was offered two choices: either live with it or have surgery to correct it. The choice was mine and it was explained that they would only do surgery if and when I was ready. However, being a young female who wanted to stay social and active, my quality of life quickly became the main concern. In addition, my team of surgeons suggested to not prolong the surgery to avoid the possible risk of affecting my body’s alignment, hip, and ankle joints, which all work in tandem with the knee.

So, four months after my initial diagnosis, and after I weighed all of my options, I opted to have total knee replacement surgery. During my surgery recovery, I learned three things to be true of a total knee replacement: It is good, it is bad, and it is downright ugly.

Here are my experiences with these three truths:

The Good

You do, for the most part, get a new lease on life. It may not be exactly the same as before your knee was affected by arthritis or injury, but the quality of life improves significantly with this procedure.

The pain does disappear or lessen after recovery. A lot.

Total knee replacements, like hip replacements, have been performed by surgeons for decades. Though surgery in general is never guaranteed and without risk, orthopedic surgeons know a lot about the mechanics of this type of surgery. The shelf life is longer than many other joint replacements, which brought me comfort in making my decision to go ahead with it.

You get everyone — well mostly, to be at your beck and call when you come out of surgery and return home. Who doesn’t like to be pampered? After a gruesome surgery, we do deserve a little rest and relaxation, am I right?

If you don’t have a lot of one-on-one personal support, there are many resources online. Before, during, and long after my surgery, I found comfort in online support groups. It is true that each person has a unique experience with this procedure, but at the end of the day, people in support groups can understand and empathize. That is a huge difference. Out of all the people in the world, you will find one, or a select few, whose story is eerily similar to yours.

The hospital you are scheduled to have surgery at prepares you. I am the type of person that has to know every single detail before I do anything, especially with something this major. If you are the same way or just feel scared, lost and unsure, these mandatory pre-surgery classes are taught by either a nurse or physical therapist. No question goes unanswered, so be sure to ask away.

Humor and laughter will be your best friend and help you through any pain, frustration, and tears you may shed. Don’t be too hard on yourself and your recovery process. Before and after my surgery, friends and family dropped off cards, flowers, and stuffed animals that were meaningful. This put a smile on my face and gave me the push I needed to keep going. Listening to music, meditation, deep breathing, watching movies, reading and anything that can take your mind off your knee also helps.

One word of advice I received from somebody that helped put things into perspective before my procedure was “Do not be a martyr to your knee.” It’s easier said than done, but when I found myself in this energy, I was mindful of it and changed my course around. Surgery recovery gives you a lot of alone time. You get to know yourself better and catch up on things you never may have had time to do before.

I had my surgery the week of the 4th of July. I am not sure why I decided on this, but I would not want to do that again, mainly because I suffer from major FOMO (fear of missing out). However, I was hooked up with one of the best views to see the fireworks. My loved ones and I put the music on and had dance parties in the room. When life gives you lemons, make your own celebration, right? My family and I didn’t let my surgery stop us from enjoying the holiday in our own way.

Lastly, you come out a survivor and a warrior. And if that isn’t bada** in and of itself, then I do not know what is. We even have a scar to prove it!

Now on to the not so bada** part.

The Bad

The overall pain, overnight stay in the hospital, pain medication, coming off of the anesthesia, swelling and bruising isn’t for the faint of heart. The second day out of my surgery I was expecting visitors, but the effects of the anesthesia wearing off was too much for me to bare and I had to cancel their visit. Not to mention that the pain medications ended up in a brown paper bag, too, if you know what I mean.

Having to rely on busy nurses to give you your pain medicine like clockwork can get tiresome. I couldn’t stare at applesauce for a while after because I got so sick of eating it in the hospital. Nurses had to watch me swallow my medicine every time, which was annoying, but is protocol to make sure patients take it. Trust me, with the level of pain I was in, I was going to take it. All that aside, my experience gave me major respect for nurses and especially those that helped me day in and day out.

Contrary to what people may think, after a total knee replacement, your knee is not bionic. Though we are warriors and superheroes in our own right, our knee doesn’t do any special tricks. If I could kick through a brick wall because I had metal in my knee, I would have gone through with the procedure immediately.

Recovering from your surgery takes work, work, work, work — as Rihanna says. If you think your 9-5 job or sitting through rush hour traffic is bad, you may want to re-think what you previously thought was hard. Recovery is a 24/7 commitment and the maintenance afterwards is lifelong to ensure your new knee functions for years down the line. My surgeon told me I would have to make sacrifices after my surgery, but I didn’t truly realize what he meant until it was done.

Contact sports such as soccer, running, football, tennis and skiing are often not recommended after a total knee replacement. Though there’s many patients who say they have no issues with the former, it may decrease the shelf life of the replacement. I wish I could partake in the sports I did before my arthritis, however, it’s just not physically possible anymore. So now I am the designated cheerleader on the sidelines with my tea in hand, but that is ok with me!

total knee replacement patient

If you have autoimmune arthritis, like rheumatoid arthritis, recovery is different than for someone who just has osteoarthritis, a sports-related injury or other common surgeries from their youth such as ACL or meniscus tears. Because I have rheumatoid arthritis, the medications I take for RA I take slows the healing process and throw off other underlying factors. Infection risks and complications are also higher for rheumatoid arthritis and chronic illness patients due to our compromised immune systems. Further, I wasn’t able to take my RA medications or any supplements that helped with pain and inflammation for a couple weeks before and one month after surgery. As if the pain from surgery wasn’t enough, the pain from my RA took it to a whole other level. Talk about hell.

On top of all that I also had to have a manipulation six weeks after my total knee replacement because my flexion range of motion in my knee wasn’t at the optimal degree. The culprit? Scar tissue and inflammation.

My surgeon sent me home with a CPM, also known as a Continuous Passive Motion machine. I had a love/hate relationship with this furry mammoth — the designated nickname I gave it. CPM helped reduce swelling and loosen me up before therapy and workouts, but frustratingly, I never reached the same number on the machine that my therapist measured me at for flexion.

If you enjoy privacy or are a private person, beware. An unfortunate reality of surgery is that you will be exposed. Having people change your bedpan in the middle of the night, especially an attractive male nurse, can be mortifying as a young woman. But afterwards, I realized how ridiculous I was being. After all, this was my first time I slept overnight in a hospital since my birth thirty years ago and everything was new to me. Can you blame me? I hated that I had to have help showering; it made me feel dependent. I am usually an independent person who likes to do things on my own terms and in my own way. But showering is an extreme challenge with an incision in your knee, plus joint damage in your upper body, making it difficult to prop yourself from a shower chair, so help was definitely needed.

My last point is that surgery makes you weak. On all physical, mental, emotional, and spiritual levels. My particular surgery ended up being three hours. Usually, it only takes one hour and half. Due to the extensive damage in my knee, the surgeon and his team had a lot of cleanup to do. Afterwards I had a lot of cleanup to do with my emotions, my body and my spirit.

The Ugly

If having your knee cut open to the bone isn’t ugly enough, having to get up and go walking the next day is a complete horror. The “use it or lose it” mentality is the ultimate slogan on the orthopedic floors. But because I also have joint damage in my elbow, wrists, and finger joints getting up and using my new knee was incredibly difficult for me. The second day I got up to walk, my incision bled through onto the gauze pad. I wasn’t ready and they do push you, mainly because they want to make sure you are safe to go home. Then, there is the insurance company and hospital rule factors that limit the amount of days that can be covered.

Medicare and Medicaid are my insurance providers. If receiving social security benefits isn’t hard enough, coverage for continual physical therapy is a huge headache. Being placed in medical reviews, needing to send in proof that I do indeed need more therapy, and being cut from social security benefits all at the same time is uglier than the whole surgery process itself.

Alternative and spa treatments such as deep tissue massage, myofascial massage, osteopathy and acupuncture all help with scar tissue, pain, inflammation and overall healing. However, they are often not covered by insurance, even when there is proof that these services help people. Unfortunately no one wants to pay for these services, often leaving patients with an inability to afford any sort of alternative treatment, limited funds or in debt.

The younger you are, the faster your body builds up scar tissue. If you have autoimmune arthritis, a complication can arise that I now have called, arthofibrosis, which is pretty much the name used for a stiff knee. I am still fighting the scar tissue every day, but I refuse to give up!

In your life, you are going to face challenges, but you are not defined by those challenges; you are defined by the actions you take and the attitude you carry when you face your challenges head on. Through the good, the bad, and the ugly of my total knee replacement, I made it out of the trenches and I know you can too.

total knee replacement patient

You can follow my total knee replacement journey on my 365 project page at or follow me on Twitter @risingabovera

Article Author
Arthritis National Research Foundation

The Arthritis National Research Foundation's mission is to provide initial research funding to brilliant, investigative scientists with new ideas to cure arthritis and related autoimmune diseases. Writing articles about the patients affected and the science being done to find a cure shows why we need to come together to #CureArthritis!

  • Teri Sims
    Posted at 09:25h, 17 March Reply

    Thank you for sharing your story. I am staring down the barrel of total knees for both knees. I’m 49 and have been suffering from OA for over 20 years. I also have RA. As an RN, I have done my research. I know how much pain I will be in. Your story has inspired me not to focus on that but to think of my improvement in quality of life. And not to give up. I will surely look to your blog for inspiration when I have my surgeries done. Thank you!

  • ShaRae Mansfield
    Posted at 06:17h, 23 March Reply

    Thank you for sharing! I have RA and osteoarthritis due to playing college and professional women’s basketball :). I had a total knee replacement at 37 and my recovery was similar to yours. Having my replacement was the best thing for me because my RA would attach my injured (ACL tear reconstruction, and 5 other scope surgeries) knee due to sports. Yes my replacement was my 7th surgery on the same knee! Even with the possible complications of a replacement surgery I was still willing to take the chance. The limitations and disability that RA causes is still unbelievable to me and I was diagnosed in 2011. So for me if I could have at least one joint that was a bit better and not attack me as much, I’d replace it.

    I never imagined being disabled at 39, especially after having such a successful sports career, but life happens but us RA warriors have to pick up the pieces and try to get our quality of life back as much as we can. I hope your story inspires others!

    • CureArthritis
      Posted at 16:10h, 23 March Reply

      ShaRae, thanks so much for sharing an honest account of your experiences; we’re happy that these stories can help others feel a little less alone in their battles.

  • Graham Macmillan
    Posted at 12:08h, 24 May Reply

    I had my left total knee replacement on the 24th November 2017, in Cape Town, South Africa.
    Thank you for sharing your storey. It is only now, that my major pain has left me and I feel human again.
    I also have RA and my recovery was the pain path to hell.
    I survived.
    My right knee is going to be replaced in November 2018.
    I do not look forward to the months of no sleep and the pain, but I now know, after the pain leaves, you are so much better.
    Thank you again for your storey. Keep healing well.
    Thank you.

  • Julie Reiman
    Posted at 06:47h, 08 July Reply

    I was diagnosed with Rheumatoid Arthritis in 2013! My left knee had been bothering me since 2011! I just had Ltkr on June 21, 2018! The knee feels pretty good but my whole leg is sore and achy! I’m doing physical therapy twice a week. The pain is usually worse at night! Hopefully the pain will settle down! Thank You for sharing your story!

  • Lynette Pugh
    Posted at 08:31h, 22 October Reply

    Omg! Youve lived my life. Im terrified. My surgeon told me exactly what yours did. I was told in July i needed the surgery. Said unequivocally no. My reason was that my mother passed 4 days after bilateral knee replacement. But here it is October im sleeping (not really sleeping) on my couch again . Insane part is almost 5 yrs ago i had spinal fusion surgery. But im getting tired of my family watch me cry in pain. Im just drained.

    • Linda Reynolds
      Posted at 13:28h, 11 March Reply

      Do you mind my asking what your mother died from? I am 50 something. 3 doctors said I need a knee replacement, the 4th said it was not possible due to a knee reconstruction surgery I had 30 years ago.

  • Larry Steffen,
    Posted at 08:55h, 23 December Reply

    Hey Effie,
    I am four days out of total knee replacement surgery and am living the life of non-sleep and constant pain you and your commenters have. But you have certainly opened up knowledge, insights and inspiration for me that doctors and the hospital overlooked..

    I have a full back rash that I don’t understand. My respite to all the discomfort has been one Oxycodine pill and one dose of liquid Ibroprophine every six hours. Hopefully all this will pass.

    I hope your words and writings continue to broaden and bring comfortand inspire others like me around the world.

  • Lynn Patterson
    Posted at 14:39h, 22 January Reply

    I love my knee replacement done 23/07/18 but can’t cope with the shin pain I started experiencing months after. Only at night as soon as I lie down in bed keeps me awake all night. I’m taking codeine paracetamol touched on Tramadol 🤮 and have once resorted to oromorph. Pain break through each time. I’ve been given 7 zopiclone to last til I see MSK PHYSIO 31st January I don’t know I’ll cope that long!

  • Olubunmi Sobo
    Posted at 13:54h, 04 March Reply

    Thanks a lot for sharing your spectacular experience. You are great in descriptions! You kept me laughing at a stage. I went through mine in Sept.2016, my other knee acting up recently. Courage, prayers and perseverance are the key words. Take care.

    Posted at 10:20h, 13 March Reply

    Thanks for sharing your experience that reflects the typical difficulties we knee replacement recipients encounter. My story is different in that I had no pain prior to surgery other than descending stairs from a torn ACL. My orthopedist convinced me that a total knee replacement would alleviate the ACL issue. I was a willing candidate to undergo all the discomfort and many months of physical exercises to be able to eventually descend stairs without pain. After months of painful physical therapy and home exercises I still can’t descend stairs without difficulty and the irony is that now it’s painful ascending stairs. My quality of life has been downgraded by not having a pain-free day in more than a year with stiffness and limited range of motion. Another problem is the constant knocking when walking. Then again I forget that I have a prosthetic knee. My orthopedics suggests my other knee may require replacement. Don’t hold your breath.

    • Lacy Brasol
      Posted at 16:07h, 27 March Reply

      I feel every ounce of your pain and dissatisfaction. They say you forget the pain and anguish. The meds, therapy and so many issues. Meds did not cut pain well enough, pinched nerve in my neck, pain med prescription did not arrive in time, therapy and everything made me ill and then they wanted a rebend procedure 3 months in. I declined because of mental and physical pain. My choice and I don’t regret it. My system could not tolerate long term pain meds. I also had reaction to anesthesia. Every person heals and reacts differently. I can only speak for myself. I truly would rather pass on. Second replacement if suggested. I say don’t give up once your in the mindset to succeed!! Listen to your self and ask for help, don’t compare yourself to anyone until you take your own journey.. Nurture your soul because your going to need a lot of tlc.

  • Katherine Reuter
    Posted at 14:32h, 06 October Reply

    Post knee replacement pain: It has taken 7 months to finally get the treatment I needed. It turns out I had an entrapped saphenous nerve that was finally relieved by a nerve ablation procedure. Prior to that, I had been made to feel that I just wasn’t working hard enough on my rehab, that a “manipulation under anesthesia” would help (it didn’t) and was prescribed Dynasplints which just made it worse! Of course, no pain killers helped, not even Gabapentin. Luckily I had a physical therapist who referred me to an MD that specialized in pain and rehab medicine. He did give me three different temporary blocks to make sure he was targeting the correct nerve and location. Then under local anesthesia, he used radio-frequency to target that nerve. It took a little over two weeks before the benefit kicked in. But I feel as if I have my life back and can actually do the rehab exercises. I have not lost any feeling in that area, except the pain. I understand it might only last 6-12 months but I will do it again in a heartbeat if needed.

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