I'm in a panic. I had a total knee replacement done about four weeks ago. The strength measurements keep going down. I'm not getting better and I have to be ready for my daughter's wedding in two months. What can I do??

It's fairly well known that patients get worse before they get better after a total knee replacement. Major deficits in strength are seen in the first month after the operation. Most likely this is because the muscles around the knee are often cut during this procedure. It takes four to six weeks for the soft tissues to heal and begin to recover.

Most patients see a remarkable improvement by the end of six months. Between one and two years post-TKR you should see small gains in function.

The best thing you can do for yourself in these next two months is to stay steady. Do your exercises faithfully every day. Don't overdo it. More isn't always better. Consult with your doctor and physical therapist about the best plan of rehab for your particular circumstances. Will you have to go up and down stairs at a church or banquet hall? How far will you have to walk during the ceremony?

You may want to have an escort at all times. No one needs to know that person is giving you more support than just a polite escort. Your escort can also discretely make sure a chair is available for you. Short rest breaks can help. Sitting too long may cause increased stiffness. Staying active is your best insurance for a good outcome. And congratulations!

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