The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement

Episode 77: Sleeping Better After Knee Replacement (Research & Real Life: Swelling, Routines, Positioning, Timing)

Episode 77 explores what the research shows about how sleep starts improving after knee replacement and why progress often comes from small adjustments that stack over time. Michelle connects findings from sleep questionnaires, wearable tracking, and overnight sleep studies to four practical areas: swelling timing, routines, positioning, and timing conversations with your provider. Episode 77 also previews Episode 78, which looks at what changes when sleep stops controlling your entire day. Making Sense of Pain After Knee Replacement [https://amzn.to/4amOicH] Total Knee Success Insider [https://totalkneesuccess.kit.com/becomeaninsider?_gl=1*18lj5ab*_gcl_au*MTE1MjY0OTYzLjE3NzA2ODQyNzEuNjk4MzU5MDI5LjE3NzQyMTk2NTguMTc3NDIyNDYwNg..] totalkneesuccess.com [http://totalkneesuccess.com] Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan. Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you. Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation. Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript. References: Krenk L, Jennum P, Kehlet H. Sleep disturbances after fast-track hip and knee arthroplasty. Br J Anaesth. 2012;109(5):769-775. doi:10.1093/bja/aes239. Van Meirhaeghe JP, Delaere O, Van Genechten W, et al. Improvement in sleep patterns after hip and knee arthroplasty: a prospective study in 780 patients. J Arthroplasty. 2021;36(2):442-448. doi:10.1016/j.arth.2020.08.034. Vitale JA, Bonato M, La Torre A, et al. How do patients sleep after orthopaedic surgery? Changes in actigraphy-based sleep characteristics and pain in patients undergoing hip or knee joint replacement during hospitalisation. Int Orthop. 2023;47(8):1959-1968. doi:10.1007/s00264-023-05862-2. Zhu Z, Zhu Z, Peng C, et al. Perioperative sleep disturbances in total knee arthroplasty: incidence, mechanisms, and management strategies. J Orthop Surg Res. 2025;20:964. doi:10.1186/s13018-025-06416-5. Ferrero A, Patrucco F, Marcolin MG, Anzillotti G. Objective sleep disturbance after total hip and knee arthroplasty: a systematic review of wearable-derived metrics and targeted interventions. Arthroplast Today. 2026;39:102013. doi:10.1016/j.artd.2026.102013. Gong L, Wang Z, Fan D. Sleep quality effects early outcomes after total knee arthroplasty: a randomized, double-blind, controlled study. J Arthroplasty. 2015;30(11):1897-1901. doi:10.1016/j.arth.2015.02.020. Krenk L, Jennum P, Kehlet H. Postoperative sleep disturbances after zolpidem treatment in fast-track hip and knee replacement. J Clin Sleep Med. 2014;10(3):321-326. doi:10.5664/jcsm.3540. Bjurström MF, Bohman T, Everson-Rose SA, et al. Promoting sleep to alleviate pain after total joint arthroplasty: protocol for a randomized controlled trial. BMJ Open. 2025;15(7):e099785. doi:10.1136/bmjopen-2024-099785.

Episode 76: Sleep Changes Everything After Knee Replacement (The Overlooked Effects of Interrupted Sleep)

Episode 76 explores what fragmented sleep can start changing after total knee replacement and why disrupted nights often affect far more than nighttime alone. Michelle explains how interrupted sleep can influence pain sensitivity, energy, focus, patience, and perceived effort during the day. The episode also discusses why progress can feel inconsistent when sleep is unreliable and why day-to-day variability can be normal in the early post-op period. Get the Making Sense of Pain After Knee Replacement on Amazon. [https://amzn.to/3RH9V0T] Kindle version is available. Print version drops on May 30, 2026. Total Knee Success Insider [https://totalkneesuccess.kit.com/becomeaninsider?_gl=1*18lj5ab*_gcl_au*MTE1MjY0OTYzLjE3NzA2ODQyNzEuNjk4MzU5MDI5LjE3NzQyMTk2NTguMTc3NDIyNDYwNg..] totalkneesuccess.com [http://totalkneesuccess.com] Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan. Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you. Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation. Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript. References: Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552. doi:10.1016/j.jpain.2013.08.007. Haack M, Simpson N, Sethna N, Kaur S, Mullington J. Sleep deficiency and chronic pain: potential underlying mechanisms and clinical implications. Neuropsychopharmacology. 2020;45(1):205-216. doi:10.1038/s41386-019-0439-z. Krenk L, Jennum P, Kehlet H. Sleep disturbances after fast-track hip and knee arthroplasty. Br J Anaesth. 2012;109(5):769-775. doi:10.1093/bja/aes239. Smith TO, Mansfield M, Dainty JR, et al. Does sleep quality improve following total hip or knee arthroplasty? A systematic review. Clin Rehabil. 2017;31(11):1445-1456. doi:10.1177/0269215517690842. Mehta N, Sancheti P, Sanghavi S, et al. Sleep quality improves after total knee arthroplasty: addressing early disturbance and risk factors. J ISAKOS. 2025;10(1):100373. doi:10.1016/j.jisako.2024.100373. Ferrero A, Patrucco F, Marcolin MG, Anzillotti G. Objective sleep disturbance after total hip and knee arthroplasty: a systematic review of wearable-derived metrics and targeted interventions. Arthroplast Today. 2026;39:102013. doi:10.1016/j.artd.2026.102013. Zhu Z, Zhu Z, Peng C, et al. Perioperative sleep disturbances in total knee arthroplasty: incidence, mechanisms, and management strategies. J Orthop Surg Res. 2025;20:964. doi:10.1186/s13018-025-06416-5. Smith TJ, Wilson MA, Karl JP, et al. Impact of sleep restriction on local immune response and skin barrier restoration with and without “multinutrient” nutrition intervention. J Appl Physiol (1985). 2018;124(1):190-200. doi:10.1152/japplphysiol.00547.2017.

Episode 75: Why Sleep Becomes So Difficult After Knee Replacement (Pain, Nervous System Alertness, and Why Your Brain Will Not Fully Shut Off)

Episode 75 explores why sleep becomes so difficult after total knee replacement and why nighttime often feels harder than many people expect after surgery. Michelle explains the interaction between postoperative inflammation, swelling fluctuations, nervous system alertness, pain sensitivity, positioning discomfort, medication timing, and sleep monitoring behaviors. The episode also discusses why many people feel physically exhausted yet mentally alert after surgery and why disrupted sleep can remain unpredictable long after the daytime environment quiets down. Get the Making Sense of Pain After Knee Replacement on Amazon. [https://amzn.to/3RH9V0T] The Kindle version is available now. The print version drops on May 30, 2026. Total Knee Success Insider [https://totalkneesuccess.kit.com/becomeaninsider?_gl=1*18lj5ab*_gcl_au*MTE1MjY0OTYzLjE3NzA2ODQyNzEuNjk4MzU5MDI5LjE3NzQyMTk2NTguMTc3NDIyNDYwNg..] totalkneesuccess.com [http://totalkneesuccess.com] Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan. Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you. Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation. Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript. References: Huang Z, Ma J, Shen B, Pei F. Combination of perioperative sleep disorder and depression can predict long-term outcomes after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2021;29(6):1905-1914. Krenk L, Jennum P, Kehlet H. Sleep disturbances after fast-track total hip and knee arthroplasty. Br J Anaesth. 2012;109(5):769-775. Madsen MT, Rosenberg J, Gögenur I. Actigraphy for measurement of sleep and physical activity after surgery: a systematic review. Sleep Med Rev. 2013;17(5):387-398. Wylde V, Rooker J, Halliday L, Blom A. Acute postoperative pain at rest after hip and knee arthroplasty: severity, sensory qualities and impact on sleep. Orthop Traumatol Surg Res. 2011;97(2):139-144. Finan PH, Goodin BR, Smith MT. The association of sleep and pain: an update and a path forward. J Pain. 2013;14(12):1539-1552. Haack M, Simpson N, Sethna N, Kaur S, Mullington J. Sleep deficiency and chronic pain: potential underlying mechanisms and clinical implications. Neuropsychopharmacology. 2020;45(1):205-216. Ravyts SG, Dzierzewski JM, Grah SL, et al. Sleep and pain interference in individuals with chronic pain: the role of anxiety and sleep hygiene. J Clin Sleep Med. 2018;14(9):1565-1573. Smith TO, Mansfield M, Dainty JR, et al. Does sleep quality improve following total hip or knee arthroplasty? A systematic review. Clin Rehabil. 2017;31(11):1445-1456.

Episode 74: When Strength Finally Turns Into Confidence (How Strength Helps Build Real World Confidence After Knee Replacement)

Episode 74 explores how strength after total knee replacement gradually turns into movement confidence through repeated successful movement experiences. Michelle discusses balance, stair confidence, walking participation, movement hesitation, and why confidence often develops more slowly than physical strength. The episode also explains how real world movement practice, repetition, and consistent participation influence long term independence after knee replacement. Get the free download: The Total Knee Success Podcast Countdown: Top 10 Walking Tips After Knee Replacement [https://totalkneesuccess.kit.com/toptenwalk] Total Knee Success Insider [https://totalkneesuccess.kit.com/becomeaninsider?_gl=1*18lj5ab*_gcl_au*MTE1MjY0OTYzLjE3NzA2ODQyNzEuNjk4MzU5MDI5LjE3NzQyMTk2NTguMTc3NDIyNDYwNg..] totalkneesuccess.com [http://totalkneesuccess.com] Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan. Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you. Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation. Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript. References: Arhos EK, Ito N, Hunter-Giordano A, Nolan TP Jr, Snyder-Mackler L, Silbernagel KG. Who’s afraid of electrical stimulation? Let’s revisit the application of NMES at the knee. J Orthop Sports Phys Ther. 2024;54(2):101-106. Duong V, Dennis S, Ferreira ML, et al. Predictors of adherence to a step count intervention following total knee replacement: an exploratory cohort study. J Orthop Sports Phys Ther. 2022;52(9):620-629. Graber CJ, Stevens-Lapsley JE, Bade MJ, et al. Expert consensus for the use of outpatient rehabilitation visits after total knee arthroplasty: a Delphi study. J Orthop Sports Phys Ther. 2023;53(9):566-576. Mizner RL, Petterson SC, Stevens JE, Vandenborne K, Snyder-Mackler L. Early quadriceps strength loss after total knee arthroplasty: the contributions of muscle atrophy and activation failure. J Bone Joint Surg Am. 2005;87(5):1047-1053. Orange GM, Hince DA, Jones M, et al. Physical function following total knee arthroplasty for osteoarthritis: a longitudinal systematic review with meta-analysis. J Orthop Sports Phys Ther. 2025;55(1):1-15. Petterson SC, Mizner RL, Stevens JE, et al. Improved function from progressive strengthening interventions after total knee arthroplasty: a randomized clinical trial. Arthritis Rheum. 2009;61(2):174-183.

Episode 73: How to Build Strength Without Setting Yourself Back (Flareups, Exercise Dosage, and Safe Strength Progression After Knee Replacement)

Episode 73 explores how to build strength after total knee replacement without triggering repeated flareups and inconsistent progress. Michelle explains the difference between productive soreness and warning signs, discusses progressive loading and pacing strategies, and reviews current rehabilitation research related to strength, balance, and movement confidence. The episode also examines how repeated successful movement experiences influence long term mobility and independence. Free download: Top 10 Walking Tips After Knee Replacement [https://totalkneesuccess.kit.com/toptenwalk] Total Knee Success Insider [https://totalkneesuccess.kit.com/becomeaninsider?_gl=1*18lj5ab*_gcl_au*MTE1MjY0OTYzLjE3NzA2ODQyNzEuNjk4MzU5MDI5LjE3NzQyMTk2NTguMTc3NDIyNDYwNg..] totalkneesuccess.com [http://totalkneesuccess.com] Medical Disclaimer: This podcast is for educational purposes only and does not constitute medical advice. The content is not intended to replace individualized medical guidance, diagnosis, or treatment. Always consult your surgeon, physical therapist, or other qualified healthcare provider regarding your specific condition, surgical decisions, and rehabilitation plan. Amazon Affiliate Disclaimer: Some resources mentioned in this podcast may include Amazon affiliate links. If you choose to purchase through these links, the podcast may earn a small commission at no additional cost to you. Evidence-Based Content Statement: All information presented in this episode is grounded in peer-reviewed research, published clinical guidelines, and current best practices in orthopedic surgery and rehabilitation. Music Licensing Statement: Intro and outro music for the Total Knee Success Podcast is licensed for commercial use. Editing and production for this episode were completed using Descript. References: Arhos EK, Capin JJ, Snyder-Mackler L, et al. Who’s Afraid of Electrical Stimulation? Let’s Revisit the Application of NMES at the Knee. J Orthop Sports Phys Ther. 2024;54(2):101-105. Bade MJ, Struessel T, Dayton M, et al. Early High-Intensity Versus Low-Intensity Rehabilitation After Total Knee Arthroplasty: A Randomized Controlled Trial. Arthritis Care Res. 2017;69(9):1360-1368. Bricca A, Skou ST, Roos EM, et al. Exercise Therapy “Wears Down” My Knee Joint: Myth or Reality? J Orthop Sports Phys Ther. 2025;55(7):463-470. Capin JJ, Minick KI, Stevens-Lapsley JE, et al. Variation in Outcomes and Number of Visits Following Care Guideline Implementation: Part 2 of an Analysis of 12 355 Patients After Total Knee Arthroplasty. J Orthop Sports Phys Ther. 2023;53(3):151-160. Duong V, Dennis S, Ferreira ML, et al. Predictors of Adherence to a Step Count Intervention Following Total Knee Replacement: An Exploratory Cohort Study. J Orthop Sports Phys Ther. 2022;52(9):620-629. Graber CJ, Stevens-Lapsley JE, Bade MJ, et al. Expert Consensus for the Use of Outpatient Rehabilitation Visits After Total Knee Arthroplasty: A Delphi Study. J Orthop Sports Phys Ther. 2023;53(9):566-576. Minick KI, Hunter SJ, Capin JJ, et al. Improved Outcomes Following a Care Guideline Implementation: Part 1 of an Analysis of 12 355 Patients After Total Knee Arthroplasty. J Orthop Sports Phys Ther. 2023;53(3):143-150. Na A, Coronado RA, Baker CE, et al. Diabetes Mellitus Blunts the Symptoms, Physical Function, and Health-Related Quality of Life Benefits of Total Knee Arthroplasty: A Systematic Review With Meta-analysis of Data From More Than 17 000 Patients. J Orthop Sports Phys Ther. 2021;51(6):269-280.