Total Knee Replacement Rehabilitation
Having a total knee replacement surgery is usually the best option for patients with severe knee arthritis. At present, more than 4.5 million people in the U.S. are living with at least one total knee replacement, and around 1.5 million people with a replaced knee are 50-70 years of age. During the last couple of decades, total knee replacement increased by 84% in the U.S. population, with the current rate 22 per 10,000 persons. The most important part the knee replacement process is rehabilitation.
The greatest demand for total knee replacement is not coming from the elderly demographics. Rather, it is younger people who have weight issues. There is a strong relationship between knee osteoarthritis and having a high body mass index. More people ages 18 to 64 years are having severe knee pain and loss of mobility related to being overweight.
- Patients are weight-bearing as tolerated with a walker, crutches, or cane until they can walk without assistance.
- Early emphasis is on developing full extension equal to the opposite leg soon as possible.
- No active or passive flexion motion greater than 90 degrees until stitches are removed.
- Early exercise will focus on recruitment of proper quadriceps set.
- Keep incision site clean and dry.
- Avoid submerging in a pool, tub, or sauna until wounds are healed.
- Avoid jumping, twisting, pivoting, or rigorous activities.
- You will return to see the Arizona orthopedic surgeon to change the dressing and review health status.
- Icing, leg elevation, and swelling control are implemented. Swelling control can be achieved using a compression wrap and circumferential massage.
- Soft tissue treatments and gentle mobilization are implemented by physical therapist.
- Exercises include gluteal sets, gait training, and balance/proprioception maneuvers. Straight leg raise exercises with quad sets are began, and passive/active range of motion exercises are started.
- Goals of therapy are to increase range of motion < 90 degrees, and to decrease swelling and pain.
- You will return to the Gilbert orthopedic surgeon’s office to have staples/stitches removed and for a check-up.
- The therapist will continue with soft tissue treatments and gentle mobilization, avoiding flexion or patella contracture.
- Exercises are continued, including progress flexion range of motion, functional exercises, gait training, and balance/proprioception maneuvers.
- Aerobic exercise is began as tolerated (cycling, swimming).
- Goals include decreasing swelling and edema and range of motion < 10 degrees extension to 100 degrees.
- You will follow-up with the orthopedic surgeon.
- Gentle mobilization and soft tissue treatments continue.
- Exercises continue, such as functional exercises (weight machines and walking outside), balance/proprioception maneuvers, and swimming after incisions are closed.
- Goals include walking without a limp and range of motion < 5 degrees extension to 110 degrees.
- Continue soft tissue treatments, joint mobilizations, and patellar glides to increase range of motion.
- Add lateral training exercises, and incorporate single leg exercises as tolerated.
- Goals include patient walking without limp, and range of motion 0-115 degrees.
- Continue joint mobilizations, soft tissue treatments, and patellar glides to increase range of motion.
- Begin activity specific training, such as gardening, sports, and household chores.
- Low impact activities after week 11.
- Patients are weaned into a home and gym program with emphasis on their particular sport/activities.
- Goals include return to functional activities and range of motion within functional limits.
Health Research Funding (2016). 23 Amazing Total Knee Replacement Statistics. Retrieved from: http://healthresearchfunding.org/23-amazing-total-knee-replacement-statistics/