Physiotherapy After Total Knee Replacement

Physiotherapy After Total Knee Replacement

Total knee replacement surgery, also known as total knee arthroplasty, is a common surgical intervention that is performed on individuals who have severe knee joint degeneration which is causing pain and impacting their daily function. Common reasons for undergoing this surgery include osteoarthritis, rheumatoid arthritis, or traumatic injury. The intervention involves removing damaged components of the knee joint and replacing them with artificial implants. The implants are designed to mimic the natural structure and function of the knee joint. This intricate procedure involves several key steps, including the preparation of the bone surfaces, precise positioning of the implants, and closure of the incision site. Similar to other orthopedic procedures, there is a long recovery period following a TKR which is where physiotherapy is crucial.

Preoperative Preparation:

Every case and timeline is different for individuals undergoing knee surgery. The current literature recommends, if able, to trial conservative management for at least 3-6 months before deciding to have a TKR. If the individual doesn’t notice any changes in pain or function following this, then surgery may be deemed appropriate. Engaging in pre-operative rehabilitation can aim to build muscle strength and master movement patterns that will be progressed postoperatively. Focusing on nutrition, weight reduction strategies if applicable and reducing poor health decisions such as smoking and alcohol consumption is also important.

Post-Operative Hospital Care:

Post-operatively you will be assessed by the medical team as well as a physiotherapist. Your range, strength and function will be assessed. The physiotherapists will help get you sitting out of bed and walking. Pending your age, strength and pain levels, you may require crutches or a frame to assist you with your mobility. The focus early on is on swelling reduction, pain management and early mobilisation. This will ultimately improve rehabilitation timeframe and reduce the risk of developing any postoperative complications such as a DVT. Once you are medically stable and have progressed in your overall function, you will either be discharged home or to an inpatient rehabilitation center, both of which will involve ongoing physiotherapy.

Rehabilitation Post Hospital:

Following back surgery, the rehabilitation process is very goal focused in terms of what you will be striving to get back to doing in your life. This will vary pending if you are returning to sport or if you are returning to walks around the block with your dog. However, the fundamentals are consistent amongst all individuals. Working on early weight bearing activities is important. You will be prescribed a mixture of range of motion exercises to get your knee moving ideally between 0 degrees extension to over 120 degrees of flexion. Balance is another component of the rehabilitation which can be prescribed within the early stage. These exercises aim to improve neuromuscular function and proprioception which can be impacted following an orthopedic surgery. Strength is the next component of the rehabilitation and will continue to be assessed over the course of the entire process. The rehabilitation should include a full lower limb strengthening program, targeting the quadriceps, glutes, hamstrings, adductors and calves. As well incorporating trunk stability within sessions. Most likely you will start with body weight movement patterns and then gradually the loads will be increased to build strength and endurance through these muscles.

See below some examples of exercises that may be prescribed in the early stages of your post TKR rehabilitation:

  1. Calf Raises > https://www.youtube.com/watch?v=b-q-UKLfaiM
  2. Quad Co-contractions > https://www.youtube.com/watch?v=76XSWfcMNlE
  3. Side Lying Clam > https://www.youtube.com/watch?v=NNAMNQpZX2g
  4. Heel Digs > https://www.youtube.com/watch?v=eKYYgLi3zCs
  5. Sit To Stand > https://www.youtube.com/watch?v=EMq3a_3bAkw

Once strength has improved and pending the individual’s goals, plyometrics can be introduced. This is to prime the knee joint for impact from any change of direction, hopping, jumping or landing movements. This part of the rehabilitation becomes very specific to the demands of the sport or activity that the individual is returning to.

Rehabilitation Journey:

The rehabilitation journey post TKR is a gradual process that requires commitment and ongoing support from your physiotherapist. If you are someone who is having or has had a TKR, book in with one of our physiotherapists. You will be provided with a thorough rehabilitation plan and tailored exercise program to get you back doing what you love, pain free!

Phoebe McGeoch – BeFit Training Physio Coogee

Phoebe McGeoch – BeFit Training Physio Coogee

Phoebe McGeoch is a physiotherapist based in Coogee in the Eastern Suburbs of Sydney. Phoebe has successfully treated musculoskeletal problems on the basis of a thorough assessment and diagnosis coupled with evidence-based rehabilitation programs tailored to the needs and goals of each individual. To book a consultation, click the link below.

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