In a revision total knee arthroplasty, or in cases where there is more connective tissue involvement, phase i and ii should be progressed with more caution to ensure adequate healing. Total knee arthroplasty tka is an elective operative procedure to treat an arthritic knee. Your orthopaedic surgeon and physical therapist may recommend that you exercise for 20 to 30 minutes, 2 or 3 times a day and walk for 30 minutes, 2 or 3 times a day during your. This physical therapy protocol applies to primary total knee arthroplasty. When you have total knee replacement tkr surgery, recovery and rehabilitation is a crucial stage. Physical therapy after total knee replacement if youve had knee replacement surgery, chances are very high that youll feel far less pain and can move around much better than before. Total knee arthroplasty rehabilitation protocol what. If you have had a tkr or are expecting to have one, you may benefit from physical therapy after surgery to help you regain your normal mobility. The knee joint is made up of the femur thigh bone, the tibia shin bone, the patella knee cap and cartilage usually worn out because of oa. Recovery and rehab play a crucial role after total knee replacement. Sports medicine physical therapy rehabilitation protocols. Progression through each phase of rehabilitation is based on clinical criteria and time frames as appropriate. Knee implants consist of 1 a metal piece attached to the end of your thigh bone, 2 a metal and plastic or.
These rehabilitation guidelines are presented in a criterion based progression. We usually prefer epidural anesthesia since a good epidural can provide up to 48 hours of postoperative pain relief and allow faster more comfortable progress in physical therapy. This type of surgery is a big decision and this manual is intended to help you prepare for your surgery and guide you through the rehabilitation. Physiotherapy advice following total knee replacement surgery. Ankle exercises point your feet up and down in a pumping motion.
You have made the decision to have a total knee replacement to decrease your pain, regain function, and increase your quality of life. Total hip precautions after surgery should be followed for 3 months and include. Rehabilitation guidelines for total knee replacement 4 p a g e phase iv continued suggested therapeutic exercises continue with progression of exercises for eccentric quad control integrate return to golf, tennis, hiking, cardiovascular program advance balance and proprioception cardiovascular exercises bike riding. Post operative total knee replacement protocol brian white, md. Total joint replacement, or arthroplasty, represents a significant advance in the treatment of painful and disabling joint pathologies.
Postoperative instructions for total knee replacements. The content of this website is intended for individuals undergoing single sided total knee replacement for either the right or left knee. Proposed rehab protocol for total knee replacement. There is at least one polyethylene piece, placed between the tibia and the femur, as a shock absorber. Gait c orrect any abnormal gait patterns noted hip rom s tay within the precaution limits hip strength. Initiate gentle strengthening exercises with the primary goal of activating the quadriceps. Postoperative rehabilitation following tka facilitates patient recovery and improves quality of life. Total ankle replacement rehabilitation protocol dr.
Patients who have had a prior patellectomy or failed total knee replacement may require modifications in regards to the progression of weight bearing and knee motion as discussion in this protocol. This illustrated guide includes exercises and activities designed to restore muscle strength and mobility to your knee following total knee replacement. Many of the protocols listed refer to specific exercises. Total knee replacement surgery provides relief for patients with severe pain caused by degeneration of the cartilage in the knee, advanced arthritis, or serious knee injuries. Rehabilitation guidelines following total ankle arthroplasty rehabilitation is vital to regaining motion, strength and function of the ankle after surgery. Weekbyweek rehab protocol for total knee replacement. The most common form of damage seen is osteoarthritis. Total knee arthroplasty protocolbrigham and womens hospital. I have shared each moment with them until their full rehabilitation. Exercise guide for knee replacement surgery vancouver. General time frames are given for reference to the average, but individual patients will progress at different rates depending on their age, comorbidities, presurgical range of.
Here are some videos explaining knee and lower extremity exercises which you may find useful. This procedure replaces your damaged hip joint with an artificial hip implant. Physiotherapy rehabilitation after total hip or knee replacement is accepted as a standard and essential treatment. Outpatient rehabilitation guidelines for total knee arthroplasty. Make sure that your patient has a follow up appointment for a wound check. General time frames are given for reference to the average. The goal of the following exercises is to regain range of motion while limiting pain and inflammation. Over 85% of total knee arthroplasty tka patients will recover knee function regardless of which rehabilitation protocol is adopted. You will work with your doctor and physical therapist to plan this exercise program. Knee implants consist of 1 a metal piece attached to the end of your thigh bone, 2 a metal and plastic or allplastic piece attached to the top of. Tighten the muscles on the front of your thigh and push the back of your knee down into the bed. Outpatient rehabilitation guidelines for total knee.
To begin, your doctor will follow the line of the incision made during your primary total knee replacement. Total knee replacement tkr is one of the most commonly done surgical procedures, with over 150,000 total knee replacements and thr performed annually in england and wales in the national health. Total knee replacement exercise guide orthoinfo aaos. This protocol provides you with general guidelines for the initial stage and progression of total ankle replacement rehabilitation. Recent efforts have been made to significantly improve patient outcomes, specifically with postoperative rehabilitation. Rehabilitation protocol this rehabilitation protocol was developed for patients who have had a cemented total knee arthroplasty. During the surgery, the knee joint is replaced with artificial material.
Total hip arthroplasty tha is an elective operative procedure to treat an arthritic hip. We have remained at the forefront of medicine by fostering a culture of collaboration, pushing the boundaries of medical research, educating the brightest medical minds and maintaining an unwavering commitment to the diverse communities we serve. Acknowledgments this edition of the guide would not have been possible without the tireless efforts and dedication of the sub. Physical therapy exercises to do after total knee replacement. Total knee arthoplasty tka or total knee replacement tkr is a orthopaedic surgical procedure where the articular surfaces of the knee joint the femoral condyles and tibial plateau are replaced.
Progression to the next phase is based on clinical criteria andor time frames as. Rehabilitation protocols following total knee arthroplasty. Make sure you check with the surgeon before you start using any protocol. Each case can be very different depending on the goals of. The full rehabilitation program may not be necessary. Rehabilitation guidelines following total ankle arthroplasty. Total knee arthroplasty protocol the following protocol should be used as a guideline for rehabilitation progression, but may need to be altered pending the nature and extent of the surgical procedure, healing restraints or patient tolerance. Exercise guide for knee replacement surgery please bring this guide to the hospital and to all physiotherapy appointments.
Patient will be weight bearing as tolerated with a rolling walking or other piece of medical equipment. Revision total knee replacement is more complex and takes longer to perform than primary total knee replacement. The accelerated rehabilitation protocol has been continued at this hospital after the period detailed in this study, and during the last 12 months there have been no further readmissions. During stage i, continue with rice rest, ice, compression, and elevation. Bell, pt, dpt, and anna shovestul, pt, dpt, originally published on ptnow october 25, 2011. This may demonstrate that community staff are now becoming familiar with the typical presentation of. An increasing number of total knee arthroplasties tkas are performed each year.
Total knee replacement may be performed under epidural, spinal, or general anesthesia. A total knee replacement tkr is usually done as the surgical treatment option for advanced osteoarthritis of the knee joint. Your pt will modify your exercises as your knee improves. Adequate pain control after tka is important in expediting patient progress with mobility and range of motion after surgery. General time frames are given for reference to the average, but individual patients will progress at different rates depending on. Total knee replacement manual and therapyrehab protocol. Recovery from surgery rehabilitation exercise handouts pain management orthopinion blog. The end of the femur is removed and replaced with a.
The tkr protocol provides you and your physical therapist a framework on which to build your rehabilitation program. Knee total knee arthroplasty brigham and womens hospital. Total knee replacement rehabilitation kaiser permanente. Each case can be very different depending on the goals of the patient, the age of the. A total knee replacement tkr surgery is typically done when severe arthritis causes knee pain, limited motion, and extreme difficulty with walking. Hip implants consist of 1 a smooth ball on a stem that fits into your thigh bone the femoral stem, and 2 a. Postoperative rehabilitation is of the utmost importance following total joint replacement in order to ensure painfree function of the joint and improve the patients quality of life qol. Patellofemoral ligament reconstruction rehabilitation program. Repeat 10 times every hour to help prevent blood clot formation and pump swelling away from the leg.
Rehabilitation goals are based on age, gender, previous activity level and other orthopedic and medical problems. Accelerated rehabilitation after total knee replacement. Total knee arthroplasty protocol brigham and womens hospital. Also, obtain a copy of the operative report from the surgeon. Knee replacement rehabilitation rehab is a series of exercises you do after your surgery. This helps you get back your knees range of motion and strength.
Knee replacement surgery can bring you huge relief from pain. Physical therapy is an important part of that recovery. These guidelines should be administered under the supervision of a physical therapist. It contains exercises and advice to help you recover to the best of your ability, and provides guidance so that. Total knee arthroplasty has become the standard of care for patients with endstage knee oa and is the most frequently performed orthopedic procedure in the united states. Physiotherapy rehabilitation after total knee or hip. Postoperative exercises weeks 12 for total knee replacement. The goals of any rehabilitation protocol should be to control pain, improve ambulation, maximize range of motion, develop muscle strength, and provide emotional support. Left total knee replacement surgery and rehabilitation. The intent of this physical therapy protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient who has undergone a total knee arthroplasty tka at brigham and womens hospital bwh. Preoperative physical therapy the patient is seen for a preoperative physical therapy session which includes. Total knee arthroplasty tka is among the most common elective procedures performed worldwide. Approximately 85 to 90 percent of all total knee replacement operations performed are successful for approximately 10 to 15 years, depending on the patients level of. A total knee replacement is a surgical operation aiming to replace a wornout joint.
Physiotherapy exercises following total knee replacement. Its aim is to maximize functionality and independence and to minimize complications such as wound infection, deep vein thrombosis, pulmonary embolism, and hip dislocation for hip replacements. This procedure replaces your damaged knee joint with an artificial knee implant. This summary is an update of the total knee arthroplasty clinical summary by karla a. Regular exercise to restore strength and mobility to your knee and a gradual return to everyday activities are important for your full recovery after knee replacement. Total hip replacement rehabilitation protocol outpatient physical therapyphase i weeks 1 6 postop patient is evaluated weekly in outpatient pt unless deemed otherwise, or in inpatient setting evaluate and document. Total knee replacement rehab protocol the stone clinic. Total hip arthroplasty protocol the following protocol should be used as a guideline for rehabilitation progression, but may need to be altered pending the nature and extent of the surgical procedure, healing restraints or patient tolerance.