Physical Therapy After a Knee Replacement-By: Jason Balogh PT, MSPT, Cert. MDT

Total knee replacements are the most common joint replacement performed accounting for approximately 790,000 annually in the US. The implant life expectancy is 20+years.

When is a Total knee arthroplasty appropriate?

They are considered an appropriate treatment after conservative care (physical therapy,activity modification,

medications, injections, weight loss program, etc) have been attempted and unsuccessful. With imaging; when a

orthopedic surgeon finds the knee to have advanced/severe arthritis and pain/function is becoming a limiting factor they will often recommend a total knee arthroplasty. The surgeon will also evaluate a prospective patients overall medical history to ensure the safety of the patient to undergo surgery.

Physical Therapy after a total knee arthroplasty:

On the day of surgery, or the morning after, it is typical that a physical therapist from the hospital will see the

patient. They will work on basic muscle contraction, knee movements, blood clot prevention, getting in and out of

bed/chair/bathroom, and walking (typically with a walker). Some patients may return home the day after surgery

while others may stay in the hospital for a few days with therapy or be transferred to a rehab facility for a short time.

Once home, home health physical therapy is often involved and evaluates the patient needs and continues to work on exercises for blood clot prevention, swelling control, strength, range of motion of the knee, transfers, walking, and balance to help the patient be independent within their home and give them the ability to get out of the home.

Outpatient physical therapy (which all 3 of Advanced Rehabilitation facilities specialize in) is seen after the above noted therapy is finished. This is typically from 2-6 weeks post surgery dependent on the patients recovery and abilities. Patients are evaluated in which their knee mobility, overall strength, transfers, walking abilities, balance, living situation and goals are assessed. A treatment plan is implemented by the therapist, that is patient specific, to improve the noted deficits (often range of motion and strength). Walking and balance are also addressed as well as stair and squatting ability as it correlates to a persons function in life. A home exercise program is given to each patient and is tailored to their deficits. Modalities, such as heat, ice, or electric stim may be used with some patients to help manage pain, swelling, muscle contraction and enhance healing. Managing swelling is critical to help with flexibility as well as reducing pain and trying to expedite the healing process.

A total knee replacement is a routine surgery, however it is still a major surgery. The surgery is the start of the

process but rehabilitation is imperative to restore the motion and strength that is necessary to regain function for

walking, stairs, daily activities and balance. Physical therapy is necessary to assess and guide a patient on a

individual program to address their deficits and empower them to a full recovery.

If you have any questions or need further assistance, do not hesitate to contact us at Advanced Rehabilitation.

References:

https://rheumatology.org/patients/joint-replacement-surgery#