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  • Writer's pictureDavid Crews

Physical Rehab After Knee Replacement Surgery


People suffering from arthritis of the knee may be steered toward total knee replacement (TKR) surgery to lessen pain, restore joint functionality and improve range of motion.

Yet patients should not expect to undergo this surgery and have a fully functioning, ready-to-use-new joint right away. Rather, about 12 weeks of physical therapy-based rehabilitation typically follow TKR surgery.

This process allows your body to integrate the replacement and helps you regain full range of motion to eventually resume an active lifestyle. Here’s what you should expect from physical rehabilitation along the way.

Knee Replacement Surgery Recovery Plan

Following surgery, the replacement knee might seem stiff or even painful. Initially, rehab focuses on restoring joint mobility and strength, with the goal of getting you home to continue recovery in an inpatient or outpatient physical therapy facility.

AFTER SURGERY

Within 24 hours after surgery, a physical therapist will help you stand up and use a mobility device like a walker, cane or set of crutches. Meanwhile, an occupational therapist will be there to assist you with bathing and using the bathroom over the next few days.

During these early stages, exercises help strengthen your knee, reduce risks for complications and help you become more mobile in a hospital setting:

  • You’ll practice getting in and out of bed, sitting on the side of the bed and transferring yourself to an adjacent toilet or bathroom.

  • You’ll start by taking a few steps in your room with an assistive device, before transitioning to walking down a hallway. In between, expect to do more walking exercises with parallel bars or a walker.

  • Additional exercises focus on improving blood flow to your legs and feet to reduce clotting and deep vein thrombosis risks.

  • Occupational therapy sessions instruct you on bathing, dressing and using the bathroom as you recover, including making various modifications.

  • A therapist may use a continuous passive motion (CPM) machine on the joint to help improve motion, reduce stiffness and lessen the occurrence of scar tissue.

Once you can bend your knees at a 90-degree angle, stand and walk with minimal assistance, and climb stairs, you should be sent home to continue your recovery in an inpatient or outpatient setting. Discharge is based on the type of knee replacement and your support system for recovery. Patients should expect at least an overnight stay.

PREPARING TO GO HOME

Following these initial sessions, your surgeon will discuss your recovery plan as you transition to a home environment. You’ll review how to care for the incision, which medications to take and when, follow-up visits, short-term restrictions for driving and showering, and continuing your physical therapy plan.

You’ll also go over your post-hospital treatment plan. Based on insurance, the knee replacement you received and your support system, your options will include a short-term in-patient center or outpatient therapy, which can involve going to a physical therapy center or having therapists come to your home.

For the time being, you will use a set of crutches or walker from the hospital at home and a physical therapist will recommend exercises to continue strengthening the joint and improving mobility. These exercises often focus on bending and straightening your knee.

CONTINUING PHYSICAL THERAPY

When you meet with a physical therapist outside the hospital, exercises and treatment will continue with the goal of improving knee mobility and strength. Building off what you’ve started, you will:

  • Focus on moving around more, improving mobility and reducing use of pain medications.

  • Aim to stand in place longer (for at least 10 minutes).

  • Find the swelling around your knee subsides with time and you’re able to fully extend and bend it beyond 90 degrees.

  • Use a walker or crutches less often after a few weeks and start walking longer distances.

  • Devise a plan to start driving again and return to work, based on your job.

  • Continue your exercise plan at home to avoid blood clot risks.

  • Start to resume a more active lifestyle toward the end of this 12-week period. Full recovery can take about six months.

Throughout all these stages, exercises tend to encompass balance, bending your knee, raising the leg and using a stationary bike.

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