According to the Academy of Medicine, Singapore, 96% of knee replacements in Singapore are caused by osteoarthritis. Total knee replacements (TKR) is a procedure when the entire knee joint is removed and replaced. Partial knee replacements (MAKOplasty) resurfaces only the damaged portion and is recommended when only 1 of the 3 compartments is affected.
What to expect after surgery
Patients are able to regain 80% of mobility after 6 weeks and full recovery after 3 months.
Physiotherapy begins the day after surgery whereby the Physiotherapist (PT) will teach specific exercises to strengthen and restore knee movement.
Ankle pumps increases blood flow and helps to prevent swelling and blood clots.
Bend ankles up and down 30x every hour.
Place a rolled towel under the knee. Activate the thigh muscle maximally to straighten the knee and hold the contraction for 10 seconds. Repeat for 10 reps, 2 sets.
Bend your knee from a straight position up to the range recommended by the surgeon.
You may use a towel to assist. Repeat for 10 reps, 2 sets.
Terminal knee extension
In standing, tie a resistance band around the back of the knee, and the other end to a table, with the knee slightly bent.
Hold on to a chair or frame for support. Straighten the knee against the resistance, hold for 5-10 seconds.
Repeat 10 reps, 2 sets.
Apply ice pack for 15 to 20 minutes every 3 to 4 hours to reduce swelling and inflammation. Painkillers should be taken 30 minutes prior to exercises.
Do the PT prescribed exercises regularly, 2 to 3 times a day. After prolonged lying or sitting, do some gentle stretching or range of motion exercises before getting up.
Resuming functional activities
A graduated walking program with the use of a mobility aid such as a quad stick or walking frame recommended by a Physiotherapist. Sitting, standing and climbing stairs will be guided. Take note of the weight bearing status recommended by the surgeon.
Climbing the stairs
Going up: Put the weight through the arm holding the rail and step up with the good leg.
Then, step up the operated leg and walking aid.
Going down: Place the walking aid down the step. Then, put the weight through the arms and step down with the operated leg first, then the other leg.
Precautions after surgery
Preventing blood clot Look out for warning signs including increasing pain in the calf and tenderness or redness above or below the knee.
Preventing infection Bacteria in the bloodstream during urinary or skin infection can affect the knee replacement.
Avoiding falls There will be a feeling of instability and knee ‘giving way’ as you stand or walk.
Look out for hazards in the environment and take extra care while walking on uneven grounds.
Life after knee replacement
Total knee replacements can function well for 15 years after the surgery with proper care.
It is normal to feel or hear clicking at the knee during walking or knee bending.
The physiotherapist will follow up after the discharge to ensure restoration of full knee motion and pre-morbid functional mobility. Most functions return within 3 to 6 months.
Surgery is offered for severe cases when conservative treatments are not helpful.
In the next few articles we will share with you more about Physiotherapy rehabilitation after Total Hip Replacement.
If you read through all the above and still have any concern please feel free to contact me +65 8550 5466 as I do provide FREE Physiotherapy consultation over the phone.
Written by: Naazreen
Edited by: Bernice