Knee Replacement
Total Knee Arthroplasty or Knee Replacement
A Total Knee Arthroplasty (TKA) surgery is the replacement of the two knee joint surfaces (femoral condyles & tibial plateau). At least part or all of the patella (knee cap) may also be replaced during the surgery. Often this surgery will be recommended by an orthopedic surgeon when one’s knee joint is “bone on bone”, secondary to joint arthritis or possibly trauma. This will frequently cause a decrease in tolerance for functional activities such as walking, getting up from sitting, or ascending/descending stairs. If only one area of the knee is degenerated a Unicompartmental Knee Replacement (partial knee arthroplasty) may be done. Typically recovery from this is quicker than a full replacement.
More than 600,000 TKA surgeries are performed annually, but this number is expected to rise in the future based on current trends. The average age of TKA surgeries is between 45 & 65 years old. Statistics indicate that obesity greatly increases the chance one will have TKA surgery. Knee replacements are 8 times higher in those with Body Mass Index (BMI) higher than 30 & 28 times higher with BMI over 35.
Phases of rehabilitation
Prehabilitation (prehab)
Orthopedic surgeons may recommend patients participate in outpatient physical therapy previous to the surgery to improve muscle strength, muscle flexibility, & joint range of motion. Participation in this “prehab” has been shown to improve a patient's function following the surgery more quickly.
In Hospital Recovery & Rehabilitation
Typically patients spend 2-3 days in the hospital following the TKA surgery to ensure they are safe to return either home or to an inpatient rehabilitation center. Patients will likely participate in “joint camp” while in the hospital. This will include instruction on use of assistive devices & initial exercises.
Home or Inpatient Rehabilitation
Depending on a patient’s circumstances, home physical therapy or inpatient rehabilitation will typically last 2-3 weeks. Patients will work on improving their leg strength & knee range of motion with physical therapy staff.
Outpatient physical therapy
This is where the majority of rehabilitation occurs. Outpatient physical therapy often lasts between 10-16 weeks. Therapy sessions will typically be more frequent early in the rehabilitation, then decrease in frequency as treatment goals are met & patients become more independent with their home exercise routine. Physical therapy will address muscle weakness, decreased joint range of motion, muscle tightness, & difficulties with functional activities such as walking & stairs. A comprehensive home exercise routine will be developed to supplement & compliment the outpatient rehabilitation. The physical therapist will be helping the patient meet treatment goals such as attaining full knee extension ROM & at least 110 degrees of knee flexion ROM. This amount of knee ROM combined with full leg muscle strength will help the patient normalize their walking pattern & become more independent with functional activities such as ascending/descending stairs. Once range of motion goals have been met, more advanced balance and functional movement activities are addressed and worked on in order for the client to reach a high level of function.
A Total Knee Arthroplasty (TKA) surgery is the replacement of the two knee joint surfaces (femoral condyles & tibial plateau). At least part or all of the patella (knee cap) may also be replaced during the surgery. Often this surgery will be recommended by an orthopedic surgeon when one’s knee joint is “bone on bone”, secondary to joint arthritis or possibly trauma. This will frequently cause a decrease in tolerance for functional activities such as walking, getting up from sitting, or ascending/descending stairs. If only one area of the knee is degenerated a Unicompartmental Knee Replacement (partial knee arthroplasty) may be done. Typically recovery from this is quicker than a full replacement.
More than 600,000 TKA surgeries are performed annually, but this number is expected to rise in the future based on current trends. The average age of TKA surgeries is between 45 & 65 years old. Statistics indicate that obesity greatly increases the chance one will have TKA surgery. Knee replacements are 8 times higher in those with Body Mass Index (BMI) higher than 30 & 28 times higher with BMI over 35.
Phases of rehabilitation
Prehabilitation (prehab)
Orthopedic surgeons may recommend patients participate in outpatient physical therapy previous to the surgery to improve muscle strength, muscle flexibility, & joint range of motion. Participation in this “prehab” has been shown to improve a patient's function following the surgery more quickly.
In Hospital Recovery & Rehabilitation
Typically patients spend 2-3 days in the hospital following the TKA surgery to ensure they are safe to return either home or to an inpatient rehabilitation center. Patients will likely participate in “joint camp” while in the hospital. This will include instruction on use of assistive devices & initial exercises.
Home or Inpatient Rehabilitation
Depending on a patient’s circumstances, home physical therapy or inpatient rehabilitation will typically last 2-3 weeks. Patients will work on improving their leg strength & knee range of motion with physical therapy staff.
Outpatient physical therapy
This is where the majority of rehabilitation occurs. Outpatient physical therapy often lasts between 10-16 weeks. Therapy sessions will typically be more frequent early in the rehabilitation, then decrease in frequency as treatment goals are met & patients become more independent with their home exercise routine. Physical therapy will address muscle weakness, decreased joint range of motion, muscle tightness, & difficulties with functional activities such as walking & stairs. A comprehensive home exercise routine will be developed to supplement & compliment the outpatient rehabilitation. The physical therapist will be helping the patient meet treatment goals such as attaining full knee extension ROM & at least 110 degrees of knee flexion ROM. This amount of knee ROM combined with full leg muscle strength will help the patient normalize their walking pattern & become more independent with functional activities such as ascending/descending stairs. Once range of motion goals have been met, more advanced balance and functional movement activities are addressed and worked on in order for the client to reach a high level of function.