Physical therapists provide manual therapy such as joint mobilization. A total knee replacement tkr surgery is typically done when severe arthritis causes knee pain, limited motion, and extreme difficulty with walking. Total knee arthroplasty protocol postop week week 46 initial evaluation evaluate history of injury premorbid activity level. Each case can be very different depending on the goals of the patient, the age of the. Here are some videos explaining knee and lower extremity exercises which you may find useful. Content validation of total knee replacement rehabilitation protocol in indian population article pdf available in journal of clinical and diagnostic research 116.
Total knee arthroplasty tka postop rehabilitation protocol. 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. Patellofemoral ligament reconstruction rehabilitation program. In order to get the best function possible from your knee, it is important that you perform the exercise program described below. Total knee arthroplasty rehabilitation protocol what. Outpatient rehabilitation guidelines for total knee. Continue with soft tissue treatments and gentle mobilization to the posterior musculature, patella, and incisions to avoid flexion or patella contracture. In hospital, rehab takes place in this area in a comfortable. 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. Early rehabilitation after total knee replacement surgery. The intent of this protocol is to provide the clinician with a guideline of the post. Marsh brook rehabilitation service wentworthdouglass hospital durham. Exercise guide for knee replacement surgery please bring this guide to the hospital and to all physiotherapy appointments.
Physiotherapy rehabilitationontario health technology assessment series 2005. Outpatient rehabilitation guidelines for total knee arthroplasty. Reminder when you and i agreed to reconstruct your torn acl you willingly committed yourself to a four month, brace free, self. Hospital after your surgery is scheduled for a free bottle. Progression through each phase of rehabilitation is based on clinical criteria and time frames as appropriate. Original article influence of conventional post total. Hold in this position for at least 5 minutes at a time. Patients ages 4575 years were allocated at the time of hospital discharge to usual care.
Is able to demonstrate the beginning exercises to be performed while in the hospital. Place your affected side on a stool or chair of similar height. Perform exercises one 1 and two 2 fifteen 15 times every hour. Total knee arthroplasty rehabilitation protocol dos all patients participate in a comprehensive joint program protocol which addresses pre and post operative pain control and rehabilitation. Total knee arthroplasty rehabilitation guideline sanford health. Total knee replacement tkr is a common surgical procedure worldwide. Getting started your mobility will be limited the first few days, so get help with the following. Regular manual treatment should be conducted to the patella and all incisions so they remain mobile. Rehabilitation protocols following total knee arthroplasty. Methods we conducted a multicenter, randomized clinical trial.
It includes your surgeon and healthcare team, a specialty care coordinator, and you. Most patients who have undergone joint replacement surgery at the cleveland clinic have been managed through our complete care program. Total knee replacement tkr is an increasingly common procedure with over 75,000 knee replacements performed each year in the uk alone. Osteoarthritis oa is one of the 10 most disabling diseases in developed countries, and it is the most common reason that people undergo tkr surgery 15. These guidelines should be administered under the supervision of a physical therapist. Total knee replacement tkr ppt linkedin slideshare. Total knee arthroplasty protocol brigham and womens. This rehabilitation protocol was developed for patients who have had a cemented total knee arthroplasty. The objective of this health technology policy analysis was to determine, where, how, and when physiotherapy services are best delivered to optimize functional outcomes for patients after they undergo primary firsttime total hip replacement or total knee replacement, and to determine the ontariospecific economic impact of the best delivery strategy. Projections of future surgical volume suggest further great increases year on year. This protocol must be followed to prevent injury to the acl graft.
Imagine that you become completely pain free after the surgery but unable to bend knees and having difficulty in doing daily activity. Exercises after the knee replacement or simply total knee replacement protocol is equally important as the surgery itself. Rehab is key after a total knee replacement tkr, but the impact of pedaling in the acute postoperative setting remains unknown postoperative pedalingbased physical therapy was found to be superior to the nonpedaling exercise protocol in this study pedaling group showed superior outcomes at 2 days postoperatively study evaluated the efficacy. The goal of the following exercises is to regain range of motion while limiting pain and inflammation. Guidelines for rehabilitation of total knee replacements what is a total knee replacement.
Home exercise program following knee surgery during your hospitalization, you have had knee surgery. Knee extension stretch gentle manual over pressure on the knee, twice. These rehabilitation guidelines are presented in a criterion based progression. 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. Any deviation from this regimen may unnecessarily compromise your final result. Repeat 10 times every hour to help prevent blood clot formation and pump swelling away from the leg. The present study aimed to validate the content of tkr rehabilitation protocol in indian.
Structured total knee replacement rehabilitation programme. 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. Early exercises should focus on recruitment proper. Initiate gentle strengthening exercises with the primary goal of activating the quadriceps. Physiotherapy rehabilitation after total knee or hip. It is recommended that the exercises be taught by a physiotherapist. Tighten the muscles on the front of your thigh and push the back of your knee down into the bed.
During stage i, continue with rice rest, ice, compression, and elevation. Rehabilitation protocol for anterior cruciate ligament. The primary goal of this protocol is to protect the reconstruction while steadily. To prevent this, postoperative rehabilitation protocol or exercises are very. This can be purchased at any pharmacy or you can go to ridges. At least 10 days before unilateral tka, patients from 4 clinical sites were enrolled and randomized 1. Weekbyweek rehab protocol for total knee replacement. The intent of this protocol is to provide guidelines for progression of rehabilitation. Physiotherapy exercises following 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. Content validation of total knee replacement rehabilitation.
Exercise guide for knee replacement surgery vancouver. Ankle exercises point your feet up and down in a pumping motion. General time frames are given for reference to the average, but individual patients will progress at different rates depending on. The end of the femur is removed and replaced with a. Factors influencing the outcomes following rehabilitation after tkr include preoperative parameters, operative methods and postoperative care. Hence, the purpose is to find the influences of conventional total knee replacement rehabilitation protocol on flat foot angles such as navicular.
Please only do these exercises if you have been advised to do so by your physical therapist. Each case can be very different depending on the goals of. Going down the stairs you should place the sticks or. The staged rehabilitation of tkr protocol follows a set pattern of exercises. Pdf content validation of total knee replacement rehabilitation. Receives any necessary therapy to assure maximized rom and good functional strength. When you have total knee replacement tkr surgery, recovery and rehabilitation is a crucial stage. This rehabilitation program is designed to return the individual to. The following is a protocol for postoperative patients following total knee arthroplasty tka rehabilitation.
It is important to be patient, to be an active participant in your exercise program, and to strictly follow the guidelines outlined in the enclosed packet. Postoperative rehabilitation following tka facilitates patient recovery and. During the surgery, the knee joint is replaced with artificial material. Rehabilitation goals are based on age, gender, previous activity level and other orthopedic and medical problems. Understanding of preop exercises, instructions, and overall. Continue with home program, progress flexion range of motion, gait training, soft tissue treatments, and balanceproprioception exercises. Head home with a continuous passive motion cpm machine. This book is a general guide to recovery from total knee replacement tkr surgery. Post operative total knee replacement protocol brian. There is at least one polyethylene piece, placed between the tibia and the femur, as a shock absorber. 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. Acknowledgments this edition of the guide would not have been possible without the tireless efforts and dedication of the sub. Effects of virtual exercise rehabilitation inhome therapy. Objective to determine, at 6 weeks postsurgery, if a monitored home exercise program hep is not inferior to usual care rehabilitation for patients undergoing primary unilateral total knee replacement tkr surgery for osteoarthritis.
A patients guide to total joint replacement and complete care. Total knee replacement manual and therapyrehab protocol dr. Revisions tka should be progressed with more caution to ensure adequate healing. Total knee arthroplasty protocolbrigham and womens hospital phase i. You will need to use it every day for the initial phase of your rehabilitation. Nurse visit at 14 days for stitch removal and checkup.
Many of the protocols listed refer to specific exercises. One high standard, three local partners for more information go to. Total knee arthroplasty protocol brigham and womens hospital. Patients who have had a prior patellectomy or failed total knee replacement may require modifications. Recovering from a partial or total knee replacement and returning to a more active lifestyle will take time. Targeted rehabilitation to improve outcome after total.
Should you have any queries or concerns, please consult with your surgeon or family doctor. Tkr is highly effective at reducing pain and improving physical function in patients with end stage osteoarthritis. The most common form of damage seen is osteoarthritis. A total knee replacement tkr is usually done as the surgical treatment option for advanced osteoarthritis of the knee joint. Total knee replacement exercise booklet sunnybrook hospital. 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. Total knee replacement tkr is the most common, gold standard surgical intervention in relieving pain, improving physical functions and quality of life in endstage osteoarthritis. Patients are in private rooms in an area of the hospital dedicated to joint replacement. A total knee replacement is a surgical operation aiming to replace a wornout joint. Rehabilitation protocol this rehabilitation protocol was developed for patients who have had a cemented total knee arthroplasty. In this stage, youll get back on your feet and return to an active lifestyle.
945 1123 16 198 1457 358 1104 1028 818 573 567 684 1124 233 315 1019 242 858 360 1236 476 778 744 1471 1296 115 1157 691 283 580 1059 1146 1046 976