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Dec 8

What to Expect after a Knee Replacement

tkrThe staff in Waterford Chartered Physiotherapy Clinic have many years of experience in rehabilitating patients back to full health following knee replacement surgery. Knee replacement surgery can take the form of a Total Knee Replacement (TKR) or Partial Knee Replacement depending on the extent of arthritis in the joint. The orthopaedic consultant will decide on the best option for you based on your x-ray findings, your age and your levels of pain and function. Irrespective of which surgery you have, most people will follow a fairly similar post-operative pathway.

In-Patient Period

Most people will remain as an in-patient for at least a few days to a week following surgery. During this period you will be prescribed pain relief and be taught how to properly look after your wound dressings by the nursing staff. Some people will see the physiotherapist pre-operatively but all patients will be visited by the physiotherapist within the first day or so post-operatively.

The physiotherapist will teach you how to walk using crutches or a zimmer frame depending on your level of mobility.People are usually encouraged to get up and weight-bearing through their new knee as soon as possible. The physiotherapist will also commence a gentle exercise programme of knee bending and straightening exercises immediately after surgery. In my experience this can be the most difficult aspect of the post-operative recovery as the knee will be swollen and feel very stiff and sore initially. Some people will be put on a Continuous Passive Motion (CPM) machine in hospital to further help their knee to bend. Achieving 90 degrees of knee bending is an important early goal post-operatively as this level of movement allows people to perform most activities of daily living such as walking, getting in/out of the car and a chair and climbing the stairs. How easily people achieve 90 degrees of knee bend is directly linked to the degree of bend they had pre-operatively.

Out-Patient Period

Some people are discharged directly home whilst others may be transferred to a rehabilitation unit or others to convalescence depending on their living situation and baseline level of mobility/function. Your local GP and Public Health Nurse will generally be informed that you have been discharged and will be in contact in relation to your dressings/staples.

People are also referred for further physiotherapy on discharge from hospital and an intensive rehabilitation programme continues on a daily basis at home. The rehabilitation programme consists of range of motion and strengthening exercises at the knee which will eventually allow you to function more independently without a walking aid (if your mobility was good pre-operatively). Some physiotherapists will encourage the use of an exercise bike once you have sufficient knee bend – this is an excellent means of exercising your operated knee and challenging your general fitness. Once the wound is fully healed any form of exercise in the swimming pool is also a fantastic option.

In order for the surgery to be successful people need to work diligently on their rehabilitation programme for approximately 12 weeks following a knee replacement. The early weeks are hard work but worth it when you see the fruits of your efforts with a more mobile knee, less pain and improved function! Working under the guidance of a chartered physiotherapist in the post-operative period can help you achieve the best results through an individually tailored rehabilitation programme.