Perform bed mobility and transfers with least amount of assistance, ambulate with assistive device for 25100 feet and ascenddescend stairs as appropriate, regain at least 80 of parom knee flexion and less than or equal to. The patients guide to outpatient total knee replacement. Include light walking for warmup, as well as stretching and light walking as a cool down for each session. Your orthopaedic surgeon and physical therapist may recommend that you exercise approximately 20 to 30 minutes two or three times a day and walk 30 minutes. During stage i, continue with rice rest, ice, compression, and elevation. Total knee arthroplasty tka is an elective operative procedure to treat an arthritic knee. Prehabilitation protocol for knee replacement surgery created by. Also, obtain a copy of the operative report from the surgeon. Initiate gentle strengthening exercises with the primary goal of activating the quadriceps. Manual therapy as needed, with appropriate magnitude based on healing status. Rehabilitation guidelines for total knee replacement 2 p a g e. This type of surgery is a big decision and this manual is intended to help you prepare for your surgery and guide you through the rehabilitation process.
Research has determined that after a successful total knee replacement protocol there are many things that you can do. Together they created the knee resource to assist healthcare professionals to make better decisions and provide patients with information and guidance about their knee problem. The number of total knee replacements tkr performed each year is increasing rapidly in most developed countries 17. Is able to demonstrate the beginning exercises to be performed while in the. Total knee replacement physical therapy protocol week 1. Total hip arthroplasty tha is an elective operative procedure to treat an arthritic hip. Qs, saq, assisted heel slides, slrs, laqs, hip flexion week 2. No driving for 6 weeks after surgery with right knee. Total knee arthroplasty protocol postop week week 46 initial evaluation evaluate history of injury premorbid activity level range of motion patella mobility swelling wound integrity inspect for infectionsigns of dvt strengthquad recruitment gait mobility. Patient will be weight bearing as tolerated with a crutches or walker initially.
Post operative total knee replacement protocol brian white, md. The knee cap patella covers the area where the two bones meet. We have remained at the forefront of medicine by fostering a culture of collaboration, pushing the boundaries of medical research, educating the brightest medical minds and maintaining an unwavering commitment to the diverse communities we serve. Postoperative instructions for total knee replacements. The goal of the following exercises is to regain range of motion while limiting pain and. Perform 2 sets of 10 repetitions, 12 times per day.
With pkr, only the damaged area of the knee joint is replaced, which may help to minimize trauma to healthy bone and tissue, and also helps relieve arthritis. With normal use and activity, every knee replacement implant begins to wear in its plastic spacer. A partial knee replacement pkr is a surgical procedure to replace only one part of a damaged knee. This motion will cause your knee to bend and you will feel a stretch. Knee implants consist of 1 a metal piece attached to the end of your thigh bone, 2 a metal and plastic or allplastic piece attached to the top of. Total or partial knee replacement rehab protocol mark w. Patients who have a desk job are able to return to work on the. The knee joint is opened by splitting the joint capsule and the quad tendon if. After introducing a rapid recovery protocol, total knee replacement patients spent an average of 1. Risks include, but are not limited to, infection, bleeding, blood clots, damage to surrounding structures, wound healing issues, leg length discrepancy, instability, continued pain. Maximum recovery after knee replacement the marker study. Total knee replacement is acknowledged as a successful and durable operation, but recovery from this surgery is often lengthy and painful. The full rehabilitation program may not be necessary. Patient will be weight bearing as tolerated with a rolling walking or other piece of medical equipment.
Total knee arthroplasty protocol brigham and womens hospital. Exercises after the knee replacement or simply total knee replacement protocol is equally important as the surgery itself. Its the joint that allows the leg to bend and straighten. A stateoftheart pain protocol for total knee replacement. Total knee arthroplasty protocol the following protocol should be used as a guideline for rehabilitation progression, but may need to be altered pending the nature and extent of the surgical procedure, healing restraints or patient tolerance. Walker or cane should be used until discontinued by doctor or. Total ankle replacement rehabilitation protocol dr. Total knee arthroplasty protocol center for sports. Total knee arthroplasty protocol brigham and womens. To prevent this, postoperative rehabilitation protocol or exercises are very. Soft tissue mobilization to the surrounding and posterior musculature, and to the patella to avoid flexion or patella contracture. Excessive activity or weight may speed up this normal wear and may cause the knee replacement to loosen and become painful. Rom range of motion this defines the amount of mobility in your knee prom passive range of motion mobility exercises remain completely passive without the use of muscles to move your knee aarom acitve assisted or partner.
Adequate pain control after tka is important in expediting patient progress with mobility and range of motion after surgery. The following protocol should be used as a guideline for rehabilitation progression. Karchs tka protocol from 2015, brigham and womens hospital tka protocol pt name and date. Total knee replacement surgery is when damaged bone from the top of the shin bone the tibia and the bottom of the thigh bone the femur is replaced with metal and plastic parts. Risks and benefits to arthroplasty are weighed on an individual basis.
After having a total knee replacement surgery, most people end up with long lists of what not to do. Unicompartmental knee replacement protocol the following protocol should be used as a guideline for rehabilitation progression, but may need to be altered pending the nature and extent of the surgical procedure, healing restraints or patient tolerance. Initiate hep, encourage wbat mobility with fww, manage painedema, 0105 degrees arom exercises. Outpatient rehabilitation guidelines for total knee arthroplasty. Imagine that you become completely painfree after the surgery but unable to bend knees and having difficulty in doing daily activity. New rx protocol improves knee replacement recovery.
Make sure you check with the surgeon before you start using any protocol. Total knee replacement manual and therapyrehab protocol dr. Our outpatient knee replacement program eliminates hospital stays and supports your recovery. This procedure replaces your damaged hip joint with an artificial hip implant. Total knee replacement manual and therapyrehab protocol. Manual therapy patella mobilization, paap tibial mobilizations grade iii. As the cartilage wears away it becomes frayed and rough, and the protected space between bones decreases causing the. A total knee replacement is a surgical operation aiming to replace a wornout joint.
These rehabilitation guidelines are presented in a criterion based progression. But total knee replacement will not allow you to do more than you could before you developed arthritis. Total or partial knee replacement rehab protocol regular exercise to restore your knee mobility and strength and a gradual return to everyday activities are important for your full recovery. 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. Total knee replacement tkr or arthroplasty tka is a surgical reconstruction procedure where the distal head of the femur and the proximal head of. Outpatient rehabilitation guidelines for total knee. Overview of total knee replacement the knee joint is the largest joint in the body. Advance hep, initiate ambulation with spc, develop quadriceps recruitment. Physical therapist ice knee frequently up to 30 minutes out of every 2 hours change knee position at least once an hour, while awake, to avoid. A great deal of attention has recently been directed at enhancing this recovery, most of which has focused on improvements in perioperative pain control. The most common form of damage seen is osteoarthritis. The goal of the following exercises is to regain range of motion while limiting pain and inflammation.
Define the protocol to be followed for all patients. Knee total knee arthroplasty brigham and womens hospital. It can replace either the inside medial part, the outside lateral part, or the kneecap patellofemoral part of the knee. Preoperative physical therapy the patient is seen for a preoperative physical therapy session which includes. Total knee arthroplasty protocol brigham and womens hospital phase i. Each case can be very different depending on the goals of the patient, the age of the. Unicompartmental knee arthroplasty uka is a procedure designed to. Background severe knee osteoarthritis, as well as the surgical procedure of total knee replacement that aims to reduce its symptoms, cause great deterioration on. In australia, the total number of tkr operations performed has increased by 150% in the past decade.
Keeping your thigh on the chair, slide your foot back under the chair as far as possible. The time frame for returning to work after a total knee replacement varies depends on you and your job. General time frames are given for reference to the average, but individual patients will progress at different rates depending on their age, comorbidities, presurgical range of. Download the 8week schedule here for the appropriate progression of resistance and repetitions. Total knee arthroplasty has become the standard of care for patients with endstage knee oa and is the most frequently performed orthopedic procedure in the united states. Proposed rehab protocol for total knee replacement. With extensive patient education and a comprehensive. Total knee replacement arthroplasty is the surgical resurfacing of the damaged surfaces of your knee, and one of the most effective ways to reduce pain and restore mobility. Joint replacement options include partial knee replacement and total knee replacement. However, it doesnt always have to end up like this. Hip implants consist of 1 a smooth ball on a stem that fits into your thigh bone the femoral stem, and 2 a metal socket with a smooth liner that is attached to.
Prehabilitation protocol for knee replacement surgery. Make sure that your patient has a follow up appointment for a wound check. A patients guide to total joint replacement and complete care. This procedure replaces your damaged knee joint with an artificial knee implant. Total knee joint replacement surgery amazon web services. The most common cause of chronic knee pain is arthritis.