This will help you regain mobility.
A post-operative protocol is a guideline that your surgeon andphysical therapist(PT) may follow.
It ensures you are making progress after your knee surgery.
Sturti / Getty Images
The TKR protocol gives you and your PT a framework for building your rehabilitation program.
This equipment helps gently and slowly bend and straighten your knee.
options on the CPM adjust the amount of motion at your knee joint.
Your healthcare provider and PT can work with you to ensure the CPM machine is set properly.
Aphysical therapist may visit you in the hospitalon the first day after your surgery.
This person is called an acute care physical therapist.
This equipment will give you extra support while you are walking.
Your acute care PT will also have you doknee exercisesin the hospital.
These exercises help improve your knee’s range of motion and strength.
They also help keep your ankles and hips moving.
This will make walking easier.
Simple exercises can help stop blood from pooling in your body.
You are particularly at risk if you are immobile for an extended period, such as after surgery.
After TKR, your main goal is to become independent withfunctional mobility.
This includes:
If you have stairs in your home, you must be able to navigate them.
Your acute care PT can also help prepare you for this.
At this point, you will be discharged to your home or to a sub-acute rehabilitation facility.
Here, you will focus on improving knee range of motion and strength.
Sub-acute rehabilitation lasts about one to two weeks.
A typical day involves two sessions of physical therapy.
Your PT will help you improve your knee strength and range of motion.
You may continue with the CPM machine if your healthcare provider feels it will help.
This option is usually for people who can’t travel to an outpatient physical therapy center.
Your goal for home physical therapy is to ensure you might move safely in your home.
You will keep working on knee range of motion and strength.
Walking and stair climbing may also be a part of your home physical therapy.
Scar tissue will form as your incision heals.
Your PT may use gentlescar tissue massage and mobilizationto help improve the mobility of your incision.
This can help the skin and other tissues around your knee move more freely.
You may begin outpatient physical therapy if you’re able to travel to a physical therapy center.
There, you will keep improving your knee range of motion.
You should be able to bend your knee to a 90-degree angle by the end of week two.
How Long Will Healing Take?
Recovery comes in stages.
Youll be discharged from the hospital within four days.
You will need to work with a physical therapist to regain mobility.
Your therapy will include more range of motion exercises.
These should continue to help you improve your knee motion.
By the end of week six, your knee motion should be about 100 to 105 degrees.
You may benefit fromriding a stationary bicycle after TKR surgery.
Your PT will help you find the right seat height.
Don’t be surprised if you’re free to’t pedal all the way around when you first start.
Keep working the pedals forward and backward.
As your range of motion improves, you should be able to pedal the bike fully.
You will keep doing exercises that build strength in your knee.
You may add cuff weights to your lower leg or ankle as your strength improves.
Your PT may also useneuromuscularelectrical stimulation (NMES).
This will help your quadriceps contract and improve your ability to use these muscles on your own.
During the three- to six-week post-op period, your PT will help you improve your ability to walk.
Youll gradually increase your distance and time.
During this time, you may still use ice to help control pain and swelling around your knee joint.
Sometimes swelling persists for many weeks after TKR surgery.
Exercises will focus on gaining strength in the muscles around your knee and leg.
You may do more advanced balance exercises.
You may also use aBAPS board.
This is a gear that can help you improve your balance.
During this time, you should move on to walking without an assistive unit.
Your pain should be under control.
Summary
Physical therapy after total knee replacement can help you regain your mobility.
You will start to walk using an assistive rig.
After you leave the hospital, you will continue therapy at home or in a physical therapy center.
You should be able to bend your knee 90 degrees at the end of the second week.
Physical therapy will continue to focus on improving strength and mobility.
You should move from a walker to a cane during weeks three through six.
Your pain should be under control by the end of the eighth week.
You should be able to walk without an assistive gear.
American Academy of Orthopaedic Surgeons.Total knee replacement.
American Academy of Orthopaedic Surgeons.Total knee replacement exercise guide.
American Academy of Orthopaedic Surgeons.Deep vein thrombosis.
2022;30(3):102255362211276. doi:10.1177/10225536221127668
