Total Knee Replacements: A Patient Resource

Disease Process


A total knee replacement (TKR) is usually done as the surgical treatment option for advanced osteoarthritis of the knee.

During the surgery, the knee joint is replaced with artificial material. 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).

The end of the femur is removed and replaced with a metal surface and the top of the tibia is removed and replaced with a plastic piece that has a metal stem. If the knee cap has also degenerated, a plastic piece may be added to the back surface to create a smoother joint surface.


For Who?:

A total knee replacement is usually recommended for people who have severe osteoarthritis (OA) in the knee, have had severe trauma to the knee, or have some other destructive joint disease.


How do I know when I am ready for a Total Knee Replacement?

Common symptoms of severe arthritis of the knee joint include:

  • Swelling of the joint
  • Knee pain
  • Bow-legged or knock-kneed deformity
  • Loss of motion
  • Feeling of the knee 'giving-way'




Risks:

The following are common risks associated with a total knee replacement:

  • Blood clots
  • Urinary tract infections
  • Nausea and vomiting
  • Chronic knee pain and swelling
  • Bleeding into the knee joint
  • Nerve damage
  • Blood vessel injury
  • Infection

Your doctor should fully discuss the surgery and all associated risks, as well as benefits before scheduling you for your surgery.

Recovery:

The typical recovery period for a total knee replacement is 3-5 days in the hospital, 2-4 weeks of skilled or home physical therapy and 6-8 weeks of outpatient physical therapy. If you live alone, you will need to arrange for someone to stay with you the first two weeks or so to help you with all of your daily activities (such as dressing, bathing, and preparing food), or plan a stay in a short-term skilled rehab facility where you will receive therapy until you are independent enough to go home.
 

How Can Physical Therapy Help

The physical therapist is an integral part of the recovery following a total knee replacement. They will work with each patient in a variety of settings towards the final goal of gaining as much function as possible.

In the hospital:

  • Will probably see the patient 2 times a day
  • Work on transfers in and out of bed, to and from a chair, and to and from a wheelchair.
  • Start range of motion (ROM) exercises on the knee, work on strengthening exercises with both legs.
  • Educate patient on the use of ice and elevation.
  • Work on walking short distances with the appropriate assistive device (such as a walker).
In a short-term / skilled rehabilitation center:
  • Work on increasing ROM and strength.
  • Increase distance of walking and progress to a less restrictive device such as a cane.
  • Practice going up and down stairs if needed.
  • Continue with icing and elevation to help decrease swelling and pain.
  • Work on balance.
  • Make sure patient is independent with all transfers (bed, chair, tub / toilet) and prepare patient for return home.
In the home:
  • Work on increasing ROM and strength.
  • Increase distance of walking and progress to a less restrictive device such as a cane.
  • Practice going up and down stairs if needed.
  • Continue with icing and elevation to help decrease swelling and pain.
  • Work on balance.
  • Make sure patient is independent with all transfers (bed, chair, tub / toilet) and prepare patient for outpatient therapy.
At an outpatient center:
  • Continue working on strengthening the knee and recovering full range of motion.
  • Continue working on walking (possible add the use of a treadmill for distance and endurance).
  • Progress to a cane or no device during walking.
  • Make sure patient is safe with stairs.
  • Use modalities and continue with icing and elevation to help decrease swelling and pain.
  • Continue working on balance.

For more information on physical therapy, please visit Physical Therapy Working For You.

Patient Resources

Medicinenet.com
American Academy of Orthopedic Surgeons
Virtual Hospital




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