Knee Replacement & How Physiotherapy can help
There are about 2200 total knee replacements carried out in Ireland each year. I’m sure we all know of someone close to us who has had such a procedure carried out. The main reason someone will have a total knee replacement (TKR) is down to osteoarthritis.
Physiotherapy plays a big role in the process of getting a person back on their feet after the TKR operation. However, physios can also play a vital role in the process before the operation even starts with prehab, which is getting you and the limb as strong as we can so that the post-op rehab is a bit easier. .
What is a Knee Replacement?
This is a procedure where the end of the femur and top of the tibia are replaced with a metal and plastic replacement. This is not an easy pressure to recover from in most cases and rehab will take several weeks to months before you are back to full function. There will be some pain and swelling for several weeks post op but in time you will recover very well, if you attend regular physiotherapy. Before the operation your surgeon will likely advise you to attend physiotherapy for a period of strength training.
This period can be anywhere from 4 weeks to 12 weeks depending on the hospital and surgeon.
Regardless, it is very important that you adhere to the advice and attend physiotherapy.
The point of pre operation physiotherapy is to get the leg muscles as strong as possible. The stronger that muscles are before the operation will make life a bit easier after then operation especially in the early post op stages.
Here your physiotherapist will focus on increasing the strength of the quads and glutes as well as hamstrings and calf muscles. We will also educate you on the TKR process and prepare you best we can so you know what to expect.
In the early stages after the operation the focus will be
on making sue the wound is safe and not getting infected. From a functional point you need to regain range of motion back as best you can, especially full knee extension. This will be difficult as the pain and swelling will inhibit the knee from going through its full range but as the swelling and pain reduces the function will increase. The hospital will provide you
with basic exercises and advice, but your private physiotherapy will tailor your program you suit you best.
There will be a big focus on getting your thigh or quad muscles very strong as well as your glutes. Getting
these strong early will help with functional tasks such as getting out of the chair and walking.
Return to activity.
The final goal of rehab is to return the patient back to their pre pain function or at least to a level of function that they can cope and manage through their day-to-day activities independently and pain free. In most cases people will return to activities such as walking, driving, shopping, and dancing without issue after a number of months of physiotherapy.
Some people may take longer to recover from this procedure than others but as long as you work hard at your exercises and adhere to the advice from the medical team there should be a good outcome.
By Darragh Bolton, Chartered Physiotherapist