What is it?

Knee replacement, also called arthroplasty, is a surgical procedure to resurface a knee damaged by arthritis. Metal and plastic parts are used to cap the ends of the bones that form the knee joint, along with the kneecap. This surgery may be suited for someone who has severe arthritis or a severe knee injury.

Several types of arthritis may affect the knee joint. Osteoarthritis, a degenerative joint disease that affects mostly middle-aged and older adults, may cause the breakdown of joint cartilage and adjacent bone in the knees. Rheumatoid arthritis, which creates inflammation of the synovial membrane and results in excessive synovial fluid, can lead to pain and stiffness. Traumatic arthritis, arthritis due to injury, may cause damage to the cartilage of the knee.

The goal of knee replacement surgery is to resurface the parts of the knee joint that have been damaged and to overcome knee pain that cannot be managed by other treatments.

What to expect in Physical Therapy

The physical therapist is an integral part of the team of health care professionals who help patients receiving a total knee replacement recover movement and function, and return to daily activities. Your physical therapist can help you recover from surgery, and develop an individualized treatment program to get you moving again in the safest and most effective way possible.

If you have any questions or concerns before or after surgery, please feel free to call Flicker Physical Therapy! 

As You Start to Recover

You will typically start in-home or outpatient physical therapy within 3 days of getting out of the hospital. The goal of the first 2 weeks of recovery is to manage pain, decrease swelling, heal the incision, restore normal walking, and initiate exercise. After those 2 weeks, your physical therapist will tailor your range-of-motion exercises, progressive muscle-strengthening exercises, body awareness and balance training, functional training, and activity-specific training to address your specific goals and get you back to the activities you love!

Range-of-motion exercises. Swelling and pain can make you move your knee less. Your physical therapist can teach you safe and effective exercises to reclaim movement (range of motion) to your knee, so that you can accomplish your daily activities.

Strengthening exercises. Weakness of the muscles of the thigh and lower leg could make you need to still use a cane when walking, even after you no longer need a walker or crutches. Your physical therapist can decide which strengthening exercises are right for you.

Soft tissue massage/Scar Mobilizations. Your physical therapist will massage your leg to assist with circulation and to reduce overall stiffness. This is normally the patients favorite part! They will also work on mobilizing your scar so that there are no adhesions to limit your range of motion.

Balance training. Specialized training exercises encourage your muscles to “learn” to react to changes in your environment, such as uneven sidewalks or rocky ground. When you can put your full weight on your knee without pain, your physical therapist may add agility exercises (such as turning and shifting direction when walking, or making quick stops and starts) and activities using a balance board that challenge your balance and knee control. Your program will be based on the physical therapist’s examination of your knee, on your goals, and your activity level and general health.

Functional training. When you can walk freely without pain, your physical therapist may begin to add activities that you were doing before your knee pain started to restrict you. These might include community-based efforts, such as crossing a busy street or getting on and off an escalator. Your program will be based on the physical therapist’s examination of your knee, on your goals, and your activity level and general health.

The timeline for returning to leisure or sports activities ranges from person-to-person; your physical therapist will be able to determine your unique timeline based on your particular condition.

Activity-specific training. Depending on the demands of your job or the type of sports you play, you might need further rehabilitation that is tailored to your job activities (such as climbing a ladder) or sport activities (such as swinging a golf club) and the demands that they put on your knee. Your physical therapist can produce an individualized rehabilitation program for you that brings all of these demands into account.