Total knee replacement, or arthroplasty, is a procedure that uses metal or plastic parts to replace damaged or worn joint cartilage in the knees. Most patients remain in the hospital for up to a week following knee replacement surgery. Rehabilitation exercises will begin soon after you return home.
Beginning Rehabilitation
The first stages of rehabilitation are usually done in the patient's home with visiting therapists. Range of motion exercises performed from a prone position are introduced to keep the muscles of the leg vital. Patients are urged to push slightly past their comfort zone, but not to the point of pain. Patients begin doing leg lifts, sometimes with the assistance of pulleys or belts.
Physical Therapy at Home
A physical therapist may visit the home two or three times a week if the patient does not have access to transportation to the physical therapy office. The therapist increases the amount and quantity of exercise each time, checking on the patient's progress. In addition to the exercises, trained physical therapists instruct patients in the use of crutches and walkers and help them arrange their home for better mobility. Physical therapists evaluate the house and make recommendations about modifications or changes that can help the patient get around and perform the necessary exercises every day.
Walking
Patients recover from a total knee replacement at different paces, but most patients usually begin to bear weight on the leg that received the knee replacement about three weeks after surgery. They may use a cane or arm crutch for another two weeks to maintain stability as they regain movement. Doctors at the American Academy of Orthopaedic Surgeons say patients should begin a gradually intensive walking program under the supervision of the physical therapist, beginning in the home and moving to the outdoors.
Exercises
Exercises should be performed several times a day to increase mobility and strengthen the muscles that have been dormant. Physical therapy sessions that teach the patient how to increase exercise usually continue for three to six weeks, during which time the patient begins to include more rigorous exercise. Light exercise on treadmills or elliptical machines can be started. The biggest obstacle to overcome is regaining a sense of balance. Exercises should not put the patient in danger of falling.
Resuming Normal Activities
Patients return to more normal activities after about six weeks. Driving usually can be resumed when the patient can easily get in and out of the car and can work the gas and brake pedals. In addition to exercises performed with fitness equipment, suggested sports activities that can be helpful include swimming, walking, golfing and cycling. Heavy aerobics, running, tennis and jogging should be avoided and may remain off-limits forever, although some patients resume all levels of exercise within three to six months.
