What is Total Knee Replacement (TKR)?
A knee replacement 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 considered for someone who has severe arthritis or a severe knee injury. TKR is among the most widely performed procedures in the world, is known to successfully relieve pain and restore function in patients with advanced knee arthritis.
Although an injury to the knee can be caused due to several factors. Some known factors are osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis. Osteoarthritis occurs when the cartilage covering the ends of the bones where they meet to form joints breaks down. Rheumatoid arthritis is a condition in which the body's immune system attacks the membrane that lines the joint.
Recovery From A Post-TKR:
Physiotherapy is extremely crucial to the process of recovery post TKR. It not only improves the motion of the knee and but also allows for a natural transition back to a more normal knee movement for daily activities. Patients who comply with physical exercises recover much faster. According to a research presented at the 2013 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), it was found that ‘98% of total knee replacement (TKR) patients who were working before surgery returned to work after surgery, and of those patients, 89 % returned to their previous position’. The research further stated that’ Nearly 75 % of patients (493) were employed during the three months prior to their TKR’.
How Can A Physiotherapist Help You Before And After TKR ?
Your physiotherapist can help ensure that your TKR will be successful by providing evaluation and treatment before and after surgery.
Before Your Surgery ("Pre-op Conditioning")
The better physical shape you are in before TKR surgery, the better your results will be (especially in the short term). Before surgery, your physiotherapist will teach you exercises and show you how you will walk with assistance after your operation. Your therapist also will discuss precautions and home adaptations, such as removing loose rugs or strategically placing a chair so that you can sit instead of squatting to get something out of a low cabinet. It's always easier to make these modifications before you have TKR surgery.
If you smoke, quit! That may help improve your healing after surgery. If you are overweight, focus on weight loss prior to surgery. Losing excess body weight may help you recover more quickly, and help improve your function and overall results following surgery.
Immediately Following Your Surgery
With a TKR, you likely will stay in the hospital 2 or 3 days following your surgery. If you have other medical conditions, such as diabetes or heart disease, you might need to stay an additional few days. If you are like most patients, you will be told to put as much weight as comfortable, when standing, on the leg that had surgery. While you are in the hospital, a physiotherapist will:
- Show you how to practice walking with a walker or crutches
- Teach you how to safely get in and out of bed or a chair
- Help you continue to do the flexibility and strengthening exercises that you learned before your surgery
During this period, it's especially important to control the swelling in your knee and to help your incision heal. Your physiotherapist may perform electrical stimulation, where electrodes are placed on the skin to stimulate the nerves around the knee to help reduce pain and swelling and promote healing.
Your therapist also may apply cold to the knee to help decrease swelling and may recommend that you wear support stockings.
As You Begin to Recover
Proper rehabilitation after a TKR is essential to your recovery. Your physiotherapist will help you regain much of your knee range of motion as soon as possible. At this point, you might be walking with a cane or with one crutch.
p>Your physiotherapist can speed up (or "hasten") your return to activity and help make your new knee better than the old one! Your therapist will tailor range-of-motion exercises, progressive muscle-strengthening exercises, body awareness and balance training, and activity-specific training to your specific needs.
Occasional swelling of the knee joint and lower leg can occur for up to 3 months after surgery. To relieve swelling, you can wear support stockings, apply a cold pack, and elevate your lower leg on a pillow when sitting or lying down.
Swelling and pain can make you move your knee less. Your physiotherapist can teach you safe and effective exercises to restore the range of motion to your knee so that you can perform your daily activities
The weakness of the muscles of the thigh and lower leg could make you need to use a cane when walking. Your physiotherapist can determine which strengthening exercises are right for you, with the goal of no longer needing to use a cane to walk.
Body awareness and balance training
Specialized training exercises help your muscles "learn" to respond to changes in your world, such as uneven sidewalks or rocky ground. When you are able to put your full weight on your knee without pain, your physiotherapist may add agility exercises (exercises that have you practice making quick stops and starts, turns, and changes in direction) and activities using a balance board that challenges your balance and knee control. Your program will be based on the physiotherapist’s examination of your knee, on your goals, and on your activity level and general health.
When you can walk freely without pain, your physiotherapist may begin to add activities that you were doing before your knee pain started to limit you. These might include community-based actions such as crossing a busy street or getting on and off an escalator. Your program will be based on the physiotherapist’s examination of your knee, on your goals, and on your activity level and general health.
The timeline for returning to leisure or sports activities varies from person to person; your therapist will be able to estimate yours based on your specific condition.
Depending on the requirements of your job or the type of sports you play, you might need additional rehabilitation that is tailored to your job activities (such as climbing a ladder) or sports activities (such as swinging a golf club) and the demands that they place on your knee. A physiotherapist’s can develop a rehabilitation program that takes all of these demands into account.
Real Life Experience with Arooj:
After a successful career spanning through decades, Mr. Amiya Shreyas, 64 years was confined to his home due to a severe case of osteoarthritis, he was unable to climb stairs or go for walks. After bearing a significant amount of pain, he underwent a knee replacement surgery. His post-surgery recovery process was taken up by Arooj Home Healthcare Services. Initially, he had very weak knee muscles and significantly restricted the range of motion, unable to walk independently. With the help of our expert physiotherapists, he was soon back on his feet and now goes for his morning walks every day.
The key to a fast post knee replacement surgery is targeted exercises for the leg. In order to get maximum mobilisation of the knee, along with a range of motion exercises, knee strengthening and stretching exercises are used for a swifter recovery. The patient’s progress is recorded in detail for tailored treatment plans. The patient's primary consultant is kept in the loop and regularly updated with patient's progress.
The remarkable difference is noted in the patient's recovery status, improved range & strength of the knee joint. The patient was able to walk independently, significant improvement in knee ranges and pain was noted. Now Mr. Amiya goes ahead with his walks and meeting up with his friends & relatives.
How Can Arooj Help Others ?
Arooj provides Home Physiotherapist treatment. Our physiotherapists follow international guidelines and a standardised approach to ensure the quality of the physiotherapy service. A physiotherapist will come to your home as per your convenience, avoiding the need to take time off work, attempt to finish early or struggle out of the house if you are undergoing extreme pain.