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Knee Replacement - Hip Replacement - Spine SurgeryFeel again the joy of life - After Joint Replacement
Total knee replacement, unicompartmental or partial knee replacement
Hemi hip replacement, total hip replacement, surface replacement
Discectomy, foramenotomy, laminectomy, spine fusion, spinal disc replacement

Knee Replacement

  What is a knee replacement?     Types of Knee Replacement     How is a knee replacement surgery performed?
  Pre-operative Preparation     Post-operative Rehabilitation

Pre-operative Preparation
Before a knee arthroplasty or a knee replacement surgery is performed on the patient, some pre-operative preparations are done. It will begin with an initial surgical consultation including pre-operative x-rays, complete blood count, urine test, ECG, APTT and PT. X-rays of the affected knee will be done to measure the size of implants needed for an individual during the surgery. The surgeon will also go through your past surgical history and the list of all medications that you have been taking. An orthopaedic examination and a discussion of the knee surgery will also follow. You will be guided about the preparations you need to make before getting admitted to the hospital. If you get the pre-op work done at the pre-anesthetic clinic, you can be admitted on the day of surgery itself. Or else, you can also get admitted to the hospital a couple of days before the surgery. In the latter case, all the pre-operative preparations will be made at the hospital. At the hospital, the anesthesiologist will meet you to ascertain the kind of anesthesia to be used.

Post-operative Rehabilitation
Formal rehabilitation begins in a few days after the knee replacement surgery. After the surgery has been performed and the incision has been closed, you need to be very confident that the implants are firmly set in place. In the first 2 weeks after the surgery, you need to have protected weight bearing using crutches and walkers when you move. As the implants are in place, you can place some weight on the knee. However, pain will prevent you from doing so. Therefore, you will need to wait till the quadriceps muscles get healed. In the initial stage of rehabilitation, main goals include reducing knee stiffness and maximizing the range of motion. Before you discharge from the hospital (which normally happens within 3-6 days after the completion of knee arthroplasty), you will need to attain more mobility. Early exercises will focus on the increasing the blood flow in the muscles.

Short-term Knee Rehabilitation Goal
In the first 2 weeks after your discharge from the hospital, 0-90 degrees range of motion is expected. Patients should gain control of the quadriceps rapidly so that they can walk about without knee immobilizer. Safety is a main concern while patients ambulate with the help of walker or are transferred. Rapid mobilization is required in patients.

To maximize your range of motion following surgery, you need to adhere to the CPM protocol that your surgeon prescribes. Early physical therapy, edema control and adequate pain control will help you become more mobile. After you are discharged from the hospital, you will be instructed to follow a home exercise program. These exercises are specifically designed and meant for strengthening of the muscles that support the knee and to regain the range of motion in the knee.

Some typical home exercises would include:
Ankle Pump: Just flex the ankle backward and forward. The exercise relieves you of stiff ankles and stimulates blood circulation in the extremities.
1 Quadriceps Sets or Quad Sets : Pushing the knee down, tighten up the thigh muscles and retain the posture for 5 seconds.
2 Heel Slides : Bend you hip and knee upwards, keeping the heel on the ground. Get back your knee again to the straight position.
3 Straight Leg Raises : Lift the leg up six inches from the ground while the knee remains straight.
4 Knee Extensions : Place a pillow under the knee and lift your foot off the bed.
5 Knee Flexion Stretch : Place a towel under the heel. With the support of the towel, pull your knee inside towards the chest. Hold the knee in this flexed position for a span of 15-20 seconds. Get the knee back to the straight position.

Quadriceps Sets or Quad Sets
1 Quadriceps Sets or Quad Sets
Heel Slides
2 Heel Slides
Straight Leg Raises
3 Straight Leg Raises
Knee Extensions
4 Knee Extensions
Knee Flexion Stretch
5 Knee Flexion Stretch

Long Term Knee Rehabilitation Goal
After the rehabilitation therapy has been completed, patients can expect a range of motion in the knee from 100 to 120 degrees. There may be mild pain or no pain at all while walking or doing any other activity. You become independent to perform all activities of daily life.

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