What is a total knee replacement?
A total knee replacement is one of the most common orthopaedic surgeries which are performed as a result of severe degeneration of the knee joint resulting in pain and immobility, commonly caused by osteoarthritis. The surgical procedure involves replacing the knee joint, which is made up of the end of the femur (thigh bone) and the top of the tibia (lower leg bone), using a metal implant. In some instances, the kneecap (patella) may be replaced or resurfaced.
What to do before the surgery
- Prehabilitation: Evidence supports better post-surgical outcomes for patients who partake in rehabilitation for at least 6 weeks prior to surgery. This will involve completing exercise under the guidance of a physiotherapist or exercise physiologist to strengthen muscles around the knee.
- Reduce excess body weight within a healthy range: Evidence also supports better outcomes for individuals with a lower BMI, as there is less stress placed on the knee joint after surgery. It also allows for easier mobilisation post-operatively and lowers the risk of post-operative complications.
- Quit smoking: Individuals who smoke have increased tissues healing times and hence poorer outcomes.
What to expect from rehabilitation after the knee surgery
The early phase of rehabilitation involves working with you physiotherapist to:
- Ensuring correct use of crutches
- Address post-operative knee swelling
- Regain knee range of motion through:
- Manual treatment techniques performed by your physiotherapist
- Set up and complete a tailored home exercise program
The later phase of rehabilitation involves working with your physiotherapist or exercise physiologist to:
- Strengthen the muscles around the knee and hip to allow for:
- An effective walking pattern (gait)
- Allow progression towards completing higher level functional tasks
Recovery time
It can generally take up to 12 months to reach an optimal level of recovery following a total knee replacement. The first 6 months will involve you working closely with your physiotherapist or exercise physiologist and during the following 6 months it is expected that you perform more of your rehabilitation strength/functional exercises independently to prepare your knee to withstand the stresses that are placed on in whilst completing the desired functional activities. During this time, it may be necessary to be periodically reviewed by physiotherapy or exercise physiology so your home exercise program can be updated. It is also vital to maintain a healthy lifestyle during this time, which includes aerobic and strength-based exercises. Ideally this will include exercise that is meaningful and important to you.