What is a total knee replacement?
A total knee replacement (TKP) or hemi(half) knee replacement (HKP) refers to the removal and replacement of damaged portions of bone and cartilage at the ends of the tibia (shin bone), femur (thigh bone) and patella (kneecap). These new implants are usually composed of metal and synthetic materials. Another synthetic material, usually plastic-based, is cemented on top of the tibial (shin) implant to reduce friction with the femoral implant. People with symptomatic osteoarthritis who suffer from persistent pain, loss of function, loss of strength and limited mobility (with unsuccessful attempts at nonoperative treatment) are prime candidates for a TKP.
When can I start walking on my operated limb?
Patients in the hospital can usually get up and walk within 24-48 hours after surgery. Walking within the first 24 hours is associated with a shorter hospital stay and reduces the risks of prolonged bed rest. During these walking sessions, you will be assisted by the nursing and rehabilitation staff and have an assistive device, usually a walker or crutches.
How do I check for a deep vein thrombosis?
A deep vein thrombosis (DVT) is a blood clot that often develops after surgery, especially in the calf area of your lower leg. There is a collection of signs and symptoms that indicate a possible DVT. These include, but are not limited to, excessive swelling along the entire leg or lower leg/calf area, warmth, localized tenderness around the calf and well edema. If you are concerned about a possible DVT, it is recommended that you contact your doctor immediately for further investigation and treatment. Other complications to watch for include bleeding, poor wound healing, loss of sensation or motor function, vascular injury, instability of the knee joint and infection. Your orthopedic/surgical team should be notified of any new or worsening symptoms.
When should I stop using my tools?
There is no black and white answer. Factors that affect the time to stop using all assistive devices include: previous level of function and whether or not you were using an assistive device prior to surgery, severity of fall risk, self-confidence and recommendations from your orthopedic and rehabilitation team. My biggest recommendation is not to rush this process. Assistive devices aim to reduce discomfort and swelling of the knee by relieving the surgical member, in addition to being a safer and more efficient means of walking. The transition from a walker to a cane with one point or quad and eventually to no assistive device is the typical progression.
What does rehabilitation entail?
There are several TKA rehabilitation protocols available on the Internet, with similar timelines, goals and interventions. Your orthopedist and rehabilitation physician also have their own protocols and prescriptions. The purpose of this last section is to give you an idea of what your rehabilitation may look like in the coming weeks and months.
Phase 1: 0-6 weeks
The main goals/priorities in the first few days/weeks after your procedure include: Protect the healing tissues Control pain and swelling Identify/control new or worsening symptoms Improve range of motion Increase quadriceps (upper leg) strengthNormalize quality and speed of walkingImprove self-confidence and competence with daily activities.
Phase 2: 6-12 weeks
Key goals/priorities during Phase 2 of your rehabilitation (weeks 6-12) include: Full (or nearly full) recovery of your knee flexion and extension range of motionContinued improvement in quadriceps strength (and the entire surgical leg) Normalized walking quality and speed Tolerance for daily activities with little to no restriction
Phase 3: 12-24+ weeks
Key goals/priorities during Phase 3 of your rehabilitation (weeks 12-24+) include: Full return to your previous level of function (or beyond) Recovery of quadriceps and whole lower leg strength (or beyond) Beginning progressive plyometric activities (with permission of physical therapist) Gradual return to sports/recreational activities (with permission of physical therapist)
