Total knee replacement is an extremely common orthopaedic surgery. Your rehabilitation following the surgery should start day one post-op while you’re in the hospital, and continues as an out-patient after you’ve been discharged until such a stage as you feel fully confident with your new knee.
Here’s an outline of what will be expected in your rehabilitation.
Day one Post-Op:
Some orthopaedic surgeons, depending on their preference, will like to use a continuous passive motion (CPM) machine to encourage gentle bending and straightening of the knee immediately after your operation. This CPM machine will be applied to your knee by your physiotherapist in the hospital and gently bends and straightens your knee to gently start increasing your range of motion in your new knee.
You will also have to perform some static contractions of your leg, thigh, calf and hip muscles the first day after your operation.
If you are feeling well on the first day after your operation you will be encouraged to get out of bed and walk a couple of steps using a walking frame. Although this doesn’t seem like rehabilitation, it is in fact the early stages of your road to recovery.
Day two Post-Op:
On the second day after your knee operation you will be encouraged to walk a little further with your walking frame. You will also have to do some exercises for bending and straightening and for strengthening your knee. Your physiotherapist in the hospital will explain all these to you.
Day three Post-Op:
On the third day after your operation, your physiotherapist in the hospital will attempt to progress your mobility by teaching you to use elbow crutches or walking sticks instead of a walking frame. From day three onwards you will be expected to attempt to go up and down steps with your physiotherapist.
You can start to do more challenging exercises to increase the bend in your knee from day three onwards including gentle squats.
Day four Post-Op:
Once both the surgeon and physiotherapist in the hospital are happy with your progress and are convinced that you are familiar with your exercise programme you can be discharged home.
Usually when you’re discharged from hospital you should have a 0-90 degrees range of motion in your knee and you should have adequate strength in your thigh muscles to lift your heel off the bed without bending at the knee.
Six Weeks Post-Op:
If you have less than 80 degrees of knee bend following your knee surgery you will be encouraged to attend physiotherapy as an outpatient. With some further work along with your chartered physiotherapist you should expect to be able to walk with no walking stick or crutch around the house after six weeks and be starting to venture outside with no support. You should have no problems climbing stairs and be able to do light household tasks. After six weeks you can begin to cycle and swim a little and should have a knee bend of 110 degrees at this stage. Usually your surgeon reviews you at this time and may give you the “go-ahead” to return to activities like walking, driving and swimming.
Six months Post-Op:
At 6 months following your knee surgery you should be walk completely pain free with no limp and perform all normal household activities. You should have 120 degrees of knee bend and be able to kneel and play golf, walk, hike, cycle and dance. You should have no further pain or swelling in the knee.