Physical therapy key to recovery after knee replacement

The goals of every knee replace­ment surgery at Ohio­Health Grady Memo­r­ial Hos­pi­tal are to relieve dis­abling pain and restore func­tion in the knee. Phys­i­cal ther­apy plays a key role in the process by max­i­miz­ing recov­ery and pre­vent­ing com­pli­ca­tions after a knee replacement.

Chances are that for patients expe­ri­enc­ing knee prob­lems, the mus­cles respon­si­ble for sup­port­ing and mov­ing the knee have weak­ened due to inac­tiv­ity. Dili­gent and con­sis­tent per­for­mance of phys­i­cal ther­apy exer­cises restores strength and range of motion, enabling patients to return to many of the activ­i­ties they enjoyed before their knee problems.

Ther­apy begins in the hos­pi­tal the day of surgery. A ther­a­pist vis­its patients to pre­scribe a few sim­ple exer­cises, includ­ing walk­ing and stand­ing when pos­si­ble. Early mobi­liza­tion strength­ens the new joint, coun­ters the effects of anes­the­sia and pro­motes blood flow in the legs that encour­ages heal­ing and pre­vents the for­ma­tion of blood clots.

The length of the hos­pi­tal stay depends, in part, on the patients’ abil­ity to meet sev­eral per­for­mance goals such as bend­ing and straight­en­ing the knee, get­ting in and out of bed, walk­ing with crutches or a walker and climb­ing up and down a short flight of stairs.

Once patients achieve a cer­tain level of inde­pen­dence either in the hos­pi­tal, or, in some cases, a reha­bil­i­ta­tion facil­ity, they will be sent home with an out­pa­tient exer­cise pro­gram that con­tin­ues to build strength, sta­bil­ity and flex­i­bil­ity in the new joint.

The ther­a­pist and sur­geon mod­ify each pro­gram to suit the indi­vid­ual patient’s age, con­di­tion, goals and other fac­tors. The out­pa­tient ther­apy typ­i­cally includes meet­ing with a phys­i­cal ther­a­pist at Grady Memo­r­ial Hos­pi­tal two to three times a week for four to six weeks. Many exer­cises are done while lying down or sit­ting in a chair. They not only address the knee but also gen­eral body con­di­tion­ing to sup­port the knee.

If needed, med­ica­tion can be taken 20 to 30 min­utes before a ses­sion to ease dis­com­fort. Icing and ele­va­tion after a ses­sion can also relive pain and swelling. Pain usu­ally sub­sides as heal­ing pro­gresses and restora­tion of func­tion occurs.

Ther­apy strikes a bal­ance between doing too much and doing too lit­tle. Patients will have good days and bad days but should notice steady improve­ment. The ther­a­pist and sur­geon reg­u­larly mon­i­tor progress to make any changes nec­es­sary. Together they will make a deci­sion about when patients can resume cer­tain activities.

Phys­i­cal ther­apy is more than exer­cise. It also involves tak­ing care of the leg after surgery with wound care, pain man­age­ment and diet. Even after patients have com­pleted their med­ical recov­ery and regained full func­tion of their new joint, their ther­a­pist and sur­geon will con­tinue reg­u­lar assess­ments of their con­di­tion to opti­mize func­tion in the new joint for years to come.

Dr. McGrail is a board-certified ortho­pe­dic sur­geon with Delaware Ortho­pe­dics and Sports Med­i­cine and a mem­ber of the Ohio­Health Grady Memo­r­ial Hos­pi­tal med­ical staff.

Posted by Grady Memorial Hospital on Dec 19 2012. You can follow any responses to this entry through the RSS Feed. Comments can be made below.