Total knee replacement (TKR) is a common surgery for individuals with severe knee arthritis or injury. Post-operative rehabilitation is an essential part of the recovery process, and exercise is an important component of that rehabilitation. The post-surgery protocol after total knee replacement (TKR) can vary depending on the surgeon, patient, and the specific surgical technique used. However, here are some recommendations based on recent research studies:
Early Mobilization: Early mobilization, including getting out of bed and walking with the help of a physical therapist, is recommended within 24 hours of surgery. A 2021 systematic review and meta-analysis published in the Journal of Arthroplasty found that early mobilization after TKR can lead to better outcomes, including improved range of motion, reduced length of hospital stay, and lower rates of complications.
Multimodal Pain Management: A multimodal pain management approach, which may include medications, nerve blocks, and non-pharmacologic methods such as ice therapy and physical therapy, is recommended to manage post-operative pain. A 2020 systematic review and meta-analysis published in the Journal of Bone and Joint Surgery found that multimodal pain management can reduce the use of opioids after TKR and improve patient satisfaction.
Knee Range of Motion Exercises: Knee range of motion exercises, including active and passive knee flexion and extension exercises, are recommended to improve joint mobility and prevent stiffness. A 2020 systematic review and meta-analysis published in the Journal of Arthroplasty found that early and intensive knee range of motion exercises after TKR can lead to better outcomes, including improved knee function and patient satisfaction.
Home-Based Rehabilitation: Home-based rehabilitation, including exercises and activities that can be done at home with the guidance of a physical therapist, is recommended to improve outcomes after TKR. A 2019 systematic review and meta-analysis published in the Journal of Rehabilitation Medicine found that home-based rehabilitation after TKR can lead to better outcomes, including improved knee function and quality of life, compared to center-based rehabilitation.
It is important to note that these recommendations may vary depending on individual patient factors and the surgeon's preference. Patients should work closely with their healthcare team to develop a post-surgery protocol that is tailored to their specific needs and goals.
How do you increase your range of motion after knee replacement?
A 2020 systematic review and meta-analysis published in the Journal of Arthroplasty found that early and intensive knee range of motion exercises after TKR can lead to better outcomes, including improved knee function and patient satisfaction. The review also suggested that passive range of motion exercises, performed with the help of a physical therapist or a continuous passive motion machine, can be helpful in improving knee flexion after TKR.
It is important to note that the specific range of motion exercises prescribed may vary depending on individual patient factors and the surgeon's preference. Patients should work closely with their healthcare team to develop an group exercise program that is tailored to their specific needs and goals.
Range of motion exercises are important for restoring knee flexibility after surgery. These exercises may include heel slides, wall slides, and knee extension. Here are some examples of range of motion exercises that have been shown to be effective in improving knee function after TKR:
Knee Flexion and Extension Exercises: These exercises involve bending and straightening the knee, and can be performed in a seated or lying down position. Patients should aim to perform these exercises several times a day, gradually increasing the range of motion over time.
Heel Slides: Heel slides involve sliding the heel towards the buttocks while lying on the back, and then sliding the heel back down. This exercise can help improve knee flexion and extension. Hamstring curls are an exercise that can help strengthen the hamstrings muscle. Hamstring curls can help to strengthen the hamstrings, which play an important role in knee stability. A 2019 study published in the Journal of Exercise Rehabilitation found that hamstring curls were effective in improving knee flexion strength and function after total knee replacement. To perform this exercise, lie face down on a mat or bed and bend your knee, bringing your heel towards your buttocks.
Quadriceps Sets: Quadriceps sets involve tightening the thigh muscles while seated or lying down, and holding for a few seconds before releasing. This exercise can help improve knee strength and stability.
Straight Leg Raises: Straight leg raises involve lifting the leg while lying on the back, and then lowering it back down. This exercise can help improve knee strength and range of motion. Straight leg raises are a simple and effective exercise that can help strengthen the quadriceps muscle which is important for knee stability and function. A 2013 study published in the Journal of Orthopaedic & Sports Physical Therapy found that straight leg raises were effective in improving knee extension strength and function after total knee replacement.This exercise involves lying on your back and raising your leg straight up off the ground, keeping your knee straight.
Wall Slides: Wall slides are another exercise that can help improve knee range of motion and strength. A 2016 study published in the Journal of Orthopaedic & Sports Physical Therapy found that wall slides were effective in improving knee range of motion and reducing pain after total knee replacement.The wall slide exercise is a simple range of motion exercise that can be performed to improve knee flexion after total knee replacement surgery. Here are the steps to perform the wall slide exercise: Stand with your back against a wall and your feet shoulder-width apart. Keep your knees and feet facing forward. Slowly slide down the wall, bending your knees and hips, until you are in a sitting position with your knees bent at a 90-degree angle. Make sure your knees are directly above your ankles. Hold the position for a few seconds, then slide back up the wall to a standing position. Repeat the exercise several times. If you experience any pain or discomfort, stop the exercise and consult with your healthcare provider.
It is important to start slowly and gradually increase the range of motion over time. Patients may find it helpful to perform the wall slide exercise with the guidance of a physical therapist to ensure proper form and technique. Additionally, patients should work closely with their healthcare team to determine the appropriate frequency and intensity of the exercise based on their individual needs and goals.
Is riding a stationary bike good after knee replacement?
Riding a stationary bike can be an excellent exercise to include in your recovery after knee replacement surgery. In fact, it is often recommended by physical therapists and surgeons as a safe and effective way to improve range of motion, strength, and cardiovascular fitness without putting too much stress on the knee joint.
There is considerable research supporting the effectiveness of these exercises after TKR. For example, a 2020 study published in the Journal of Orthopaedic Surgery and Research found that a six-week cycling program improved knee range of motion, muscle strength, and physical function in patients who had undergone TKR. Additionally, a 2018 systematic review published in the Journal of Physical. A 2016 study published in the American Journal of Physical Medicine & Rehabilitation found that stationary cycling was effective in improving knee range of motion and function after total knee replacement.
If you're considering riding a stationary bike after knee replacement surgery, it's important to start slowly and gradually increase the duration and intensity of your workouts over time. You may need to adjust the seat height or handlebar position to ensure that you're comfortable and that your knee is not overly stressed during the exercise.
What is the best exercise after knee replacement?
Walking is often considered one of the best exercises to do after total knee replacement surgery. This is because walking helps to improve circulation, reduce swelling, and promote healing, while also strengthening the muscles of the lower body, including those around the knee joint.
In the early stages of recovery, you may need to use a walker or crutches to assist with walking, and you may need to limit the distance you walk at first. However, as your strength and stability improve, you can gradually increase the amount of time and distance you walk each day.
Walking is an excellent low-impact exercise that can help to improve cardiovascular fitness, leg strength, and balance immediately after Total Knee Replacement. Gradually increase the distance and speed of your walks as your knee heals will help to improve independence with functional mobility.
Can you go up steps after knee surgery?
Absolutely! Step-ups are an exercise that can help improve leg strength and function. A 2018 study published in the Journal of Physical Therapy Science found that step-ups were effective in improving knee function and reducing pain after total knee replacement. Step-ups are a great exercise for improving leg strength and function, particularly in the muscles of the lower body, such as the quadriceps, hamstrings, and glutes. Step-ups help to strengthen the muscles around the knee joint, which can help to stabilize and support the joint and reduce pain and discomfort. Other studies have also shown that step-ups can be effective for improving balance, increasing power and explosiveness in the legs, and reducing the risk of falls in older adults. Overall, step-ups are a versatile and effective exercise that can be incorporated into a variety of workout routines to improve leg strength, function, and overall health.
You should only step up with the leg where you had TKR after consulting with your physical therapist or surgeon. In general, it's important to follow the guidance of your healthcare team and to progress at a safe and appropriate pace during your recovery from TKR surgery.
Initially, your healthcare provider may recommend that you start with step-ups using your non-surgical leg only. This can help you to build strength and stability in your non-surgical leg before adding resistance to your surgical leg.
As you progress in your recovery, your physical therapist or surgeon may give you the green light to begin incorporating step-ups with your surgical leg. However, it's important to follow their specific guidance and to avoid any movements that cause pain or discomfort.