Knee Replacements: The Role of Physiotherapy and benefits of In-home Rehabilitation
Types of knee replacements
Your decision to have a knee replacement should be made jointly with your orthopedic surgeon. Usually this decision is based on a risk-benefit analysis and on the likelihood of successful rehabilitation. Of course, this decision is also based on your age, level of function, physical goals and and what anatomical changes there are on x-ray, MRI or CT. These factors also help to determine which type of knee replacement you are recommended to have.
1. Total Knee Replacement (TKR):
This is the most common type of knee replacement surgery. It involves replacing all three compartments of the knee: the medial (inside), lateral (outside), and patellofemoral (front of the knee) compartments. The damaged bone and cartilage from the femur, tibia, and patella are removed and replaced with metal and plastic prosthetic components.
2. Partial Knee Replacement (PKR):
Also known as unicompartmental knee replacement, this procedure is suitable for patients who have damage in only one compartment of the knee. It's less invasive than a total knee replacement and involves replacing only the damaged compartment with a prosthetic. This can result in a quicker recovery and less postoperative pain.
3. Kneecap Replacement (Patellofemoral Arthroplasty):
This type of surgery focuses on replacing just the under-surface of the kneecap and the groove it slides in, on the femur. It's typically indicated for patients with arthritis confined to the front compartment of the knee.
4. Revision Knee Replacement:
Sometimes, a previously implanted knee replacement can fail due to wear and tear, infection, or other complications. A revision knee replacement is more complex and involves removing the original prosthesis and replacing it with a new one. This surgery often requires addressing bone loss or correcting alignment issues.
5. Bilateral Knee Replacement:
This refers to replacing both knees during the same surgical session. It can be done simultaneously (both knees replaced on the same day) or staged (one knee done first, followed by the other at a later date). This can be beneficial for patients suffering from severe arthritis in both knees.
The Role of Physiotherapists… we are really important too!
Physiotherapy plays a crucial role in the recovery process after a knee replacement surgery. Here are some key components of physiotherapy post-knee replacement:
Early Mobilisation: Getting up and onto your feet as early as possible is really important. In some low risk cases, patients can now go home on the same day as their surgery. This shows how physically able you can be early on in your recovery. Physiotherapy usually starts within 24 hours after surgery. The therapist will help you stand and take a few steps with the aid of a walker or crutches, focusing on getting you moving as soon as possible. Sometimes patients feel a little dizzy and can suffer from low blood pressure, our physiotherapists are ready to assess this and will do a risk assessment before getting you up and walking.
Range of Motion Exercises: These exercises help improve the flexibility of your knee. Being able to bend and fully straighten your knee following surgery is really important. Our physiotherapists will ensure you are working towards target degrees of movement from week to week. Often we help patients to bend and straighten their knee manually, this can be beneficial for increasing your movement and showing you how much you are able to do! Your exercises may include passive, assisted, or active exercises to bend and straighten the knee, targeting to restore the full range of motion.
Muscle Strengthening: We have to start activating your leg muscles to help you get back onto your feet. Strengthening the muscles around the knee joint, such as the quadriceps and hamstrings, is vital. Your exercises to begin with will focus on activating your muscles and progress onto body weight and then weighted exercises. Exercises might include knee extensions (sitting on a chair and straightening the knee), squats, glute bridges, straight leg raises and so on. Your physiotherapist at Home Physio Company will create a personalised program based on your post-operative physical ability, pain levels and current strength levels.
Pain Management: Physiotherapists can guide you on how to best manage your pain and the swelling associated with your surgery. Usually this is a combination of positioning, cryotherapy, oral medication and manual therapy. Physiotherapists can provide manual therapy (assisted stretching/joint movements as well as massage) to help manage soreness.
Walking and Gait Training: Your physiotherapist will guide you on how to improve your walking pattern. We usually see patients walking with a limp or “off-loading” their surgery leg which is really normal. We also guide you on when and how to progress with your walking aids until you are using none, or one that you are most comfortable with if you still require one. Over time, you will be able to fully stand on your operated leg!
Functional Exercises: These exercises focus on activities of daily living. You might practice steps, sit-to-stand motions, getting into and out of bed and movements to improve balance and stability.
Education and Precautions: Understanding the mechanics of the knee replacement, proper body mechanics, and techniques to avoid undue stress on the knee are essential parts of your rehabilitation. Usually there are no post operative “precautions” after a knee replacement but occasionally, depending on your surgery you may not be able to fully weight bear for a short period of time.
Home Exercise Program: You will likely be given exercises to continue at home to reinforce what you have learned in therapy and to continue your progress.
How long will my recovery be?
Recovery timelines vary, but most patients see significant improvements within 3-6 months, with full recovery potentially taking up to a year. Recovery timelines do really vary from person to person. Always follow your physiotherapist's and surgeon's guidance to ensure a safe and effective recovery.
With Home Physio Company we always work with our patients to achieve better physical functioning than they were pre-surgery and for some, we work towards sports specific goals like cycling, jogging, racquet sports, or swimming.
Undergoing a knee replacement is a significant step toward reclaiming mobility and alleviating chronic pain. However, the road to full recovery doesn't end with surgery; it begins with a rigorous and well-structured physiotherapy regimen. While many patients opt for outpatient clinics, in-home physiotherapy offers a convenient and personalised approach to rehabilitation.
Why In-Home Physiotherapy?
Convenience: Leaving home and getting into a car after a knee replacement can be really challenging. That’s why with Home Physio Company we come to you. In home Physiotherapy is hugely beneficial for many reasons, convenience is definitely one of them!
Personalised Care: Home Physio Company values personalised treatment plans and continuity. You will always have the same physiotherapist. Being at home we can show you how to complete exercises in the perfect places and positions. Each session is personalised towards your goals and agreed treatment plan.
Comfort: Being in the environment where you will be completing your exercises is a great benefit! Whilst recovering from surgery being in a familiar environment can reduce stress and anxiety, fostering a positive mindset, important for recovery.
Are you looking for specialist in Home Physiotherapy following a Knee Replacement? Look no further!
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