TKR REHABILITATION: Key to enjoy a pain free life
Total Knee Replacement has become a routine procedure to tackle age related osteoarthritis knee pain and deformities. But unfortunately less emphasis is given on the importance of the rehabilitation protocol. Even the best of surgeries will lead to unsatisfactory outcomes if post operative rehabilitation exercises are neglected.
We are here to discuss and guide TKR patients through various post operative exercises so that they can achieve a full recovery and a pain free post operative life.
Unlike other types of surgeries, after TKR, rest is seldom advised. Exercise protocol should be followed strictly. In case of increased swelling with or without pain, patient can take rest and cold compression for 24 hours and is advised to get back to the exercise regimen as soon as tolerable.
Day 1:
Post operative exercises start from the very next day after surgery. After post operative dressing, the patient is asked to stand and bear weight on the operated knee with the help of a walker.
Week 1:
Stand with the help of a walker and bear weight on the affected knee as long as tolerable. This should be repeated every few hours.
Extend and straighten the operated knee actively with a pillow on the foot end. Keep it extended as long as tolerable.
Flex the affected knee with support as much as tolerated. In absence of any assistance, it can be done on bed where the bed acts as support.
Ankle Pump Exercise: Move your foot up and down rhythmically by contracting your calf and shin muscles. Do this for 10-15 mins every 2 hours
- Quadriceps Exercise: Tighten your thigh muscles, straighten your knee and dorsiflex your foot. Hold for 30 seconds or as much as tolerated. Repeat the same after 30 seconds of rest. This exercise should be done for 5-10 minutes every few hours or as much as tolerated
Week 1-2:
Ankle Pump Exercise
Quadriceps Exercise
- Assisted Knee Bending Exercise: Place a folded towel over your operated knee and drop the towel to your foot. With the help of the towel bend your knee as much as tolerated and hold it for 30 second. Extend your knee, rest for 30 seconds and repeat the same.
Knee Range of Motion Exercises (ROM) with legs hanging from chair-
Straight Leg Raise Exercise: Raise your operated leg several inches off the floor, hold it in that position for 30 seconds and then lower it slowly. Repeat this exercise for 10-15 minutes every few hours or as tolerable.
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Walking with support for as long as tolerable. Start with walker after the surgery. Later, you can shift to walking stick if needed.
Week 2-4:
Add weight cuff (1 kg) to your exercise regimen where applicable and if tolerable.
Ankle Pump Exercise
Quadriceps Exercise
Assisted Knee Bending Exercise
Walking with support
Straight Leg Raise Exercise
- Knee ROM Exercise with leg hanging+/- wt. cuff
- Knee ROM exercise in prone position+/- wt. cuff
- Ball squeeze between knees Squeeze a ball between both knees, hold it for 30 secs and then relax. Repeat this for 10-15 mins at least twice a day.