When Is Knee Replacement Necessary?

Knee replacement is considered when other treatments have failed to provide relief for severe knee pain and impaired function. The most common reasons include:

1. Osteoarthritis: The breakdown of knee joint cartilage that leads to pain and stiffness.
2. Rheumatoid Arthritis: An autoimmune disease that affects the knee joint.
3. Post-Traumatic Arthritis: Arthritis resulting from a severe knee injury.
4. Avascular Necrosis: Diminished blood supply to the knee causing bone damage.
5. Other Conditions: Knee replacement may also be necessary for fractures, ligament tears, and other knee disorders.

Types of Knee Replacements:

There are different types of knee replacements based on the extent of knee damage:

1. Total Knee Replacement (TKR): This is the most common type, replacing both the tibia and femur portions of the knee joint.
2. Partial Knee Replacement (PKR): A portion of the knee is replaced. It’s suitable for patients with damage limited to one area.
3. Kneecap Replacement (Patellofemoral Arthroplasty): Only the kneecap and trochlear groove are replaced.

The Surgical Process:

A knee replacement surgery typically includes the following steps:

1. Anesthesia: You’ll receive either general or spinal anesthesia.
2. Incision: A cut is made to access the knee joint.
3. Reshaping: The damaged bone and cartilage are removed from the femur, tibia, and kneecap.
4. Implants: The artificial joint components are attached to the reshaped bones.
5. End of Surgery: The incision is closed, and you’re monitored in the recovery area.

Recovery After Knee Replacement:

Recovery plays a crucial role in the success of your knee replacement. The process includes the following phases:

1. Hospital Stay: Most patients stay in the hospital for a few days.
2. Physical Therapy: Post-surgery, you’ll start physical therapy to regain strength and mobility.
3. Pain Management: Pain is managed with medication.
4. Preventing Complications: Techniques to prevent blood clots and infection are essential.
5. Returning Home: Once stable, you’ll be discharged and continue your recovery at home.
6. Long-Term Recovery: Complete recovery takes several weeks to months. Commitment to physical therapy is vital.

Phases of Knee Replacement Rehabilitation:

Rehabilitation after knee replacement surgery is typically divided into several phases:

1. Immediate Post-Operative Phase:

• Day of Surgery: The initial focus is on pain management. Patients are encouraged to move their toes, feet, and ankles while in bed to improve circulation.
• Post-Operative Day 1: Patients are assisted in standing and walking with the help of a walker or crutches.

2. Early Recovery Phase:

• Days 2 to 6: The emphasis is on improving mobility and reducing swelling. Patients continue to use assistive devices and begin gentle range of motion exercises.

3. Intermediate Recovery Phase:

• Weeks 2 to 6: Patients work on increasing their range of motion and strength. The use of assistive devices may decrease, and walking without support is encouraged.

4. Late Recovery Phase:

• Weeks 7 and Beyond: Patients focus on regaining strength and function. Most patients can return to normal daily activities at this stage.

Exercises for Knee Replacement Rehabilitation:

While every individual’s rehabilitation plan is tailored to their specific needs, some common exercises are often included:

1. Quadriceps Sets:

• These are simple contractions of the thigh muscles that help improve strength around the knee.

2. Straight Leg Raises:

• Lifting the entire leg while keeping it straight helps strengthen the quadriceps muscles.

3. Heel Slides:

• Sliding the heel towards the buttocks while lying down aids in improving knee flexion.

4. Ankle Pumps:

• Moving the ankle up and down promotes blood circulation and reduces the risk of blood clots.

5. Standing Knee Flexion:

• Gently bending the knee while standing helps regain range of motion.

6. Step-ups:

• Step-ups onto a stable platform can improve strength and balance.

7. Stationary Bike:

• As the knee improves, stationary biking can be introduced to improve mobility and strength.

The Role of Physiotherapy in Knee Replacement Rehabilitation:

Physiotherapy is an integral part of knee replacement rehabilitation. The following are some ways in which physiotherapy plays a crucial role:

1. Individualized Treatment Plan:

• Physiotherapists create personalized treatment plans based on the patient’s condition, needs, and goals.

2. Pain Management:

• Physiotherapists use various techniques to manage pain and inflammation, ensuring comfort during the rehabilitation process.

3. Range of Motion Improvement:

• Specialized exercises and manual therapy help improve the range of motion in the knee.

4. Strengthening Exercises:

• Physiotherapists focus on strengthening the muscles around the knee, providing stability and support.

5. Gait Training:

• Patients are guided on walking and regaining proper gait patterns, reducing the risk of limping.

6. Assistive Device Training:

• If required, patients are trained in the proper use of assistive devices such as crutches or walkers.

7. Home Exercise Program:

• Patients are given exercises to continue at home, promoting ongoing progress.