Due to aging, or because of a serious injury, some individuals may start suffering from joint issues that limit them from performing everyday activities. One of the most common among these is knee osteoarthritis, which is a result of old age. Other knee diseases caused by inflammation and injury are rheumatoid arthritis and post-traumatic arthritis, respectively. Serious knee diseases make normal activities like walking, sitting, climbing stairs, lifting heavy weights, or standing for a long period of time very difficult. If medicines are unable to show significant improvement in the knees, then the patients are suggested to undergo a total knee replacement surgery (TKR). It is advisable to undergo this surgery surrounding circumstances that involve:
Total knee replacement, or knee arthroplasty, involves a surgical process to entirely remove the damaged or ruptured part of the knee and replace it with an artificial joint made of metal and plastic. This is done with the objective of relieving pain and disability, while also treating leg deformity. This surgery has a high success rate, although the recovery greatly requires physiotherapy until the patient gets comfortable with performing daily activities.
To prepare the patient for the surgery, they are recommended to follow a session of physiotherapy to prepare their muscles and bones for the impact of the surgery. It builds up the muscles around the area to be operated to better withstand the effects of surgery, as well as gives them the strength to accelerate the process of healing. Exercises for the upper body helps in making the trunk stronger to stand and walk with the help of walkers after the surgery is over. These exercises include thigh squeezes, heel slides, knee bends, chair push-ups, etc. They assist in improving the muscle flexibility and functional ability to enhance the chances of a successful surgery and healthy recovery. Moreover, physiotherapy also has a psychologically positive effect on the patient which prepares him/her not just physically, but also mentally.
To ensure an easy healing and adjusting process, doctors recommend their patients to follow the protocol of post-TKR physiotherapy. The postoperative exercises are instructed by the physiotherapist in a systematic manner according to their level of intensity and the condition of the patient.
Surprisingly, a patient can start exercising mildly just a couple of days after the surgery. These exercises allow blood circulation to increase in the limbs so that blood clotting does not take place and hinder the healing process. Quadricep sets are performed by tightening and holding the thigh muscles for a short period of time. Another easy exercise is straight leg raise that allow the leg to be raised to a little height and held for a few seconds before releasing and repeating. Then the patient gradually moves to knee-bending exercises that help them get comfortable with the new knee. Apart from knee-pumping and buttock-squeezing exercises meant for increasing blood circulation, the patient is also assisted by the physiotherapist in sitting up, performing knee-bending exercises while sitting, and getting out of bed. After achieving that, the patient is helped in standing up, and then walking. A walker is usually provided to the patient for support in walking, and sometimes it is fitted with wheels.
As the patient learns to stand and walk on crutch, depending on his/her health condition, the patient is either discharged or sent for rehabilitation. As walking becomes easier, walkers are replaced by a crutch, and walking distances are increased. The patient then learns to toleratea bearable amount of weight on the legs, which slowly increases with practice and time. When the patient learns to balance the body weight properly on the operated knee(s), the physical activity gets more intense as activities like, climbing and descending the stairs, are taught. Since it requires applying pressure on the knees, the steps are taken very slowly, and with the support of a hand or two. As the knees get stronger, exercises get heavier and the operated knee is made familiar with the force and pressure applied by the patient, like assisted knee bends, knee-bends with resistance, etc.
After the patient has adjusted to the requirements of the daily lifeand gets acquainted with the ways to work with the replacedknee(s), he/she is advised by the physiotherapist to go back to performing the daily life activities like driving a car, lifting heavy objects, etc. Sometimes pain may arise due to several medical reasons, but that shouldn’t discourage him/her from remaining physically active. Some activities that involve intense physical movement like running, skiing, and playing sports that involve jumping should still be avoided. In the end, one must remember that recovery is a procedure that varies from individual to individual depending upon their physical health and metabolism, but one must learn to strike a balance between rest and activity to avoid overexertionof the knees.
