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Continuous passive motion

One of the most common joint replacement surgeries is the total knee replacement (TKR) or total knee arthroplasty (TKA). Despite the numerous surgeries performed each year many individuals are ill prepared regarding the total knee replacement recovery process. Below we will discuss some of the issues involved in recovering and rehabilitating from this orthopedic surgery.

1. Preoperative Physical Conditioning

Knee replacement recovery actually begins well before the surgery takes place. Here’s why. Successful knee replacement recovery will depend on many different factors but some include the age of the patient, the number of commodities and the general condition of the individual prior to surgery. Patients who are in better physical shape and overall condition tend to have an easier time with the rehab program.

Many orthopedic doctors will recommend a patient lose weight and/or strengthen the muscles of the involved leg to better prepare the knee joint for surgery and postoperative rehab.

2. Pain

I won’t sugar coat this one. Other than shoulder replacement, the total knee replacements are among the most painful orthopedic surgeries that are done. I have rehabilitated many joints in my career and this one gets frequent complaints regarding the level and duration of pain through the rehab phase. The good news is that your doctor will prescribe pain medications if indicated and there are special therapy treatments to help reduce pain as well. Once you can get through the initial week or two of total knee replacement recovery it gets significantly better.

3. Early Postoperative Rehabilitation

It is crucial to start the total knee replacement recovery as soon as the physician indicates. Early rehabilitation will reduce joint stiffness, swelling, improve overall circulation in the extremity, speed up weight bearing activities and reduce pain. Most patients will have a continuous passive motion (CPM) device placed on the surgical knee within hours of the operation. This mechanical device will provide automatic passive range of motion to the knee while the patient is lying in bed.

4. Progressive and Continuous Rehab

Some of the goals for total knee replacement recovery is to walk down the hallway with a crutch or walker, climb a short set of stairs, fully straighten their knees, bend the knee to approximately 90° or greater, and perform home exercises independently. If the patient is unable to reach these goals within three to six days, further aggressive rehab is needed and they may be sent to a rehabilitation center for a week or two or longer depending on their medical and social needs.

Ultimately the goal of replacement recovery is to return the patient to their prior level of function and living environment. Most total knee replacement surgeries have a high success rate when combined with early, progressive rehab intervention.

Richard is a clinical physical therapist and health promoter.

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