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Total knee arthroplasty (TKA) is one of the most common surgeries we see at our clinic.  It is a surgery that is now fairly common, but still a very involved surgery.  Many patients are unaware of just how involved the surgery is, and because of that most hospitals will make TKA patients go to a pre-surgical class to prepare them for not just the surgery itself, but the rehab to follow.  Check the bottom of this post for pictures and video.

Rehab begins in the hospital/surgery center with basic range of motion exercise and walking with a walker.  We usually see the patient anywhere from 3 days to 1 week after surgery in the clinic.  The primary goals of the first couple weeks are establishing a home exercise program (HEP) and advancing the patient's range of motion (ROM) as quickly as possible.  Regarding ROM, extension (or straightening) of the knee is the primary goal, as you effectively have a shorter leg if it isn't straight, and therefore a limp with your walk.

Many patients have high pain levels post-op and are concerned that something went wrong with surgery.  Blood clots and infection are the greatest complications post-op, but are fairly uncommon.  Your family doctor will usually have you on blood thinners to prevent the chance of a blood clot, and your therapist will be able to identify signs of infection.

We cannot emphasize enough how important a daily HEP is to a successful rehab.  A surprising amount of patients do not take their rehab seriously and are surprised when they are behind in their strength and ROM goals.  So, listen to your therapist and enjoy that new knee!

For great pictures:  http://en.wikipedia.org/wiki/Knee_replacement

For some general expectations on rehab:  http://orthopedics.about.com/od/surgicalrehabprotocols/p/replacementrehab.htm

For a general protocol regarding rehab:  http://www.stoneclinic.com/totalkneereplacementrehab

Here's a couple of great videos, but not for the faint of heart!  http://video.google.com/videoplay?docid=-3347931048322867705#

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