The knee is the most commonly replaced joint in the United States, with slightly more than one out of every ten people undergoing what is known as a total knee arthroplasty by the age of 80— almost double the number of total hip replacements at that age. It is well documented that aggressive physical therapy after this surgery is the difference between success and failure in the eventual outcome and, if incomplete, may result in chronic knee pain and a joint that doesn’t bend or twist naturally.
Most knee surgeons prescribe physical therapy in combination with knee replacement, but also call for sessions in the weeks leading up to scheduled surgery. Improving the deteriorated strength and flexibility of the joint itself is important, of course, but this is also imperative for the surrounding muscles which will be called upon to do more than their share during immediate post-surgery demands. Physical therapists are also invaluable in educating and demonstrating to patients the adjustments they will have to make after surgery, such as efficiently utilizing assistive devices like walkers and how to get in and out of cars and bathtubs.
At Montvale Health Sport + Spine, our physical therapy includes treatments offered in our 3-phase knee protocol. This protocol is amazingly effective in combating chronic knee pain, because a replaced knee in itself does not solve all pain and flexibility issues if the knee is not properly rehabbed.
Our three-phase knee protocol is geared toward chronic pain, but its components may be applied to those recovering from major knee surgery. These include:
- reduction of joint pain and inflammation
- strengthening and stabilizing
- lubricating and cushioning
Gone are the days when you get to slowly and comfortably recuperate by staying in bed for days. Today, the physical therapy usually begins immediately after surgery by in-house hospital staff and then you will be discharged from the hospital within 48 hours and scheduled to begin physical therapy with an external provider. The more options provided by that provider, the better.
Depending on how you adapt to those early physical therapy sessions, the first week or two are restricted somewhat by the healing process, including some swelling and tolerable pain, with graduated exercise that will take you into critical exercises and treatments and a return to normality. There will be muscle strengthening, retaining balance and flexibility, known as range-of-motion, which will ultimately allow you to walk naturally on smooth and uneven surfaces and give you the strength to walk up and down steps.
All these tools and knowledge are available to make recovery from a total knee arthroplasty and other major knee surgery a rousing success.