Total Knee Arthroplasty (Replacement)

Total Knee Replacement (TKR), also known as a Total Knee Arthroplasty (TKA), is a surgical procedure commonly used to relieve knee pain due to arthritis or in some cases trauma-related injury. TKR is a viable option when the individual’s function is extremely limited due to pain and when conservative care, an exercise program, and weight loss was not substantially effective in relieving symptoms. Greater than 600,000 TKR are performed each year with approximately 90% of individuals experiencing significant symptom reduction.

Knee Replacement Surgery

There are multiple surgical approaches with Total Knee Replacement with most common types being Traditional and Minimally Invasive Surgery (MIS). In both approaches, the damaged cartilage and bone surfaces are removed and replaced with prosthetic implants. The Traditional approach will typically result in an 8-12 inch scar, whereas the MIS results in a 3-4 inch incision. Research suggests outcomes for both procedures are similar over the long term, with fewer complications experienced with the Traditional approach.

The Role of Physical Therapy

Following TKR most individuals are fully weighted bearing on the involved lower extremity, but will likely have to use an assistive device for a short period (walker, crutches, cane). Best evidence supports that patients receive outpatient orthopedic physical therapy where the focus is on restoring normal knee motion, strength training, normalizing walking patterns and restoration of prior functional/recreational activities. Your physical therapist will work with you targeting your greatest impairments and develop a plan of care to help you achieve your goals. The entire surgery and rehabilitation process is typically 12 weeks in length with continued functional gains made after 12 weeks by the performance of a home exercise program.

A recent study suggests that approximately 98% of individuals who undergo TKR will be able to return work, including heavy work activities. Depending on the type of work patients with sedentary jobs can return to their work tasks as early as 1 month after surgery, whereas more strenuous jobs may take up to 3 months. Patients can expect to realistically return to walking without an assistive device, swimming, golfing, driving, light hiking, biking, dancing, and other low-impact sports. However, outcomes are specific to each patient and is based on prior levels of function.

Closing Thoughts

Physical therapy following knee replacement surgery requires a team approach between the patient, surgeon, and physical therapist.  If you are considering undergoing a knee replacement, or have recently undergone this procedure, please call one of our physical therapists to learn more about your recovery and return to function.

 

-Dr. Jermemy Boyd, PT, DPT, OCS