Rehabilitation after TKR
Your rehabilitation starts on the afternoon of your operation.
You should do deep breathing exercises to make sure you do not get any collapse of your lungs. You may move around in the bed but always keep your knee fully straight. If you wish to roll onto your side please place a pillow between your knees.
The next day you may be allowed to sit out of bed depending on how your are feeling and your blood pressure, pain levels etc. When sitting out of bed your leg must be elevated and fully straight on a footstool or bent as much as possible. Do not leave your knee in a half bent position.
You are permitted to take your full weight through the operated leg and doing so helps speed up the healing process.
Goals
- Control swelling
- Minimize pain
- Get the knee fully straight
- Bend the knee to at least 90°
- Improve muscle strength
- Walk with or without stick/crutches
Try to keep the Calf or foot pumps (to decrease risk of DVT/blood clots) on even when you are sitting out of bed (you may remove them to exercise) for the first 3 days at least.
- Heel slides lying down or sitting to bend the knee
- Muscle-setting exercises of the thigh and hip
- Straight leg raising exercises
- Gravity-assisted knee straightening (get the heel off the bed so the knee sags backwards and stretches straight.
- Gentle stretches for the hamstrings, calf, and iliotibial band
- Tubigrip to knee
- Learning to walk again
- Continue ice compression
- Improve bending to 115° or more
- Progressive passive stretches to hamstrings and calf
- Stationary bike or peddler without resistance to increase bending Range Of Movement
- Pain-free progressive resisted exercises
- Proprioceptive training (reconnecting the brain to the knee)
- Closed-kinetic chain strengthening, such as 1⁄4 squats, 1⁄4 front lunges
- Gait training as needed to decrease limp
- Enhance strength and endurance and motor control of the involved limb
- Increase cardiovascular fitness
- Develop a maintenance program
- Specific functional tasks, such as transferring from sit-to-stand, lifting, carrying, push/pulling, squat/crouching, return to work tasks, return to sport tasks
This is a general guide only and the programme will be tailored specifically to your needs and progress. Remember everyone is different and you will probably do better than some people and worse than others. Do not be scared to use the pain killers in the first few weeks after the operation. Consider them as a tool to allow you to do your exercises more effectively to improve your range of motion and final outcome.