Total Knee Replacement - Exercises and Physical-Therapy

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How does the patient continue to improve as an outpatient after discharge from the hospital?

It is important for patients to continue in an outpatient physical-therapy program along with home exercises for optimal outcome of total knee replacement surgery. Patients will be asked to continue exercising the muscles around the replaced joint to prevent scarring (contracture) and maintain muscle strength for the purposes of joint stability. These exercises after surgery can reduce recovery time and lead to optimal strength and stability.

The wound will be monitored by the surgeon and his/her staff for healing. Patients also should watch for warning signs of infection including abnormal redness, increasing warmth, swelling, or unusual pain. It is important to report any injury to the joint to the doctor immediately.

Future activities are generally limited to those that do not risk injuring the replaced joint. Sports that involve running or contact are avoided, in favor of leisure sports, such as golf, and swimming. Swimming is the ideal form of exercise, since the sport improves muscle strength and endurance without exerting any pressure or stress on the replaced joint.

Patients with joint replacements should alert their doctors and dentists that they have an artificial joint. These joints are at risk for infection by bacteria introduced by any invasive procedures such as surgery, dental or gum work, urological and endoscopic procedures, as well as from infections elsewhere in the body.

The treating physician will typically prescribe antibiotics before, during, and immediately after any elective procedures in order to prevent infection of the replaced joint.

Though infrequent, patients with total knee replacements can require a second operation years later. The second operation can be necessary because of loosening, fracture, or other complications of the replaced joint. Reoperations are generally not as successful as the original operation and carry higher risks of complications. Future replacement devices and techniques will improve patient outcomes and lead to fewer complications.

Previous contributing editor: Dennis Lee, MD

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See what others are saying

Comment from: jvr, (Patient) Published: December 31

I had undergone knee replacement surgery, on the right one on 19th June 2014 and the left one on 13th August 2014 in one of the best hospitals. I am 70 years old and my height and weight are 1.65 m and 66 kg respectively. I have done the physiotherapy as directed by the physiotherapist for one month for each joint and continuing it even now. I am experiencing stiffness and tolerable pain for both the joints even now. The pain for the left knee is more than the right one. I did not get the benefit of the surgery to the extent the surgeon promised. I am having disturbed sleep during the night due to the pain on the knee joints particularly the right knee.

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Comment from: librarian, 55-64 Female (Patient) Published: June 02

I had a total knee replacement in 2010 after an injury to the knee. When released from the hospital, I went to a rehabilitation facility on a Saturday. This facility does not do therapy on weekends, so I went two days with no therapy. No one bothered to tell me to bend the knee and by Monday, I had only a 90 degree bend and it has stayed that way in spite of 6 months of therapy. The therapist did not attempt to help me bend the knee. I wish he had. Stairs are difficult and there are many things I can no longer do. If you have a knee replacement and go for rehab, make sure the facility does therapy seven days a week and keep bending that knee!

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