Knee Replacement.

A knee replacement is a procedure to replace one or more of the articular surfaces of the knee joint to relieve pain or increase function.

It is commonly performed for degenerative diseases like Osteoarthritis or Rheumatoid Arthritis when other conservative strategies such as Physiotherapy, exercise, or medications have been ineffective in reducing pain that is impacting function or quality of life.

Knee replacements can either be partial (involving the replacement of one articular surface) or total (involving the replacement of all knee bones)

What’s Involved in a Knee Replacement

Pre-operative Physiotherapy

You may be requested by your doctor or Orthopaedic Surgeon to undertake Physiotherapy guided exercises to strengthen the knee before surgery. This has been shown to improve recovery after surgery by improving the inherent support around the knee post-operatively.

Surgical procedure

A Partial procedure involves the replacement of one part of the knee, whereas a total procedure is the replacement of articular surfaces of both the femur (thigh bone) and tibia (shin bone).

Postoperative Physiotherapy

Most people recover quickly from knee replacements and have much less pain than what they did before the surgery, improving function and quality of life

Physios are involved from day one post-op, and will often be involved in your initial assessment before getting out of bed. Here, they assess and prescribe exercises to target quadriceps (thigh) strength, knee range and lower limb circulation.

Don’t be surprised if you’re asked to get up and walk the afternoon of (or the day after) the surgery. Moving and walking as soon as possible (within pain limits) has been shown to improve the rate of recovery.

Physios may also be involved in fitting walking aids such as walkers or walking sticks if needed to assist with mobility once you are home.

From 4-6 months after surgery, Physiotherapists are able to assist with rehabilitation by utilising manual therapies or treatment modalities to reduce pain, and prescribing an exercise program that help.

  • Reducing pain and inflammation
  • Normalise knee range of motion
  • Strengthen muscles around the knee (particularly quads) as well as other muscles including calves, hamstrings, hip and pelvis muscles
  • Improve lower limb proprioception and balance
  • Return to activities such as walking, stair climbing and squatting
  • Reduce chance of re-injury

Other Treatment Options

Diet

As the knee is a weight bearing joint, overall body weight can affect prognosis before and after surgery as the extra weight can place more strain on your joints. Often losing weight can help reduce arthritic pain before surgery, and increase the likelihood of long-term benefits afterwards.

Exercise

Guided exercises are important to consider when preparing or recovering from a knee replacement to improve strength and functionally. These exercises should be prescribed by your doctor, Physiotherapist, or Exercise Physiologist and can be for the knee itself or for the whole lower body.

Exercises can be undertaken at home, or in supervised Pilates or Gym classes where appropriate.

Occupational Therapy

Occupational Therapists are able to provide advice and equipment as necessary to help with mobility around your home. This may include techniques to make things like showering or dressing easier until pain settles and you regain movement and strength.

GPs & Doctors

Your doctors can be involved throughout the knee replacement process to help guide your rehabilitation, and for further pain relief if required.

Advice

At home exercises are integral in your recovery, and these can be started once approved by your Doctor or Physiotherapist. The types of home exercises you undertake are determined by your individual circumstances, but commonly include:

  • Knee extension – sitting with knee supported over a towel or pillow, focus on stretching the knee, lifting the heel up and pulling the kneecap up towards the hip. Hold for 5-10 seconds then release with control
  • Knee Flexion – either lying on your back or seated on a chair, gently slide the heel in towards your bottom, bending the knee. Only move within a pain-free range

Post-operative Precautions

There is a risk of dislocation post-op while you heal, particularly within the first 3 months after surgery. Keep this in mind, and speak to your surgeon, doctor or Physiotherapist if you are concerned by this. It may also be useful to avoid sitting in low chairs, squatting, jumping and high impact sports.

Be sure to take regular rests during the day to give the knee a rest when needed and reduce swelling, and take things at your own pace as advised by your health professionals.

How to Book

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