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Do You Need a New Knee? Physiotherapy & Total Knee Replacements

Do you need a new knee?

by Matthew Hanna

Are you wrestling with relentless knee pain, hindering your daily activities and robbing you of peaceful sleep? A total knee replacement surgery might help reclaim your quality of life.

Let’s delve into why this procedure is often deemed necessary, who can benefit from it, and what the journey entails, from pre-surgery considerations to post-operative care.

Understanding Total Knee Replacements

Total knee replacement surgery becomes imperative when the knee joint undergoes significant wear and tear or sustains damage – to the point where mobility is severely compromised, and pain persists even during periods of rest.

While osteoarthritis stands as the primary culprit, other conditions contributing to knee damage include rheumatoid arthritis, haemophilia, gout, bone disorders triggering abnormal growth, and even situations where blood supply issues lead to bone deterioration within the knee joint.

It is best to consult your general practitioner if you believe you may have one of these conditions.

Candidacy for Knee Replacements

Given its magnitude, knee replacement surgery is usually recommended only after exhausting conservative treatments like inpatient physiotherapy or steroid injections. Surgery is a big step, so your health professional will want to make sure that it is absolutely necessary before moving forward.

You may be considered a candidate for knee replacement if you experience:

  • Severe pain, swelling, and stiffness, significantly impairing knee mobility.
  • Debilitating knee pain impacting your quality of life and disrupting sleep.
  • Challenges in performing routine tasks like shopping or bathing.
  • Emotional distress stemming from pain and mobility limitations.
  • Impediments in work or social engagements due to knee-related issues.

Moreover, being physically robust enough to withstand the operation and subsequent rehabilitation is paramount. That may be where your journey with us begins…

Preparing for Surgery

Physiotherapists are here to help with that initial journey in conservative management. At PhysioWest, we are highly experienced not only in post-operative knee replacement care, but in pre-operative care! Knee pain is very common, ranging from twinges to surgical intervention – and we love to help with everything in between. We always recommend completing a ‘prehab’ program to support your post-op rehab – the treatment that you do prior to surgery, is super important in ensuring a safe and smooth recovery.

If you have osteoarthritis (OA), we highly recommend preparing for knee replacement surgery with the GLA:D program! The GLA:D program involves targeted exercises to strengthen the muscles around your knee and improve your mobility. Under the guidance of PhysioWest’s expert exercise physiologists, patients engage in activities tailored to their needs. Whilst the goal of GLA:D is to manage OA conservatively and improve quality of life without surgery, it also ensures optimal fitness for surgery and a smoother recovery process post-operation. Want to learn more? Check out the GLA:D page on our website above!

What to Expect from Surgery?

Depending on the type of operation, a total knee replacement surgery typically spans around two hours and involves several key steps:

  • Removal of worn surfaces at the bottom end of the thigh bone (femur) and the top end of the shin bone (tibia).
  • Installation of metal implants on these surfaces, secured with bone cement.
  • Affixing a smooth plastic insert atop the tibial implant, ensuring frictionless movement.
  • Optionally, resurfacing the underside of the kneecap (patella) with plastic.
  • Repairing and closing soft tissue, muscle, and skin layers.

Post-surgery, patients generally spend one to two nights in the hospital and are urged to diligently adhere to prescribed by the in-patient physiotherapist for optimal recovery.

Where do we come in? Post-operative Care and Rehabilitation

As we maintain a strong relationship with Calvary, if surgery is decided to be performed with a surgeon from Calvary Adelaide, you may be eligible to see us from the comfort of your own home! The Rehab In the Home (RITH) program provides 1-12 sessions (depending on your hospital referral) in the home spanning over 2-6 weeks. If you don’t book through Calvary, don’t fret. We also do private home visits!

Engaging in physiotherapy plays a crucial role in restoring independence, so we always recommend engaging a physiotherapist beyond these first few weeks. Those first 12 weeks are as crucial as the first 12 months – and we would love to continue seeing you throughout that time.

Here is how we assist at home to ensure you can have a smooth recovery:

  • Help you manage your post-operative pain, including any swelling.
  • Focus on gradually increasing mobility and strength.
  • Adhere to prescribed medication and care instructions diligently.
  • Practice caution to prevent falls and ensure your safety at home.
  • Communicate with your family or next of kin and your healthcare team.
  • Keep you accountable with your treatment plan.
  • Ensure you are safe and support whilst recovering at home, and getting back to doing what you love!

The rehabilitation period for a total knee replacement (TKR) can vary depending on the individual, but the most intense part of recovery typically lasts around 12 weeks. Some people may experience a full recovery in as little as 6 months, while others may take up to 18 months to regain full function of their knee. As a general rule, we say that your recovery journey will take place over 12 months.

Here’s a general timeline of what to expect during rehabilitation:

Weeks 1-6: During this time, you will focus on pain management, reducing swelling, and improving your range of motion. You may need to use a walking aid to get around for a while, and you will begin physical therapy to strengthen the muscles around your knee and help your mobility. Your physiotherapy treatment plan will gradually increase from weeks 1-6.

Weeks 7-12: You will continue with physiotherapy and gradually increase your activity level. You should be able to walk unsupported by this time, and you may be able to return to some of your normal activities! Your physiotherapy treatment plan will continue to ensure that your knee is strong and healthy, long term.

Months 3-12: You will continue to strengthen your muscles and improve your flexibility. You may be able to return to most of your normal activities, but you may need to avoid high-impact activities for a while. You should be reaching your physiotherapy goals at this point, and setting new ones!

It is important to note that this is just a general timeline, and your recovery may progress differently. As we say, progress isn’t linear! You may encounter set backs but your physiotherapist is here to help. Your healthcare team will be able to give you a more specific timeline based on your individual circumstances.

Here are some of PhysioWest’s tips for a successful and speedy recovery:

  • Follow your doctor’s instructions carefully. This includes taking your medication as prescribed, attending all of your physiotherapy appointments and sticking to your recovery plan, and avoiding activities that could strain your knee.
  • Be patient. It takes time to recover from surgery. Don’t get discouraged if you don’t see results immediately.
  • Stay positive. A positive attitude can go a long way in helping you recover.
  • Set goals with your physiotherapist. We want to know exactly what you are hoping to achieve following your new knee, so that we can help you get there.
  • Listen to your body.

And most importantly…

  • Have a physiotherapist or exercise physiologist to support you over the full first 12 months. You’ve worked hard for that new knee! Now we want to make sure that it continues to work hard for you. The best thing that you can do is invest in your knee health for that first 12 months. We promise it’s worth it.

Want to see one of our physiotherapists in the clinic or in your home to chat all things Total Knee Replacements? Give us a call on 8352 3582, or book in the clinic online via the link below! We can’t wait to see you soon…

 

Thanks!

 

 

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