Abstract: Knee Replacement Rehabilitation
Restoration of physical function in patients following total knee arthroplasty: an update on rehabilitation practices.
By Bade MJ, Stevens-Lapsley JE., School of Medicine, University of Colorado, Aurora, Colorado USA. March 2012
Knee Replacement also called Knee Arthroplasty, is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability.
Knee replacement is surgery for people with severe knee damage. Knee replacement can relieve pain and allow you to be more active. Your doctor may recommend it if you have knee pain and medicine and other treatments are not helping you anymore.
When you have a total knee replacement, the surgeon removes damaged cartilage and bone from the surface of your knee joint and replaces them with a man-made surface of metal and plastic. In a partial knee replacement, the surgeon only replaces one part of your knee joint. The surgery can cause scarring, blood clots, and, rarely, infections. After a knee replacement, you will no longer be able to do certain activities, such as jogging and high-impact sports.
Previous studies on rehabilitation following Total Knee Replacement demonstrated limited efficacy in increasing long-term outcomes. More recently, several rehabilitation approaches have demonstrated greater efficacy for increasing long-term strength and functional performance outcomes following Total Knee Replacement.
Neuromuscular electrical stimulation, applied to the surgical limb’s quadriceps muscle for the first 6 weeks following surgery, has been shown to improve the speed of recovery from Total Knee Replacement and leads to long-term increases in strength and functional performance. Rehabilitation programs that incorporate higher intensity, progressive resistive exercises that target all major muscle groups of the lower extremity have demonstrated superior long-term strength and functional gains compared with lower intensity programs. Finally, although the greatest strength and functional losses occur immediately after surgery, there is emerging evidence that strength and functional gains can be made after the acute postoperative recovery period with programs focusing on the use of progressive aquatic exercise or eccentric exercise.
Functional recovery following Total Knee Replacement can be enhanced by the use of Neuromuscular Electrical Stimulation and utilization of a comprehensive, higher intensity strength training program in conjunction with traditional rehabilitation approaches.