YourPhysio - Gajanan Nagar (9607788738)

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Total Knee Replacement

Overview

The knee joint is the largest joint in the body. It is the “hinge” joint of the leg. It’s the joint that allows the leg to bend and straighten. The knee joint is located at the meeting point of the thigh bone and the shin bone and has a knee cap which covers the joint. Knee joint is prone to wear and tear as age progress.

What is Total Knee Replacement?

During the total knee replacement, lower part of the thigh bone(femur), upper part of shin bone (tibia) and underside of the knee cap is removed. Most of the major ligaments and tendons of the knee are left in place so that the knee can bend and straighten, yet remains steady in position from side-to-side and front-to-back. Varieties of implants are used depending on the age of the patient. Implants are mostly made up of metal, acrylic or polyethylene materials. Implants fixation on bone is achieved by bone cement in few cases.

What is Arthritis? Why Does the Knee Hurt?

In the knee joint, there is a layer of smooth cartilage on the lower end of the femur (thigh bone), the upper end of the tibia (shin bone), and the under surface of the kneecap (patella). This cartilage serves as a cushion and allows for smooth motion of the knee. Arthritis develops when the smooth cartilage wears away. The knee can then become stiff, swollen and painful. Eventually, the cartilage can wear down to the bone and the bones can rub against one another, causing more pain.​​

Who needs Total Knee Replacement?

Patients who suffer from following:

  • Severe Osteoarthritis of Knee

  • Severe Rheumatoid Arthritis

Patients having following complaints are also in the need of surgery:

  • Bed bound due to continuous knee joint pain and stiffness

  • Prolonged swelling around the joints

  • Bow legs and Knock knees

  • Not able to perform day to day activities like cooking,bathing,domestic jobs independently due to pain.

Pre operative care:

  • Your orthopaedic surgeon will inform you about the surgery, the implant to be used and the care to be taken for the wound.

  • You will meet your Physiotherapist who will teach you exercises for strengthening the knee joint before operation at least for two weeks

  • Physiotherapist will also show you how to get in and out of bed, and how to use the crutches or the walker to enhance the good operation results.

Post operative care :

  • Doctors recommend walking two or three times a day first inside your house with walker, stick, and then independently to increase mobility. The goal is not only to strengthen the knee joint, but to increase the range of motion.

  • Walk for short periods - to increase mobility.

  • Climb stairs, do chores, and work on other everyday activities.

  • Continue to do the knee-strengthening exercises that you learned from the hospital’s physical therapist.

1. Leg lifts: These involve straightening your knee on a bed and tightening your thigh muscles. You then lift your legs off the bed several inches and hold them in that position from 5 to 10 seconds and then lower them slowly.        

Leg Lifts

2. Ankle pumps: Lie on your bed with your ankles hanging off the end. Next, move your foot back and forth. This will strengthen calf muscles and improve circulation in your legs. 

Ankle Pumps​

3. Short-arc quads: You can exercise them by lying on your back with your legs extended. Put a pillow under your operated leg. Lift the heel of your operated leg off the bed. Hold for five seconds. Try to do one set of 10 repetitions three times a day.

Short-arc quads

4. Straight leg raises: Just lie on your back and raise one leg at a time as much as you can, holding it in the air for 5 seconds. Do one set of 10 reps three times a day.

Leg- raises

5. Gait training: Proper way of walking (equal weight on both legs) will be taught to you by your physiotherapist. Activities at home for same will be explained to you.

Gait training

What we offer at YourPhysio?

  • Evaluation of the patients according to the age and their functional and medical goals.

  • Different specialized gadgets are used for different exercises

  • Phase 2 and phase 3 exercises are added which ultimately leads to complete strengthening of muscles and balancing. As balancing, coordination, stability, strengthening exercises leads to a pain free and normal life.

  • Training for Sport Activities such as

 -Lawn Tennis: along with lower limb the trunk and the upper limb is strengthened.

 -Trekking: along with strengthening of muscles huddle walking , coordination , balance ,stability is taken care of.

 -Zumba / Kathak: balancing, coordination,strength are worked upon.

  • Training the patient according to job requirements to facilitate early return to work place.

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By- Dr. Purva Sonegaonkar and Dr. Sheetal Mundhada