What does rehabilitation after knee replacement involve?

  1. Ankle pump exercise: This exercise can be done in bed from the day after surgery. The patient should straighten the knee joint and dorsiflex the ankle joint, then try to contract the thigh and calf muscles for at least 6 seconds, and then relax completely. This allows the quadriceps to contract isometrically and prevents muscle atrophy. There is also rotation of the ankle joint and random movement of the toes, which can promote blood return. The exercises should be performed in groups, 5-10 times per group, 3-6 groups per day.  2. Leg compression exercises: on the second day after surgery, the patient can sit up and practice pressing the knee joint.  Put the leg straight on the bed, use a soft pad at the heel, and put your hands on top of the knee, gently press down to straighten the leg as much as possible, maintaining it for about 5 minutes each time, until the patient can tolerate the pain, which is the best way to exercise leg straightening.  Straightening the knee joint after an artificial knee replacement is much more difficult than leg flexion, and equally important. Only when the leg is straightened can it walk normally without causing pain.  3. Continuous passive mobilizer exercises (CPM): On the third day after surgery, remove the drainage tube and take X-rays to review the position of the prosthesis before starting the exercises.  ① Start using it three days after surgery; ② Start with 0°-30° of initial flexion and extension; ③ Increase the degree of flexion by 10° every day thereafter; ④ It should reach 120° two weeks after surgery; ⑤ Twice a day for one hour each time.  4. Straight leg raising exercise: start the exercise on the 3rd day after surgery.  Straighten the knee joint with force and dorsiflex the ankle joint, then raise the whole leg by 30°, maintain it for a few seconds and then put the leg down and relax completely. Exercises should be performed in groups of 5-10 reps each, 3-5 sets per day. The exact amount of exercise depends on the patient’s physical condition. If the amount of exercise is too large at the beginning, soreness in the front of the thigh will occur.  5.Leg bending exercise: start to practice from the 3rd day after surgery.  At the beginning, the patient can sit on the side of the bed and relax naturally, and the lower leg will hang under the bed by gravity to reach 90 degrees; then put the healthy limb in front of the affected limb and press it backward to increase the angle of knee flexion, and the size of the force will be tolerated. If you can maintain the force for a few minutes, the effect is better.  6. Active knee flexion and extension activities: Patients start the exercises on the third day after surgery under the guidance and assistance of the rehabilitation teacher.  It is used to make some recovery of quadriceps and N cord muscle strength; when the postoperative pain is mild, it is performed at the same time as using continuous passive activator exercise.  7. Knee exercises when extension is delayed and flexion is limited: for 2 weeks after surgery when the knee cannot be fully extended or flexed up to 90°.  Generally, when the extension deficit of the affected knee exceeds 5°-10° and the flexion is less than 75°-90° at 9-10 days postoperatively, we can start to correct the knee with manual massage under anesthesia and supervision, so that the knee can be passively straightened and flexed to more than 90°. Afterwards, rest for 1 day and restart the above exercises the next day.