Early rehabilitation after knee arthroplasty is important for restoring the patient’s limb function and directly affects the outcome of surgical treatment and the patient’s subsequent quality of life. For this reason, we have developed a postoperative rehabilitation program for total knee arthroplasty, with the aim of guiding patients on how to start rehabilitation training early after surgery to facilitate their early recovery.
However, individualized programs should be developed according to the patient’s condition, and this program is for reference only.
1, postoperative ice, after the elimination of anesthesia can be carried out thigh muscle contraction and ankle joint exercise, knee joint stationary inactive, and pay attention to elevate the affected limb to promote lower limb venous return and reduce the affected swelling. The main purpose is to promote blood return to the lower limb, reduce the chance of deep vein thrombosis and reduce the swelling of the lower limb.
2. The active and passive knee flexion exercises with the assistance of the knee joint will be started on the first 1-2 days after surgery, with the range of motion being as much as the patient can tolerate in pain (generally about 80° of bending). The main objective is to prevent knee adhesions and promote drainage of bruising. It is very important to pay attention to the straightening of the knee joint, training method: elevate the ankle to suspend the knee using its own limb weight and ice bag to straighten the leg.
3.After the drainage tube is removed on the 2nd postoperative day, the knee joint can be gradually trained to bend and straighten the knee joint after 4-5 hours of rest, the main purpose is to train the thigh muscle strength.
4. The patient can walk with weight on the ground with the help of crutches on the 2nd-3rd postoperative day. According to their own situation about 2 weeks after surgery can remove the crutches for normal walking training.
5, about 3-5 days after surgery, according to the patient’s condition, you can carry out continuous passive exercises of the knee joint, that is, the CPM machine exercises. Generally, the angle of movement increases gradually from small to large. Increase the angle as much as the patient can tolerate. Depending on the patient’s condition, physical therapy such as waxing can be performed, mainly to help reduce swelling, promote blood circulation, activate blood circulation and relieve pain.
6, 10-14 days after surgery can gradually increase the flexion angle of the knee joint there are the following three methods methods.
(1) sitting on the edge of the bed with the operating leg down with the healthy leg placed on it to help flexion.
(2) Wall sliding exercises are performed by bending the hip and knee and placing the foot on the wall and slowly sliding down.
(3) Flex the hip and hold the calf with both hands to assist in flexion.
7, 2 weeks after surgery knee flexion should reach 90 °, the knee joint and can be completely straight for good.
8, 2-3 weeks after surgery can strengthen the thigh muscle strength training.
(1)Add sandbag on the ankle joint for straight leg raising exercise, the weight should be 1-2 kg to start (the amount of exercise should not feel muscle soreness on the 2nd day, and then gradually add weight and exercise times).
(2) Postoperative 4-6 sitting on the edge of the bed to add weights to the ankle joint for knee flexion and extension exercises (the amount of exercise should be such that no muscle soreness is felt on the second day. Gradually increase the weight and the number of activities).
9, the posterior thigh group muscle strength training.
10, Strength training of calf muscles (i.e. toe pads.
11, 4-6 weeks after surgery for knee flexibility training (riding a stationary bicycle and knee pendulum training), and gradually start training to walk according to the normal gait. The amount of exercise should be sufficient to not feel muscle soreness on the second day.
12, 4-6 weeks after surgery (according to the recovery of the wound to decide, after the wound is completely healed can be squatting training) can be hands under the protection of the railing squatting exercise.
13.Post-operative exercise pain is inevitable, but the patient should also adhere to the exercise. This will achieve good surgical results. The pain will gradually decrease after 4-6 weeks after the operation. These exercises should be continued after discharge home. Knee flexion training should gradually reach normal, i.e. 120°-130°, 8-12 weeks after surgery, and the knee should be fully straightened within 6 weeks after surgery. Insist on knee flexion training and muscle strength training, and insist on training for 3-6 months or longer to gradually return to straight normal activities.
Common problems and solutions and precautions after discharge from the hospital.
I. Joint swelling and discomfort. Causes.
1.Weather change.
2, excessive activity.
3. Joint effusion (significant increase in mid-patellar circumference).
You can try to deal with it by the following methods.
1.Suspend walking and training.
2. Immediately elevate the affected limb and place the knee joint in the highest position. Until the swelling disappears. Note: This should be done on a case-by-case basis. If you feel uncomfortable, lower the height, but make sure it is above your heart level. If the joint swelling subsides, resume training. If the swelling is not relieved but becomes heavier, please return to the hospital for a review.
Pain in and around the joint may increase.
1. Reduce or suspend the activity.
2. If there is swelling and discomfort, treat as above.
3. Appropriate oral or topical anti-inflammatory and pain-relieving drugs, such as Fotarim.
4.If there is no redness, swelling and fever in the painful area, physical therapy measures such as hot compresses can be applied. After the symptoms are relieved, training can be resumed. If the pain is not relieved but heavier, please return to the hospital in time for review.
Third, the degree of activity grasp.
1. Do not engage in strenuous competitive sports activities.
2, walking, activities to not pain, not tired for the principle. Whenever infection occurs in any part of your body after implantation of artificial prosthesis (e.g. upper respiratory tract infection, gum swelling, hemorrhoids, foot odor, etc.), please go to the hospital for treatment as soon as possible.