There are two main components of rehabilitation after artificial knee replacement: knee mobility training and muscle strength recovery. We have collected the scientific rehabilitation methods recommended by the American Academy of Orthopaedic Surgeons and combined them with years of clinical experience in Shanghai’s joint surgery department to compile the following self-learning rehabilitation programs that are easy to learn and can be completed in the hospital or at home.
Early postoperative training
You may feel uncomfortable when you first start training, but these exercises will speed up your recovery, reduce complications and relieve pain.
1.Quadriceps contraction training
Contract the quadriceps muscle in front of the thigh and press the knee downward toward the bed for 5-10 seconds, and repeat 10 times in 2 minutes. Repeat the above action after 1 minute of rest until you feel muscle fatigue in front of the thigh.
2.Straight leg raise training
This training is to further train the quadriceps muscle in front of the thigh. Knee straight, raise the lower limb, so that the heel is raised off the bed, hold for 10 seconds, slowly put down. Repeat the training until you feel thigh muscle fatigue.
3.Ankle pump training
Ankle pump training is very effective for lower limb swelling and prevention of lower limb deep vein thrombosis. Rhythmically perform ankle flexion and extension activities, staying in the flexion and dorsiflexion positions for 3 seconds each. This is performed 2-3 times per hour for 3 minutes each time. This training should be maintained for one month after surgery.
4.Knee extension training
This training is to ensure that your knee joint can be fully straightened after surgery so that your standing and walking posture can be normal. Place a towel roll behind the ankle so that the heel is above the bed. Contract the quadriceps in front of the thigh to straighten the knee as much as possible and bring the back of the knee close to the bed for 5-10 seconds. Repeat the movement until you feel muscle fatigue.
5.Knee flexion training in bed
Try to flex the knee joint, bend the knee while the heel slides on the bed, knee flexion to the maximum extent when held for 5-10 seconds, repeat the action until you feel muscle fatigue.
6.Knee flexion training on a chair
Sitting on a chair or bedside, place the foot of the healthy side behind the heel of the operated side, support the knee of the operated side, while slowly flexing the knee of the operated side until it cannot be bent, hold for 5-10 seconds. Repeat the movement until you feel muscle fatigue.
At a certain point, you can exchange the position of the two feet and increase passive knee flexion by pressing the foot on the operated side with the foot on the healthy side to the rear.
Another method is to sit in a chair with the foot on the surgical side on the floor and the ipsilateral knee flexed to the maximum angle that can be achieved. Keeping the foot on the floor still, slide the body forward in the chair to increase the knee flexion angle.
7.Walking
On the second day after surgery, after the wound drain is removed, you can contact to stand and walk on the ground.
When you first start walking, you need to prepare a four-cornered walker. Before walking, you need to stand firmly and hold the walker, first move the walker forward a little, then keep the knee on the operated side straight and take a step forward, so that the heel hits the ground first, and then put the body weight evenly on the whole foot surface.
Walk steadily rather than quickly, and maintain a good rhythm. You can adjust the amplitude and speed of your own steps. As your muscle strength and endurance gradually return, you can put more of your body weight on the leg on the side of the surgery. At this point, you can use a cane instead, remembering to use the hand on the healthy side to hold the cane.
8.Going up and down stairs
At first, you need to use the handrail of the stairs to go up and down the stairs, and you can only take one step at a time. When going up the stairs, take the “good” leg first (the side without surgery), and when going down the stairs, take the “bad” leg first (the leg on the side with surgery), so that it is easy to remember “good up and bad down”.
It is recommended that you do each of these exercises 2-3 times a day, and walk twice a day for 30 minutes each time.
You may feel swelling and pain in the knee joint after each session, so elevate the affected leg and place an ice cube wrapped in a towel around the knee joint to reduce swelling and pain.