1.Early stage (0-1 week)
(1).On the day of surgery.
After the anesthesia subsides, start to move the toes and ankle joint. If the pain is not obvious, try to contract the quadriceps muscle, i.e. the anterior thigh muscle, to tense and relax. Ren Yizhong, Department of Joint and Sports Medicine Surgery, Second Affiliated Hospital of Inner Mongolia Medical University
(2) One day after surgery.
(1) Ankle pump: forceful, slow, full range flexion and extension of the ankle joint. There is no prescribed time for ankle flexion and extension exercises, which can be performed while reading newspaper, watching TV, reading books or resting in bed, the more the better, which is important for promoting circulation, decreasing swelling and preventing deep vein thrombosis.
② Quadriceps (anterior thigh muscle group) isometric exercises: i.e. thigh muscle tensing and relaxation. Do as many as possible without increasing pain. (Greater than 500 times/day)
(③N rope muscle (posterior thigh muscle group) isometric exercise: the affected leg force down the padded pillow (the height of the pillow in a soft state not more than 5cm), so that the posterior thigh muscle tensing and relaxation. The requirement is the same as above, more than 500 times/day.
④The first day after surgery, you can walk on the ground with the help of crutches, but the affected leg should be protected under the splint, and the affected limb should not bear weight with crutches.
(3) 2 days after surgery.
① Remove the drainage. If no drainage tube is placed in the joint and the postoperative joint swelling is severe, joint cavity puncture can be considered to draw out the accumulated blood. Continue the above exercises.
②The ankle pump exercises are the same as the first postoperative day.
③Start to try straight leg raise – straight leg raise after knee extension to 15M heel off the bed and hold until exhaustion, 2-3 times/day. Pain at the surgical incision during the exercise is normal and should be tolerated. Special attention should be paid to the exercise: before starting the leg lift, the muscles in front and behind the thigh should be tensed so that the whole leg forms a whole under the protection of the muscles, and the knee joint should be ensured to be completely straight before lifting the leg, which can prevent the newly reconstructed ligaments from being stretched loose during the straight leg lift.
④Start side leg raise exercises, 10 reps/set, 2 sets/day, you can do one set in the morning and one set in the afternoon.
⑤ Walk on the ground with the help of crutches, but the affected leg should be protected under the splint, and the affected limb with crutches should not bear weight.
(4) 3 days after surgery.
①Continue the above exercises.
② Weight-bearing and balance – separate both feet under protection, move the center of gravity alternately from side to side within the range of slight pain, and strive to achieve the same weight-bearing when both feet stand on the ground, 5 minutes/time, 2 times/day. (Note: do not walk with weight, walk with crutches, and only carry one-third of the weight of the surgical knee).
Start flexion exercises. The patient can try sitting on the edge of the bed and lowering the knee naturally to within 30° of minimal pain. If the patient has difficulty completing this on his or her own, ask a family member or supervising physician to assist with this. If the affected limb is in a splint or cast at this time, remove the cast or splint during the exercise and put the cast or splint back on after the exercise.
(5) 4 days after surgery.
① Continue the above exercises.
② Strengthen the weight-bearing and balance exercises, gradually until you can stand on one leg with the affected leg. If this can be done easily, start walking with a single crutch (on the healthy side) (note: do not walk with full weight, walk with only one-third of your weight).
(3) Flexion exercises to the range of 0°-60° (if basically pain-free can reach close to 90°).
(6) 5 days after surgery.
① Continue and strengthen the above exercises.
② Flexion exercises to 70°-80°, and active flexion and extension exercises can be started.
③Start extension exercises (seated suspension): put a pillow at the heel, make the affected leg leave the bed completely, relax the muscles to make the knee joint extend naturally, 10 minutes/time, 1-2 times/day.
(7) 1 week after surgery.
①Continue and strengthen the above exercises.
②Passive knee flexion angle to 90°, active flexion can also be 90°.
2. Initial period: (2-4 weeks)
(1) 2 weeks postoperatively.
① Passive flexion to 100°.
(2) Strengthen muscle strength exercises (straight leg lift up to 6 minutes).
③ At this time, the affected limb should still not be fully weight-bearing, and walk with crutches and one-third weight-bearing on the affected limb.
(2) 3 weeks after surgery.
① Passive flexion to 110°.
② Strengthen active flexion and extension exercises and strengthen muscle strength exercises.
(3) At this time, the affected limb should not be fully weight-bearing, but walk with crutches and one-third weight-bearing of the affected limb.
④ Start knee flexion exercises in sitting or lying position. Hold the knee to the place where you start to feel pain for 10 seconds, relax slightly (do not rest completely straight during the whole exercise), rest for 5 seconds, then hold the knee again, and repeat the exercise for 20 minutes, once a day.
(3) 4 weeks postoperatively.
①Passive flexion up to 115°
②Start static squatting or sliding exercises against the wall.
③Strive to achieve normal gait walking.
④At this time, the affected limb should still not be fully weight-bearing, hold the crutches while walking, and bear one-third of the weight on the affected limb