KNEE REPLACEMENT - PRE AND POSTOPERATIVE REHAB

PRE OPERATIVE REHAB

•  Educate patient about knee surgery & procedure to reduce anxiety & stress.
•  Importance of Pre operative exercises :-

1. Ability to build up strength in the knee muscle around your knee prior to surgery will have great impact on speed & quality of recovery. 
2. And it did help in many other ways, pre-operative therapy strengthened his core, hip & quadriceps, the muscles surrounding knee joint.
3. All the muscle that was needed for speedy recovery was prepared for action. 

POST OPERATIVE REHAB

• A regular exercise program is a key part of recovery from operation. 
• Regular exercise to restore your knee mobility & strength & gradually return to everyday activities is important for full recovery.
• When you build up strength in the muscle around your new joint, it will help you get back to your normal activities. 
• It is recommended that exercise approximately 20-30minutes, 2/3 times a day & walk 30minutes.

BENEFITS OF POST OPERATIVE REHAB

1. Restore normal range of motion.

2. Build up strength in the joint & surrounding muscles.

3. Ease pain and swelling.

4. Let you get back to normal activity.

5. Help with circulation, so you don’t have blood clot problem.

POST OPERATIVE CARE

• Post surgical pain usually subsides after a week of rest and strengthening exercises.
• Surgical wound should be kept clean and dry until area heals 
• Patient should avoid soaking for about 2 weeks after total knee replacement.
• Physical therapist involves movements and exercises to help the patient adjust to the new joints and gradually make patient walk.
• Swelling is normal for 2 to 3months after total knee replacement, elevating the leg for 30 to 60 minutes every day can help.
• Patient should be sure to eat a healthy diet and should follow specific dietary instructions.

DO’S

• Walk and exercise daily. 
• Use an ice pack for pain and swelling. 
• Elevate your leg 1hour 2times in a day for swelling 
• Proper use of cane/ stick/ walker 
• Use western toilet 

DONT’S

• Do not twist your knee.
• Avoid putting unwanted load or stress on your knee. 
• Don’t put a pillow or a roll directly under your knee while you are a sleep. 
• Always keep knee out straight while lying down. 
• Avoid a sitting cross leg position 

Dr Purvi Thakkar
B.P.T., STOTT Pilates Trainer
Consultant Physiotherapist
Ashutosh Hospital

Recovery From An MCL Injury?

The medial collateral ligament or the MCL is a large ligament

running along the inner side of the knee. The MCL helps prevent the knee from caving inward. MCL injuries can occur from being hit on the outside of your knee. An MCL injury can also occur if our leg slides to the side and our knee caves inward. Your recovery from an MCL injury can vary from weeks to months depending on the severity of the tear.

The MCL is one of the strongest and largest ligaments in the knee. Anatomically there are two separate parts to the MCL, the deep and superficial portions. The MCL is commonly injured in isolation. Most MCL injuries are usually mild in severity. MCL injuries can also occur in combition with ACL injuries, but that is not a common injury pattern. Unfortunately, MCL injuries are one of the most painful knee injuries.

Types of MCL Injury

MCL injuries are graded 1-3. Grade 3 injuries are the most

severe and represent a complete rupture. The ligament has completely torn into 2 parts. Grade 1 injuries are the least severe and only a small portion of the MCL has torn. Grade 2 injuries are somewhere in between. In grade 2 MCL injuries, nearly half of the ligament is usually injured, stretched or torn.

Treatment of MCL Injury

Most MCL injuries do not require surgery. Most MCL injuries are grade 1 or grade 2 tears. Because of the pain that occurs when the MCL is stretched we will typically put you in a brace for a few weeks to support the ligament and ease your pain. Most of you can be started in physical therapy to rehab your knee soon after the injury. Grade 3 injuries might require a longer period of bracing and in some instances a grade 3 complete MCL tear might require surgery to repair the tear.

Recovery From An MCL Injury

Recovery from an MCL injury is very dependent on the grade of your MCL tear. Recovery from a grade 1 MCL injury can be as short as a few weeks. Once your range of motion and strength have recovered most grade 1 MCL injuries can anticipate a full return to sports. MCL injuries do tend to be painful so the pain from the injury might linger on for a month or two.

The recovery from a grade 2 MCL injury will take a while longer. A grade 2 injury might take between 2-3 months until you are comfortable, the knee is stable and your motion and strength have returned to normal. Once you have sustained a grade 2 or 3 injury it is also very important to focus on sports specific rehabilitation and neuromuscular rehabilitation to make sure that your knee is ready to compete.

The recovery from a grade 3 injury can take up to 6 months to recover from. Especially if surgery is necessary to repair the ligament. If surgery was not necessary then you may recover between 3-5 months after your injury. Once again, sports specific and neuromuscular rehabilitation is critical to your recovery and minimizing the risk of reinjury when you return to play.