Surgical Explanations
Rehabilitation Protocols
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Total Knee Replacement
Guidelines:
The patient should achieve full extension in three to four weeks. If this benchmark is not met, notify Dr. Bryan.
Approximately 120° flexion should be obtained in two months
Notify the office of any excessive redness, swelling, warmth, or drainage.
If the patient demonstrates excessive gait deviations, the following activities may be modified.
Phase 1: WEEK 1
Quad sets for ten minutes (10 second hold, 10 second rest). Perform these three times daily.
Hip abduction and adduction at high repetitions, i.e. 1-2 sets of 25 repetitions (add weight as needed)
Prone hangs for knee extension for 10 minutes, 2-3 times daily
ROM knee flexion, heel slides 3-4 time per day, 30-50 reps, 5-10 second hold
Ankle pumps (500 hundred repetitions per day—keep the blood moving)
Patella mobilizers superior/inferior
Continue with CPM use, at least 8 hours a day, progressing 5° per day until 90° flexion is achieved.
Phase 2: WEEKS 2-3
*Note: These exercises should be performed pain-free.
0-45° squat
Knee extension with Thera-Band®. High reps, 20-25. Similar to above.
Scar mobilizers, approximate incision, gliding perpendicular to incision 5 min/day
Closed-chain heel extensions, bilateral to unilateral, adjust ROM to keep pain-free
Balance and pro-erc single-leg balance, cone walking, side-to-side
Ball squats against wall, approximately 60 flexion°
Forward chair scoots
GOALS:
Patient should reach 100° flexion at this time
Phase 3: WEEK 4 ONWARD
**EMPHASIZE WEIGHT CONTROL!!!**
About 110° flexion is necessary at this time.
Begin biking--DO NOT use the bike as a means of regaining ROM; you need at least 100-110° flexion prior to biking. |
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