Two challenges exist after total knee replacement—regaining motion and regaining strength. Almost every patient will need a physical therapy carrot and stick to regain motion after what is no doubt a major knee surgical procedure. If your primary insurance is Medicare, a physical therapist will come to your home 3 times a week
for 3 weeks. This is very appropriate, as you don’t need exercise machines during the first month.
Recovery after total knee replacement is not like “going to the gym 3 times a week to work out.” Small, frequent exercise episodes are mandatory. Your physical therapist will instruct you in the nature of those frequent exercises to be performed almost hourly throughout the day. We advise you doing 5 minutes of exercise and maneuvers every waking hour to get back motion. Do not attempt a massive exercise effort—“say twice a day,” as this will result in undo pain and discourage you from further exercises.
The goal is to have at least 90 degrees of flexion at your 3-week followup visit. The physical therapy interventions may be uncomfortable, but remember that they can do no harm to your knee. Tolerate as much discomfort as you can with and without the physical therapist.
You must have 105 degrees of flexion comfortably at 6 weeks after surgery. If not, you must contact my office, for it will be best to carry out a manipulation under anesthesia (MUA). Done under intravenous propofol in the OPC operating room, we will gently break up the scar tissue with manipulation and inject your surgical knee with powerful pain medicines.