Health Break | Published May 2, 2011

Improving Range of Motion After Knee Replacement Surgery

Both patients and rehab therapists agreed on one thing following knee replacement surgery—the main goal is for the patient to get up, get moving, and get back to a normal life. After knee replacement surgery, patients are in the hospital only two or three days, and during that time, both physical and occupational therapy are started. Recovering knee range of motion and mobility are paramount. Immediately after surgery, the knee may be stiff, painful, or swollen, but it is important to begin rehabilitation immediately. Therapists at Mount Nittany Medical Center engage patients in supported walking the day after surgery, and they may be asked to begin exercises in bed and while sitting in a wheel chair.Starting exercises quickly after surgery is very important to regaining range of motion. Patients receive occupational therapy and learn how to get out of bed, get dressed, walk to the bathroom, or get in and out of a car. Physical therapy, on the other hand, focuses on improving the knee range of motion, walking, increasing the ability to bear weight, and walking up and down steps.A major goal of rehabilitation is to be able to bend the knee 90 degrees, enough to engage in normal activities. The final range achieved following surgery will sometimes depend on how much range the patient had before surgery. One unknown factor is that every person heals differently, and recovery can differ among patients. Since many knee surgeries are done to relieve the pain of arthritis, many patients experience greater range of motion after surgery since the cause of the pain has been alleviated. The amount of time needed to regain range of motion varies widely, from days to months. If there is no swelling after the surgery, recovery is easier. A complicating factor can be obesity. The heavier a patient is, the more pressure placed on the joints, causing patients to experience more pain.Outpatient physical therapy after knee replacement can last for several weeks, and complete rehabilitation can take several months. For six weeks after surgery, the patient should not pivot or twist the knee, and kneeling and squatting should also be avoided.Exercises that are begun in the hospital must also be continued at home as an outpatient. It is not enough to just go to therapy while in the hospital. Plainly put, the exercises are critical to regaining range of motion; if the knee heals after surgery without achieving a wide range of motion, the knee may never be able to regain the range desired. Once the patient is back home, the guidelines provided by the therapist and patient's physician should be followed. For instance, climbing stairs should be kept to a minimum and short walks, several times a day, are usually recommended. In addition, patients will be given a set of exercises to complete daily. After knee surgery, most patients will regain a range of motion that will allow them to lead an improved life with less pain and more mobility than they had before. Emidio Krupa, OTR/L, is an occupational therapist and director of rehabilitation services at Mount Nittany Medical Center, State College, Pa.

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