Total knee replacements have been proven to be an effective long term intervention for the geriatric population; improving function and social interaction, and decreasing pain levels.

Signs you are ready for a need replacement include:

• Having consistent pain that also wakes you up at night.
• Having limitation in your daily activities due to increased pain levels
• Having limitations in your leisure activities due to increased pain levels
• You have tried other methods of treatment consistently for long periods of time including:
  • Injection(s): cortisone, Synvisc (1-3 injections dependent on the doctor or type of injection)
  • Physical Therapy involving hands on techniques to improve:
    • joint mobility
    • soft tissue (fascia, muscle, tendon, ligaments) mobility
    • exercise program to work on strength
    • flexibility
    • balance
    • walking tolerance
    • instructions in home exercise program
  • Activity modification including more rest breaks, water exercise, biking

Many factors need to be included when considering total knee replacement, including age, health and current bone density levels.

Relative and absolute contraindications to receive a total knee replacement:

• Active infection
• Significant knee hyperextension
• Severe obesity
• Arterial insufficiency
• Mental illness

What to expect following a total knee replacement.

• Typical hospital stay for 2-4 days
  • An assistive device such as a walker or cane may be needed for walking for a few weeks
  • Continuous passive motion device may be used
• After hospital there are three options
  • Home health care Physical therapy (1-2 weeks)
    • Typically involves a visit from a physical therapist 3 days a week
  • Inpatient rehabilitation at a hospital or nursing home
    • Typically involves 4-10 physical therapy sessions
  • Outpatient Physical therapy typically within 5-7 days following surgery
  • Last anywhere from 3-8 weeks

By Jessica Wyens, PT
References:

1. Dutton, Mark. Orthopaedic examination, evaluation, and intervention. New York: McGraw Hill Companies, 2008.
2. image: http://bit.ly/sD8ZEY

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