Total Knee Replacement: Post-Operative Physiotherapy Protocol
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PHASE I— IMMEDIATE REHABILITATION – Usually 1-2 weeks
Goals
Protect integrity of repaired tissue
Restore independent mobility
Reduce pain and swelling
Restore range of motion
Precautions
Crutches for first 4-6 weeks – wean to 1 crutch in OPPOSITE HAND
No extension activities beyond neutral extension with extension
No crossed legs
Specific Exercises
Straight line walking
Heel Slides
Heel lifts
Knee extensions
Straight leg raises
Drop and dangle exercises
It is imperative during this time that you have sufficient pain relief to allow you to have 0-90° Range of motion
PHASE II— INTERMEDIATE REHABILITATION – 2-6 weeks
Goals
Restore range of motion >100° flexion, full extension
Restore normal gait pattern
Improve pain
Precautions
Avoid extensive walking – aim 2-4000 steps/day
Specific Exercises
Straight leg raises
Quads sets + short arc quads
Hamstring curls
Calves
Hip abduction and flexion
Hydrotherapy and upper body exercises (after 2 week wound check)
One leg balancing
Exercise bike
PHASE III— ADVANCED 6 weeks+
Goals
Restoration of muscular endurance/strength
Restoration of cardiovascular endurance
Optimize neuromuscular control/balance/proprioception
Precautions
No precautions
Specific Exercises
Proprioception + balance
Forward step ups/downs
Treadmill – inline walking 20mins 2 x per day
Advanced strength training
Side to side lateral agilities
Leg presses
Activity specific resumption
