Total knee arthroplasty is one of the commonest surgery now a days. Knee arthroplasty was first performed in 1968. As per the statistics around 6 lakh knee replacement takes place in United States every year. 

Anatomy – The Knee complex is the largest joint of the human body. It is made up of the lower end of the thigh bone (Femur), the upper end of the shinbone (Tibia) and the knee cap (Patella).The ends of these bones where they touch are covered with articular cartilage, A smooth substance that protects the bones and unable them to move easily. The two menisci are located between the femur and the tibia which acts as shock absorbers and are C shaped that cushions the joint. Large ligaments holds the femur and tibia together and provide stability. Long thigh muscles improves the knee strength.

A knee replacement is also known as knee joint arthroplasty. It can be more accurately termed as knee resurfacing. 

Basically, TKR is a surgery where surfaces in the joint where bone meets are resurfaced. There is very minimal chances for the body to reject the implant. It is basically a procedure in which arthritic or damaged parts of the knee joint are being replaced with the artificial joint which is termed as prosthesis. 

1. Osteoarthritis 

2. Rheumatoid Arthritis 

3. Post traumatic arthritis 

TKR is usually recommended where NSAIDS & Physiotherapy treatment fails to restore the mobility and relief the pain in the knee joint.

1. Absolute 

2. Relative contraindications 

An evaluation with an orthopedic surgeon and Physiotherapist consist of many components –

1. Medical History of the patient  - About the general medical conditions and the extent of knee pain and the ability to function. 

2. Physical Examination – Thorough assessment of knee motion, stability, strength and overall leg alignment. 

3. X-rays and other radiological imaging helps to determine the extent of damage and the deformed knee.

4. Other tests – Occasional Blood tests, or advanced imaging such as a Magnetic Resonance Imaging (MRI),

a. NSAIDS

b. Glucosamine Sulphate

c. Intra articular Corticosteroids 

d. Intra articular Hyaluronic acid.

a. Patient’s education

b. Use of assistive devices 

c. Weight Loss

d. Physiotherapy 

The pre-operative physiotherapy treatment phase is very important for the patient who is going to get his/her TKR done in coming few weeks as It assists in recovery. This phase must poses a set of exercises and few controlled trainings Like – Functional Lower limb exercises, postural control and most importantly teach the patient to ambulate with walker and other assistive devices to assist post operatively.

1. Partial Knee replacement

2. Total Knee replacement 

a. Un constrained TKR

b. Constrained TKR

c. Uni Condylar TKR 

• Pain relief 

• Restoration of Normal limb alignment 

• Restoration of a functional ROM

• Precise Surgical technique 

• Sound implant design

• Appropriate Material 

• Patient Compliance with rehabilitation 

If you have had TKR, Physiotherapy is very important part of that recovery. It will make you feel very less pain and will make you able to move around more freely. 

Start Physiotherapy From the Day of Surgery – Early the treatment intervention will start Earlier the recovery will get processed.

This will surprise you, but you can expect our experts at MAKINO HEALTHCARE to start physiotherapy treatment within the same day of your joint replacement.

• Ankle plantarflexion/dorsiflexion

• Isometric knee extension in outer range

• Inner Range Quadriceps strengthening using a pillow or rolled towel behind the knee

• Knee and hip flexion/extension

• Isometric buttock contraction

• Hip abduction/adduction

• Straight leg raises

• Bridging

Mostly a patient need to stay 1-3 days in the hospital for TKR surgery. After the patient get’s discharged we make it possible to go back home WALKING with support. And strictly recommend the patient to start taking physiotherapy treatment from very first day for 6 days/week for at least 4 weeks. 

Few people will go directly home. Done right, MAKINO HOME PHYSIOTHERAPY is just as helpful as In-Patient Physiotherapy treatment. The patient likely requires home physiotherapy treatment for several days per week for 4-6 weeks.

After around 3-4 weeks, We allow our patients to drive your car, shop groceries and do other activities that were difficult before the surgery. You might not be 100% complete pain free but the major issues gets resolved out.

Your replaced/resurfaced articular cartilages could last more that 12-15 years but it also eventually wear outs. It will sustain even longer if the patient will avoid stress activities Like – Running, Skiing, Tennis or Jumping sports. 

The activities which are best performed with new replaced joint are –

Walking, Swimming, Golf, Going on light hikes, Biking etc. 

We will help you recommend best to undergo conservative treatment or to plan a Total knee replacement surgery.