Friday, May 13, 2022

Physiotherapy after TKR (Total Knee replacement) Surgery


Physiotherapy after TKR (Total Knee replacement) Surgery:

Some Facts

Before TKR or knee replacement surgery

1.       A person, who is suffering from severe pain in the knee joints, avoids activities like climbing up and down the stairs, running, cycling, sitting on the ground, squatting, sitting cross legged or even walking.               

As the activity slows down, strength of thigh muscles, muscles around knee joint, calf and foot muscles reduces.

2.       If a person is suffering from osteoarthritis or rheumatoid arthritis, a deformity is developed in the knee joint.

Due to this deformity, wrong style of walking leading to wrong posture or “Gait Pattern” is developed.

After TKR or knee replacement surgery

1.       Pain in the knee joint reduces.

2.       Deformity of the knee joint is corrected.

But still there is some nagging pain in the knee!!!

Many a times this pain is unbearable and is troublesome physically and mentally.

This is due to lack of muscle strength.

Due to lack of muscle strength in legs, person even after a successful surgery, is not confident to walk or to climb up and down the stairs.

Statistical data tells that 25-30% of patients who have undergone the TKR surgery are unhappy with the results!!

The most common complaints are,

“I can’t tell you what is wrong.  I am not comfortable with my knee joint. I still don’t feel like doing any physical activity”.

“I have spent so much of money and got my knees replaced but the pain is still there.  I am not sure about success of this surgery.”

This happens because during (Robotic or Conventional) TKR surgery

1)      Muscles are dissected or cut to reach up to the bones.  After the replacement of knee joint, these muscles are sutured or stitched.

2)      Two major ligaments of the knee joint (ACL-anterior cruciate ligament and PCL- posterior cruciate ligament) are totally cut off and removed. Necessary design features are incorporated in the knee joint implant to take care of loss of these ligaments.

3)      To correct the deformity of the joint, ligaments, tendons and muscles are partially ‘released’ from the bone attachment. Because of this coordination between signal from the brain and   joint movement is disturbed.

4)      This signals sent by the brain to the muscles and ligaments to do a movement, known as Proprioception’, may not be still accurate, after the surgery.

5)      Till the time these dissected/cut muscles do not get functional, some pain or limitation on joint movement remains.

Therefore, physiotherapy plays a very important role in total recovery of the TKR patient.

Physiotherapy post TKR:

·         Get rid of residual pain post TKR surgery.

·         Re-educate or train the muscles around the knee joint and all muscle groups of the leg post TKR surgery.

·         Regain muscular strength

·         Correct the walking pattern and locomotion or movement of the knee joint (Correct the ‘Gait’ or posture of patient).

·         Regain ‘burst energy’ or ‘firing power’ in muscles, whenever body demands it.

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