Week 6:
Twin Cities Orthopedics

July 5, 2013

The rehabilitation process after a knee replacement is quite taxing on the individual. There is a lot of work that must go in the first week or two following the surgery. This week at Twin Cities Orthopedics I was able to meet with a patient who was only three days post- operation from a total knee replacement. The patient was very conversational and gave me some insightful information to the initial stages of recovery. Not only did I learn the initial goals of rehab but I also received specific protocols directed by the surgeon.

The first phase of rehab is to regain early function. The goals of phase one rehabilitation are: control post-operative pain, reduce inflammation, provide passive motion in a specific plane of movement, and protect the healing repair or tissue. This is accomplished by building up the patient’s confidence and key components to motion such as balance and ambulation with assistant devices. The majority of motion of the knee is passive early on. A continuous passive motion (CPM) device is used to guide the patient into a light passive stretch without the requirement of the therapist. With the help of a CPM a patient aims to be able to extend the knee to 0° and flex the knee to 100° hopefully by the end of rehab.

A statistical analysis by a hospital in Minneapolis showed that the average knee flexion of patients one year after a knee replacement was 116°. Some patients that I have seen are right on track with this statistic while other patients achieve 120° or more within the first three weeks. A study conducted at Queen Margaret University College indicated that 110° of flexion is a suitable goal for total knee rehab and would not limit daily activity for the patient.

The range of motion that is achieved is influenced by a number of factors including how much time and effort the patient puts into their rehab as well as how well the parts of the new knee fit together. After speaking with several physical therapists, I learned that the more knee flexion does not necessarily mean better results because this could indicate the parts of the new knee are too small and therefore are not as supportive as it could be.

Throughout my time at Twin Cities Orthopedics, I am constantly learning about how intricate and amazing the human body truly is. I am very excited to attend graduate school and have made some great connections as well as some insightful information regarding programs I may apply to.