A total knee replacement is an orthopaedic procedure where the articular surfaces (end of the bone) of the femur (thigh bone) and tibia (shin bone) are replaced. A polyethylene piece is placed between the tibia and femur as a shock absorber. In about half of cases the patella (kneecap) is also replaced.
Why get one?
The main reason people have a knee replacement is that they have most commonly over a period of time noticed;
- Increased pain at the knee joint that in the latter stages can affect sleep at night time
- Decreased mobility to the point that they may require use of a walking aid
Outcomes anticipated from a TKR (Total Knee Replacement) are;
- Reduction in pain
- Increase in Function
The most common cause of this is OA (Osteoarthritis). This is where the cartilage of the joint becomes damaged and is unable to absorb the shock as well as a healthy joint.
Anatomy:
The knee joint is made up of the Femur and Tibia with another joint at the front called the patellofemoral joint (Kneecap) encompassing the patella.
The knee is a modified hinge joint. The main movement is flexion and extension along with small amounts of internal and external rotation. There is a thin layer of cartilage at the end of the bones and also the shock absorbers in the knee known as the cartilage.
There are large ligaments supporting the knee joint some of which are;
- ACL (Anterior Cruciate Ligament)
- PCL (Posterior Cruciate Ligament)
- MCL (Medial Collateral Ligament)
- LCL (Lateral Collateral Ligament)
Who is more likely to have a knee replacement?
Risk factors that can increase your chance of a knee replacement are
- Previous knee surgery (often to remove meniscus)
- Previous Fracture
- Rheumatoid Arthritis
- Being Overweight
The Surgery
The surgery can take about an hour and most frequently is under general anaesthetic.
The actual replacement has 3 parts;
- Femoral Component
- Tibial Component
- Polyethlene shock absorbent disc
The most appropriate size and shape of the prosthesis is chosen on a patient by patient basis.
When does Physiotherapy Play a Role?
Pre Surgery:
Physiotherapy can provide you with;
- Exercises to maximise the strength in the muscles pre-operatively
- Show you the exercises that you will be doing post surgery to ensure that you are aware of the correct technique
Post Surgery:
- Get you up and moving within 24-48 hours of surgery
- Strength exercises
- Balance exercises
- Gait Re Education
- Increase ROM (Range of Movement)
- Decrease Pain
Examples of common exercises post Total Knee Replacement:
- Ankle movement exercises
- Knee ROM exercises e.g. heel slide into Knee Flexion/extension
- Quadricep Strengthening exercises e.g. straight leg raise
- Hamstring Strengthening exercises e.g. Bridging
Here at Bodies Under Construction all of our team have vast experience dealing with Total Knee Replacements so if you need any advice please don’t hesitate to contact us.
If you’d like more info on this, and some easy, actionable tips you can use now to start easing your knee. We have a free knee pain guide that we can send you. Connect with us on 020 87474 029(Chiswick) , 020 87887 804(Putney) or email us on info@bodiesunderconstruction.com and tell us what’s going on with your knee. A member of the team can take your details and we can email or post you a copy.
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About the Author: Leslie Abrahams
Every week, for over 20 years, 100’s of people aged have consulted Leslie Abrahams looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness. He has previously worked and travelled with high-level athletes in the field of cycling and volleyball. Leslie also has a special interest in Spinal Treatments and Rehabilitation, lower limb injuries, and has experience dealing with patients post injury or surgery.
Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI Pilates). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the founder of Bodies Under Construction Clinics situated in Chiswick and Putney, London. South West London’s Specialist Private Physiotherapy Practice for People of all ages, but especially those in their 30’s. 40’s, 50’s, 60’s and beyond, who want to keep healthy and active.
