Total knee prosthesis is the creation of an artificial joint by covering the worn joint surfaces with special parts made of metal and polyethylene, designed for painless joint movement.
Who is total knee prosthesis suitable for?
Although treatment methods such as rest, medications, physical therapy methods, cane use and intra-articular injections have been applied, knee pain cannot be controlled, daily life activities such as walking and climbing stairs are severely restricted and joint cartilage is severely damaged. Total knee prosthesis is suitable for patients with damage. It is preferred that the patient be between the ages of 60-80, but in some special cases such as rheumatoid arthritis and osteonecrosis, a prosthesis can be made at an earlier age.
Rehabilitation
Physiotherapy and Rehabilitation studies must be done together with a physiotherapist.
65-70 degrees of flexion are required for the swing phase of walking, 90 degrees for climbing stairs, 100 degrees for descending, and 105 degrees of flexion (knee bending) for getting up from a low chair.
Functional capacity depends on joint range of motion. Therefore, early mobilization is essential.
Mobilization begins after the catheters are removed (2-3 days), with the knee in full extension and 40 degrees of flexion. It is increased by 10 degrees every day, reaching 90 degrees on the 6th day. It is used 20 hours a day for the first 3 days, and 16 hours a day for the next 4 days. During this period, full extension exercises are performed twice a day under the supervision of a physiotherapist. Active flexion begins on the 7th day. This protocol does not have a negative effect on wound healing.
Post op.
Day 3: He sits on the edge of the bed
Day 4: The patient is stood up with a walker. The amount of load to be given depends on the type of fixation. In cemented prostheses, the load is increased according to tolerance. In biological fixations, only the feet and fingers touch the ground.
Cutts are not allowed until the patient can do the straight leg lift. When he can, lower extremity control is achieved.
10-12. Exercises are continued increasingly until the next day.
Most patients have 90 degrees of flexion at discharge and no manipulation is required
6. Until next week, he uses crutches and does the following exercises.
Exercises
1.Isometric Exercises:
Gluteal group: Squeeze your hips for a count of 3 and relax
Quadriceps group: Press the backs of your knees to the bed and relax for a count of 3. Ankle isotonics: Dorsiflex your ankle while sitting with your legs extended 3 Count to 3 and relax.
2. Hip and knee reflection: Flex the knee and hip, pull the knee towards the chest, count to 3 and relax
Straight leg stretch: raise the leg straight, ankle in DF, count to 3 and lower.
Knee Stretch: with the healthy leg, force the operated leg to flex, count to 3 and relax.
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