Knee prosthesis surgery is a serious surgery in which the degenerated joint is replaced with an artificial joint in patients with severe degeneration of the knee joint. Knee prosthesis is performed to relieve pain and movement limitations that do not respond to conservative treatments, to provide stability, and to improve the quality of life by making daily life activities more comfortable.
When is Total Knee Prosthesis Needed?
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If there is extensive degeneration in the joint due to osteoarthrosis (calcification)
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Rheumatoid arthritis, ankylosing spondylitis, which completely or largely restricts the range of motion of the joint Presence of rheumatic diseases such as
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Bone tumors or diseases
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Irreversible damage to both joints forming the knee joint
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People with serious damage to the knee after knee joint infection
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If injections and physiotherapy techniques do not reduce pain and movement problems
Surgical decision is taken by the relevant branch specialist physician. Since the prostheses used have a certain lifespan, surgery is generally performed on people aged 60 and above, except for emergency cases.
Physiotherapy and rehabilitation before knee prosthesis surgery
Success of knee prosthesis surgery It is very important to apply a preoperative and physiotherapy and rehabilitation program to increase the Receiving physiotherapy and rehabilitation services during the pre-operative period makes post-surgical rehabilitation very comfortable. Having the patient enter the surgery with the maximum possible strength and flexibility accelerates the post-operative recovery process and ensures the fastest return to daily life activities.
In the program to be applied after surgery;
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Teaching the correct positioning of the knee
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Trying to maximize the range of motion in the joint
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Strengthening exercises, especially for QDC and hamstring
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Stretching, stretching and relaxing exercises for shortened or tight muscles
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To be done after surgery Teaching physiotherapy and rehabilitation program
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Lung
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Performing respiratory rehabilitation to prevent complications that may occur in the lung and increase vital capacity
Physiotherapy and rehabilitation after knee prosthesis surgery are very important for the patient to return to a healthy life fully and quickly. Muscle strength and flexibility exercises are performed even in the pre-surgical period.
Post-surgery
Phase-1
️Increasing mobilization and joint range of motion and pain control in the early post-surgery period. It is very important. The leg is elevated with external support to prevent loss of knee extension. The hip is positioned rotationally in neutral and the knee is in full extension. In this position, cold is applied for 15 minutes every 2 hours. Compression stockings can be used for 6 weeks with the doctor's recommendation. Exercises begin 1 day after the operation.
️Stand up on the side of the bed and bear weight at the tolerance limit
️Supine passive-active assistive-active Knee-hip flexion
️Terminal knee extension
️Isometric qdc strengthening
️Active assistive active knee extension in sitting position
️Active assistive straight leg raise
️Hamstring and calf stretching exercise
️isometric gluteal strengthening
️Foot pumping exercises
️Patellofemoral and Tibiofemoral joint mobilizations
️5th day Stair training
When climbing, respectively; Healthy leg, operated leg, crutches or canadian
During descent; crutches, operated leg, healthy leg
Phase 2
️isometric qdc exercise with long arc
️standing terminal knee extension
️hamstring curl exercises in prone position
️Stationary bike without resistance
️Step after the 4th week exercises
️Standing hip strengthening exercises
️Resistive terminal knee extension
Phase 3
️Resistances of Phase II exercises continue increasingly.
️Hip extension and knee flexion exercises with a stabilization ball.
️Squat exercises (at appropriate angles)
️Deng e exercises
️Aerobic exercises (low intensity)
️Swimming
Tens or interferential flow can be used for pain, NMES can be used for qdc muscle strength . If there is severe pain, limitation of movement or edema, CPM (continous passive motion) can be used with the advice of the physician.
Therapy is personalized. The patient's age, weight and current physical characteristics may cause changes in the rehabilitation program.
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