What are some Cautionary Movements for Knee Replacements?
What are some Cautionary Movements for Knee Replacements?
From Justine:
Knee replacements can be full or partial. A full replacement would be the lower femur replaced with metal, top of tibia replaced (softer and with padding) and sometimes the underside of the patella. The person is usually in the hospital for 3-5 days and in Physical Therapy (PT) for 4-8 weeks- if you know them at the time of surgery encourage them to do the FULL time on their PT.
There are few restrictions on range of motion (ROM), however, it is very difficult to get full ROM back. A long term goal for knee flexion is 0 degrees to 120 degrees. Sometimes the person cannot do full extension – straight leg at 0 degrees, and some people don’t gain more than 90 degrees of flexion. I can’t stress enough how different results can be for various people.
Precautions:
- Stop at ROM, don’t push.
- Kneeling can be difficult, in some cases not at all.
- NO rotation in the knee.
Post surgery
Tracking and functional movement patterns need to be worked with. Get in the pool and walk. Some people start to develop low back and SI joint pain – this is usually due to leg length discrepancy. I always encourage people to research the surgeon extremely well, and to discuss areas of concern. I think the leg length discrepancy is avoidable – but I had one client who was starting to get into distress during surgery and they had to rush to close up. The result was a leg length discrepancy and chronic pain in her back.
Here is a video to work with the tracking of the knee and hip.
