Total knee replacement - acute phase - beginners program (1. - 45. day)

Total knee replacement is an orthopedic surgical procedure where the articular knee joint areas are replaced with artificial joint areas. Knee joint is connection of tibial plateau, femoral condyles and patella. Patellar replacement includes 50% of the knee replacement.

Main cause for total knee replacement is bone and cartilage degeneration often caused by Osteoarthritis. Most common risk factors are:

- previous knee injuries of ligaments and cartilage
- partial or whole removal of meniscus
- overweight
- osteoarthritis, rheumathoid arthritis
- genetics

Most common symptoms for having knee replacement surgery are unbearable pain in the area of the knee, decreased range of motion and functionality of knee joint. The worst cartilage degeneration symptom is pain during rest, pain during doing everyday activities, going up and down stairs and walking.

The main purpose of the knee replacement is getting rid of pain, increasing the quality of life and painless walking and doing everyday activities. Patient should undergo the preoperative part of the rehabilitation where he/she can try all the exercises that are expected of him to do after the operation. This helps better understanding and easier perfomance in the rehabilitation protocol.

Postoperative part in the first 45 days is directed towards decreasing swelling, pain, gaining range of motion and starting with strength exercises which are modified to the individual needs.

Postoperative part from 45th day and on is directed towards further decreasing swelling and pain, but in this part we should continue with gaining better range of motion and strength exercises for the knee, hip and core muscles. This part includes learning the gait without the crutches.

After 90 days the patient should continue with same principles of rehabilitation with a purpose of gaining full range of motion, hypertrophy of the knee and hip muscles and gaining biomechanically clean and healthy gait.