Total Knee Replacement (TKR) Prevention and Rehabilitation

Osteoarthritis and Rheumatoid Arthritis

Knee Support

Osteoarthritis is the number one reason cartilage in knees wear out, but rheumatoid arthritis can also be why people have to face total knee replacement surgery (TKR). Many people who choose to go the surgical route believe they will walk out of the operating theater and be just like they were at the age of 19! The truth is the rehabilitation, including physical therapy and special exercises after knee replacement surgery, can last for 12 or more months. People, who skip the rehabilitation, whether at home, in an out-patient clinic or in a residential rehabilitation center, often find themselves back with knee pain and wondering why they had ever agreed to have the surgery in the first place.

What to do to Avoid Total Knee Replacement (TKR)

Physical Therapy, Exercise and Silicon Knee Supports

The truth is that a similar program of physical therapy and exercise carried out in time can put off indefinitely the need for surgery. Sadly, few people realize this. Also, wearing silicon knee supports can stop the progression of osteoarthritis in the knees, although it will not cure the damage that has already been done. Moreover, the use of knee supports can often stop the advance to a total breakdown in cartilage. It usually takes about four to six weeks wearing the silicon knee support for the knee pain to stop. However, many people do not want to wear a removable silicon knee support, especially women. While some knee supports are in various colors including beige, for women it means wearing longer skirts or more baggy pants to hide the knee guards from the public view. So, often the breakdown in cartilage progresses until the point of no return.

Orthopedic Shoe Inserts, Anti-shock Soles and Foot Exercises

Knee pain and problems really begin with our feet. Wearing the right shoes and making use of orthopedic shoe inserts can go a long way to taking stress off the knees. Also, it is very important to have shoes with anti-shock soles, as hard soled shoes put more pressure on the knees, the lower back and the neck. Also doing foot exercises can strengthen the muscles surrounding joints in the feet and ankles.

Exercise and Losing Weight

Physical therapy, exercise and losing excess weight can take pressure off the joints and help to avoid knee replacement surgery. Exercises to strengthen thigh, pelvis, buttocks and back hamstring muscles can relieve joint pressure, as the muscles can bear more of the work load. Stretching exercises are also important. It is crucial to be persistent, as it takes at least four to six weeks to feel the results and then one must continue non-stop with this regime forever, or else the pain will return and result in further knee deterioration.

Rehabilitation after Knee Replacement Surgery

If the need for TKR surgery arises, a rehabilitation plan must be in place. Some patients will choose to enter a rehabilitation facility to begin their treatment after TKR surgery.

The first 12 weeks are critical for a proper rehabilitation program to succeed.

During the first 24 hours after surgery the patient must get up and walk around using a cane, walker or crutch. In the hospital a patient will have their newly operated on leg in a continuous passive motion (CPM) machine to keep the knee in motion to prevent the formation of scar tissue which can lead to stiffness and pain. This CPM machine may also be used at home or at a rehab facility after they are discharged from the hospital.

After four to six weeks of the rehabilitation regime, which is mainly exercising, patients should finally begin to see good results, have better mobility and less need of pain killers.

By the 12th week after surgery most patients will be able to return to moderate physical activities that their doctor allows, like walking (not running), swimming and dancing. They will have reduced or no pain. However, it really takes 12 months for total healing, and so physical therapy with exercising must be kept up.


Everything should be done to prevent reaching such a state of deterioration that total knee replacement (TKR) surgery is necessary. To this end physical therapy and exercises, losing weight and wearing knee supports should be the first resort. However, if in fact total knee replacement is required, a proper rehabilitation regimen must be strictly followed for at least the first year or the TKR may not succeed.

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