While You Are in the Hospital

Range of Motion Exercises: The physical therapist will schedule your first inpatient visit shortly after surgery. Treatment will address the range of motion in the knee. Gentle movement will be used to begin to help you regain both the bending and straightening of the knee. If you are using a continuous passive motion (CPM) machine, it will be checked for alignment and settings. Next, you'll go over your exercise regimen. When you are stabilized, your therapist will assist you during a short outing using your crutches or your walker. Treatment will proceed on a one to two time per day basis. You'll be on your way home when you can demonstrate a safe ability to get in and out of bed, walk up to 75 feet with your crutches or walker, get up and down flight of stairs and access the bathroom. It is also important that you regain a good muscle contraction of the upper thigh muscle (quadriceps) and that you gain improved knee range of motion.

After You Leave the Hospital

Home Health Needs: Once discharged from the hospital, your therapist will likely see you for in-home treatment. This is to ensure you are safe in and about the home. You should be seen for at least one visit for the safety check and to review your exercise program. In some cases, you may require up to three visits at home before beginning outpatient physical therapy.

As You Progress

Outpatient progression: Your therapist may choose one or more modalities such as heat, ice, or electrical stimulation to help reduce persistent swelling or pain. Continue to use your walker or crutches. If you had a cemented procedure, you'll advance the weight you place through your sore leg as much as you feel comfortable. If yours was a noncemented procedure, place only the toes down until you've had a follow-up x-ray and your doctor or therapist directs you to advance the amount of weight through your leg (usually by the 5th or 6th week postoperatively). Range of motion exercises and techniques will be used to help you regain full bending and straightening of the knee.

An exercise program will be developed, including strengthening, balance, endurance, and functional activities. Your strengthening program will address key muscle groups, including the buttock and hips, thigh and calf muscles. When you are safely putting full weight through the leg, several balance exercises can be chosen to further stabilize and control the knee. Endurance can be achieved through stationary biking, lap swimming, and using an upper body ergometer (upper cycle). Finally, a select group of exercises can be used to simulate day-to-day activities, like going up and down steps, squatting, raising up on your toes, and bending down. Specific exercises may then be chosen to simulate work or hobby demands.