Total Knee Replacement: What you need to do to get better!

Are you pencilled in for a total knee replacement? Or have you just recently got it done? Have you had knee surgery and been told you will need a total knee replacement in the future? Are you just sitting there and waiting for your knee to get sorer and then get the op? I am not going to tell you that you might not need a total knee replacement but I am going to tell you that if anyone says you don’t need physiotherapy after, they are wrong. For some reason you might hear along your travels “I don’t believe in physio” or “you won’t need physio after your operation”. You most certainly will and lots of it. Why? Well, first off, do you know what actually happens in the operation? 

A total knee replacement is needed when the surfaces of your femur and tibia (See attached picture) are damaged and need to be replaced. This is done by: 

1. Cutting the quadricep tendon so the kneecap can be assessed. 
2. Sliding your kneecap to one side 
3. Shaving down the femur bones surface to make it smooth for the replacement metal
4. Shaving down the tibia bones surface to make it smooth for the replacement metal
5. Using cement to seal them to the bone
6. Using a plastic disc in between to allow for smooth movement 
7. Putting the kneecap back in place, sometimes you need to resurface the knee cap as well. 
8. Sewing up the quad tendon and initial incision. 

So here is why you might want to consider physiotherapy after: 

1. Quadriceps tendon is how you straighten your knee - you might need some strength work on that!
2. Quadriceps tendon attaches to the knee cap, and then another tendon attaches the kneecap to the tibia(See pic), very important to make sure that it is aligned properly. 
3. The Femur bone: 23 muscles originate or attach to it, might need some work on that.
4. The Tibia bone: 11 muscles originate or attach to it, might need some work on that. 
5. Scar tissue: It is very important to get the skin flexible after a surgery as this will restrict your ability to bend and straighten the knee. 

The surgery is always very successful, when I see clients in my clinic sometimes knees can be stiff from the muscles which I have listed above getting used to life under a new knee. My job is to help people get moving again, get out of pain and make full use of the new knee they have been given. Every total knee replacement surgery I have rehabilitated have been successful, I have never seen a surgery go wrong but I have seen people go wrong. They think that all the work done above will take away all the problems. It simply won’t, you have to work hard to get back your strength and flexibility, the easy part is the surgery because someone else is doing the work, the hard part is when you have to do the work yourself and my job is to make that work easier. It riles me to be honest when people say “you don’t need physio”, I just don’t understand why someone would say that. We all know drinking water is good for you, it is a necessity and we should all start realising strength training and flexibility training are just as good for you. Only a physio knows how to teach them properly, that’s our job description, that’s what we do, day in, day out, we are as necessary as water recovering from a total knee replacement. 

To finish here is something to think about the next time you pass a Walsh, Dolan or county council van and see the road being resurfaced, think that’s just like what happens with a total knee replacement. The main difference is with a total knee replacement you are not only getting the road being resurfaced but the sky is being resurfaced at the same time, make sure to drink lots of water after the surgery, smiley face. 

I hope this helps

Tommy