173. Total Knee Replacement Rehab w/ Chris Hughen and Marc Surdyka
Nov 5, 2024
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Marc Surdyka, a Doctor of Physical Therapy specializing in total knee replacement rehab, joins Chris Hughen to dig deep into crucial pre-operative tips and early post-op care. They explore the importance of personalized rehabilitation plans and discuss the controversial role of ice and CPM machines in recovery. The conversation emphasizes transitioning through assistive devices and returning to high-level activities after surgery. They also highlight maintaining fitness for prolonged knee replacement longevity, balancing activity with recovery.
Pre-operative management strategies such as exercise and lifestyle modifications are crucial for improving knee osteoarthritis symptoms before surgery.
Early post-operative rehabilitation focuses on regaining strength, improving knee range of motion, and ensuring functional mobility through targeted therapy exercises.
Maintaining consistent physical activity and a well-rounded strength training program is essential for long-term success and overall health after knee replacement.
Deep dives
Preoperative Considerations for Knee Replacement
Before undergoing total knee replacement, various factors must be assessed to determine if surgery is the appropriate course of action. Patients should evaluate their overall quality of life and consider potential preoperative management strategies for knee osteoarthritis, including exercise and lifestyle modifications, to improve symptoms. Recommendations suggest a trial of non-operative management for around six months prior to considering surgery, while recognizing that individual health conditions may necessitate a shorter or longer timeframe. It's essential to weigh the benefits of delaying surgery against the risks of living with debilitating pain that restricts daily activities.
Understanding the Total Knee Replacement Procedure
Total knee replacement involves the surgical removal of damaged joint surfaces and their replacement with metal and synthetic components. This procedure is typically accompanied by significant trauma to the body, leading to an extended rehabilitation period compared to other knee surgeries. Patients can expect an average hospital stay of around three days, with the potential for earlier discharge if no complications arise. Early mobilization post-surgery is encouraged, with physical therapy starting as soon as the day of the surgery to promote recovery and reduce the risk of complications, such as deep vein thrombosis.
Postoperative Rehabilitation Goals
Rehabilitation after a total knee replacement focuses on regaining strength, improving knee range of motion, and restoring functional mobility. Initially, the primary goal is achieving full knee extension and improving flexion, with targeted exercises to activate the quadriceps muscle. Patients are encouraged to monitor symptoms like pain and swelling, as these can affect the success of their rehabilitation plan. A structured approach to therapy incorporates the gradual introduction of resistance training and functional movement patterns to facilitate recovery and improve overall fitness.
Long-Term Recovery and Activity Resumption
As patients progress in their rehabilitation, attention shifts to integrating higher-level functional and recreational activities back into their routines. While low-impact exercises such as walking, swimming, and cycling are generally encouraged, caution is advised when considering return to high-impact sports. A well-rounded strength training program that focuses on the entire lower leg is crucial for long-term success, helping to prevent falls and maintain overall health. Regular discussions regarding activity modifications and ongoing physical fitness can empower patients to stay active and avoid adverse effects associated with inactivity post-surgery.
Maintaining Knee Replacement Longevity
To maximize the longevity of a total knee replacement, patients are advised to engage in consistent physical activity, following recommended guidelines for resistance training and aerobic exercises. Achieving a balanced level of fitness not only supports knee health but also enhances overall body functioning and quality of life. Nutritional factors also play a role in post-surgical success, underscoring the importance of a comprehensive approach to health. Ongoing dialogue with healthcare providers about maintaining physical activity levels and performing regular exercise is essential for extending the life of knee replacements and ensuring patient well-being.
Chris Hughen sat down with Marc Surdyka to discuss all things Total Knee Replacement. We dive into pre-operative recommendations, early post-op priorities, normalizing knee range of motion and improving quad strength, rehab progressions, and much more.