This may be a total knee replacement or partial (unicompartmental) replacement. Unicompartmental replacements will probably progress more quickly and achieve a greater degree of knee flexion.
ACUTE STAGE (Whilst on ward)
C.P.M. 0 – 60 ° overnight and subsequently as necessary.
Rest the knee in full extension (no pillow under the knee)
P.W.B. with frame
T.E.D. stocking for both legs (To continue for six weeks)
Muscle pump exercises
Active knee flexion aiming for 90 ° when C.P.M. can be stopped
Active knee extension g S.L.R. when able
Progress to: ……P.W.B. with crutches
- Increase weight bearing as able
- Active hamstrings
- Increase flexion gently
Progress to full weight bearing (stick for balance)
Progressive mobilising and strengthening to include : Static bike, Step work, flexion in prone lying, proprioceptive re-education etc.
CONDITIONS FOR DISCHARGE
Reduced swelling and pain
Knee flexion at least 90 ° hopefully 110.
Able to demonstrate control on ascending and descending steps
Full weight bearing, may need walking aid as appropriate for general condition