Rehabilitation is the Key to Successful Total Knee Replacement (TKR)

Knee Support can Help Stop the Progression of Knee Arthritis

Many people who choose to undergo a total knee replacement (TKR) believe that as soon as the surgery is over, they will walk out of the operating theater and be just like they were at the age of 21! The truth is that rehabilitation, which can last for a year or more, is the main key to successful total knee replacement (TKR). The rehabilitation that includes 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.

Osteoarthritis is Main Cause for Needing a Total Knee Replacement (TKR)

Why Knees Wear Out

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).

Osteoarthritis is one of the leading causes of disability in seniors. In fact, the older one gets, the greater is the chance to get osteoarthritis. According to the Centers for Disease Control and Prevention (CDC), more than 30 million Americans have osteoarthritis, which is the most common form of arthritis in the United States. Arthritis is a leading cause of disability in the United States. Twenty-four million adults report limitations due to arthritis. To date, no cure has been found.

Total Knee Replacement Surgery is not Without Risk

According to the AARP, total knee replacement surgery is not without risk. The AARP reports about serious risks and complications from TKR surgery such as:

  • Infections
  • Blood clots
  • Severe knee stiffness that requires another medical procedure under anesthesia.
  • Last, but no least, one in every 100-200 patients who have a TKR die within 90 days of the surgery.

Steps that can be Taken to Slow Down the Progression of Knee Arthritis

Since total knee replacement surgery is not without risk, the following steps should be tried to slow down the progression of knee arthritis.

Physical Therapy and Exercise

Physical therapy and physical exercises can also put off the need for total knee replacement, but it has to be carried out in time. Physical exercises to the knees and feet must be recommended by someone who is expert, as the wrong kinds of exercises can sometimes make things worse.

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.

Bracing

Bracing with various kinds of knee supports, including those that contain silicon rings, can stop osteoarthritis in its tracks and keep it from progressing further. However, bracing cannot reverse damage to the knees that occurred before bracing. It usually takes about 3-6 weeks for the braces to stop knee pain. Knee supports must be worn on a regular basis. They come in various colors and patterns including skin color. However, many women balk at wearing them as they can only be worn under skirts or very loose baggy pants. They need to be worn for standing or walking and pulled down for prolonged sitting.

Orthotic Shoe Inserts and Anti-shock Sole

Knee problems and pain begin with the feet. Orthotic inserts can do a lot to help against knee pain and arthritis. Also, shoes with anti-shock soles can take stress off the knees, lower back and even the neck.

Lose Weight

People who are overweight or obese are putting extra pounds of pressure on their knees and joints.

Avoid Stairs

Climbing up and down stairs is very bad for knee arthritis. Try to avoid daily use of stairs.

Knee Injections

Cortisone, hyaluronic acid or other medications  injected into the knees can relieve pain and help with mobility.

Diet and Supplements

Sulforaphane

Scientific research has shown that a substance in cooked cruciferous vegetables like broccoli called sulforaphane can prevent the destruction of knee cartilage. It is also found in cooked cabbage, Brussels sprouts and cauliflower, but it is best in broccoli. Broccoli has to be eaten daily and in fairly large amounts to be effective. Frozen broccoli usually no longer has sulphoraphane because it is blanched before freezing. Broccoli and the other vegetables mentioned above all contain generous amounts of Vitamin K and should not be taken in large amounts by seniors on blood thinning meds like warfarin without the consent of their doctors.

Extra Virgin Olive Oil

Extra virgin olive oil (EVOO) contains a substance called oleocanthol which acts the same way as ibuprofen to stop inflammation and pain. Moreover,  EVOO does not have the potentially dangerous side effects of Ibuprofen and other non-steroidal anti-inflammatory drugs  (NSAIDs). People who use extra virgin olive oil as the sole oil and fat in their diet report a relief in pain. Extra virgin olive oil can also be massaged into the knees for further anti-inflammatory pain relief.

Vitamin D

There is some evidence that a deficiency of Vitamin D makes arthritis worse.

Acupuncture

Many people report relief from pain by acupuncture treatments and at least one animal study showed that acupuncture caused cartilage to grow back in damaged knee joints of rabbits.

When A Total Knee Replacement (TKR) is Necessary

If you have reached the point where your orthopedic surgeon recommends a total knee replacement (TKR) and you have also received a second opinion, you must understand that in order for the TKR to be successful the first 12 weeks of rehabilitation are crucial and at least 12 months of rehabilitation may be necessary for the success of the TKR.

Studies have shown that people who go to a short-term rehabilitation facility immediately following the surgery have the best chances for the knee replacement to succeed. Usually only one knee is operated on at one time and even if both knees are afflicted, usually one knee is worse than the other one.

You should check out a rehab even before you have the operation. You need both an excellent surgeon and you need an excellent rehab.

Rehabilitation after Total Knee Replacement Surgery (TKR)

During the first 24 hours after surgery the patient must get up and walk around using a cane, walker or crutch.

Continuous Passive Motion (CPM) Machine in the Hospital

After the leg has been operated on, while still In the hospital, the leg and knee will be kept in a continuous passive motion (CPM) machine to prevent the formation of scar tissue. If scar tissue forms, it can lead to stiffness and pain. This CPM machine may also be used at home or at a rehab facility after the patient is discharged from the hospital.

Good Results may be Seen after Four to Six Weeks of Rehabilitation Treatment

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 Return to Moderate Physical Activities

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 less pain or no pain. However, it really takes 12 months for total healing, and so physical therapy with exercising must be kept up.

Rehabilitation after TKR Surgery at Park Crescent Healthcare and Rehabilitation Center in East Orange, New Jersey

The Park Crescent Healthcare and Rehabilitation Center in East Orange, New Jersey offers expert rehabilitation after total knee replacement surgery (TKR) and they have a state-of-the-art gym. Park Crescent also offers fine dining and a rich array of recreational activities and programs.

Conclusion

Everything should be done to prevent the need for TKR surgery. 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. You need to have a good surgeon and a good rehab lined up before having the TKR.

 

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