Knee Arthroplasty
What is knee arthroplasty?
Knee arthroplasty is the fancy name healthcare professionals usually use but in everyday conversation, you’ll probably hear it called knee replacement. There are several different kinds, with the four most common being total knee, partial knee, complex or revision, and kneecap.
Total knee arthroplasty removes part of the end of the femur (big bone in the thigh), part of the end of the tibia (bigger of the two bones in the lower leg), and the patella. These bone pieces are then replaced with artificial parts that provide better support and smooth, painless movement in the knee. A partial knee arthroplasty replaces one side of the knee, kneecap replacement is exactly what it sounds like where the bony patella is replaced with an artificial one, and a complex or revision knee replacement is like a deep total knee for extra stability.
There are a lot of things that can lead to the need for a new knee, including various types of arthritis, fractures, tumors, ankylosing spondylitis, and avascular necrosis.
"Dad's New Knee" by MTSOfan is marked with CC BY-NC-SA 2.0.
Do people ever get both knees replaced at the same time?
Ever? Yes. Often? No. It isn’t uncommon for people to need both knees replaced. I know getting both done at the same time does happen but I’ve never seen it myself. Much more frequently, what I see happen in this situation is getting one knee replaced, mostly healing, then getting the other knee done.
From a rehab standpoint, it’s a lot easier to control how much weight you bear on the new joint if you have another leg to stand on, which can make gradually returning to full use easier. If you have TWO new knees, it could be a lot less comfortable to reach your desired level of activity. Other factors that can contribute to a decision on whether to do both knees simultaneously or one at a time include the length of time you’d need to be under anesthesia, how much help you have available at home during recovery, urgency (traumatic injury may necessitate having both done even if it’s not the standard approach), what assistive devices are available to you, and more.
PSA: It is incredibly important for you to follow the advice of your healthcare team when it comes to taking care of your new knee! They are trained on how injuries happen and how to prevent them. Even if one of your restrictions seems very tedious and small and insignificant, there’s a reason it’s there.
"New Knee" by Northfielder is marked with CC BY 2.0.
What do physical therapists do for knee replacements?
PTs are not just there for you after surgery, they’re there for you before as well! Your physical therapist can help you develop an exercise plan leading up to surgery that will condition your body to heal faster after your knee replacement. At this point, your PT will likely go over flexibility exercises (helps prevent injuries), strengthening exercises (helps stabilize everything in there), how to use your aids (like crutches, walkers, or special pillows), and your post-surgery precautions.
In the first few days after surgery, your PT should help you move around your hospital bed safely, sit and stand, walk, transfer to a chair or wheelchair, use your aids, and continue flexibility and strengthening exercises.
As you progress on your path of rehabilitation, your PT should start helping you with things like navigating stairs and tubs, balancing, getting full movement and strength in your leg, and getting you back to doing the things you love.
If you’ve had personal experience with physical therapy and total knee replacement, I’d love to hear what you liked and didn’t like in the comments below!
If you’d like to know more on this topic, I recommend checking out these sources first:
