GOALS

  • To reduce pain and swelling
  • To strengthen the muscles
  • To regain the ROM
  • To early mobility.

MANAGEMENT

Post-Operative Physiotherapy for TKR was given in the ward.

During 1 st Day

  • Chest physiotherapy was done such as deep breathing exercises.
  • Ankle Toe movement for leg
  • Isometrics exercises for Quadriceps and Hamstrings 15 repetitions
  • Assisted SLR with ankle dorsiflexion 15 repetitions
  • Hip Abduction and Adduction 15 repetitions
  • Ice for 20 minutes after every 2 hours.
  • CPM approximately 10° Continue daily until patient achieves 100° of active knee flexion.
  • Heel slides with 15 repetitions

During 2-3 rd Day

  • Same exercises will be followed on the 2 and 3 rd day
  • Ice involved knee for 20 minutes for minimum of 4 times per day (more if necessary).
  • After remove of the drain slow Passive Knee Flexion upto 30 0 was done 10 reps
  • Bed side sitting and Dynamic Quadriceps was done 15 reps
  • Ambulation with the help of walker

During 4-6 th Day

  • Same exercises will be followed on the 4 and 5 th day
  • Now patient is allowed to stand and ambulate with full weight bearing with walker.
  • CPM – 5 degress-10 degrees daily (1 cycle per minute)
  • Begin active or assisted exercises, if the wound is clean and dry
  • Bed Side active knee flexion – extension
  • Ambulation with full weight bearing with the help of walker

During 7-10 th Day

  • Same exercises will be followed
  • Work up towards 90 degrees knee flexion by 10-11 days
  • Assisted step and stairs

During 11 days – 3 weeks

  • Progress all exercises with half kg of weight cuff
  • Squats and Lunges
  • Stationary bicycle

During 4-6 th Week

  • Progress all exercises with one kg of weight cuff
  • Quadriceps dips and step up
  • Stationary bicycle
  • Total Weight Bearing with cane

After 6 th Week

  • Ambulate without cane.
  • Progress all exercises with one kg of weight cuff
  • Quadriceps dips and step up
  • Stationary bicycle

HOME MANAGEMENT

Exercises which were taught to the patient were to be continued by the patient at home also for at least 3 times a day

PRECAUTIONS

  • Avoid cross sitting
  • Do not lying down on the left side
  • Always keep the limb elevated and positioned the pillow beneath the heel to avoid swelling in the foot.