What is a total knee replacement (TKR)?

When health professional use expressions such as ‘total knee’, they mean a joint replacement operation in which the complete knee joint is replaced. An artificial joint is called a prosthesis. There are many different kinds of prosthesis and are all made of materials such as metal, plastic or ceramic.

Why have a joint replaced?

The aim of having a joint replaced is usually to relieve severe pain and restricted movement, especially when other non-surgical treatments no longer bring sufficient relief.

In most cases the operation will reduce pain, improve mobility, make day-to-day activities easier and improve your quality of life. As with all other treatments, joint replacement is not a miracle cure. The artificial joint will not restore things to the way they were when the joint was completely normal and healthy, or when your body was at its physical peak. To achieve maximum flexibility and strength of the knee replacement, you will need to follow a program of physiotherapy in the weeks following the operation.

What is the long-term outcome?

Most joint replacements have a very good outcome. More than 90 per cent of knee replacements survive for 10 to 15 years. Some have lasted for up to 25 years.

What will the physiotherapist do?

Your physiotherapist will assess the range of movement of your knee and strength of the surrounding muscles. Your rehab exercises will be gradually progressed appropriate to your level and stage of recovery. The physiotherapist may also provide manual ‘hands on’ therapy to assist in further regaining range of movement. This can include mobilization of the knee cap and knee joint, and soft tissues massage. Your physiotherapist will also provide advice on pain and swelling control, the use of crutches and gait correction and the appropriate level of activity that you should be completing.

People vary greatly in their abilities post-operatively, so try not to compare yourself to others.

How much physiotherapy will I need?

Generally most knee replacement patients progress very well. If your knee is a little stiff and swollen post operatively, you may require physiotherapy twice a week for two to three weeks to achieve maximum flexibility, then once a week for a couple of weeks. If you have good range of movement, you will probably require three to four sessions of physiotherapy, usually weekly.

Exercises

The exercises that you are prescribed will be the most effective exercises for regaining good flexibility and quadriceps strength, without unnecessarily aggravating your knee joint. Pain is very normal during exercises and should be minimized by analgesics taken prior to exercise. If you feel you are regressing in your ability to do some or all of the exercises, please advise your physiotherapist.