Physical Therapy and Exercises

Engaging in a structured exercise regimen is crucial for a successful recovery after knee replacement surgery. Here are some essential exercises and guidelines to help improve your mobility, strength, and overall recovery:

Initial Exercises (Weeks 1-2)

Weightbearing: Limited weightbearing with an assistive device for at least the first week.
Range of Motion Exercises:
- Perform 5-8 minutes of range of motion exercises per hour while awake.
- Seated Knee Flexion/Heel Slides: Perform 10 repetitions per hour.
- Passive/Active Assisted Knee Extension: Perform 10 repetitions per hour.
- Ankle Pumps: Perform 10 repetitions per hour.
- Walking: Walk 5-10 steps per hour.
- Heel Hang: Hold for 10 minutes, three times a day.
Elevation and Ice: Elevate the limb for 40 minutes per hour for the first 10-14 days (toes above nose). Ice the surgical limb for 40 minutes per hour for the first 10-14 days.
Stair Use: Limit stair descent/ascent as much as possible.
Quadriceps Sets: Perform isometric quadriceps sets in full extension, avoiding isotonic or closed kinetic chain strengthening.

Advanced Exercises (Weeks 3-6)

Assistive Devices: Progress away from assistive devices as tolerated.
Range of Motion Exercises: Continue performing 5-8 minutes of range of motion exercises six times a day. Focus on achieving the maximum intra-operative best range of motion by week 4.
Elevation and Ice: Continue elevation and icing of the limb for 40 minutes, three times a day at minimum.
Quadriceps Sets: Continue isometric quadriceps sets in full extension, avoiding isotonic or closed kinetic chain strengthening until six weeks post-op.

Step Count Goals

Week 1: 750 steps/day maximum.
Week 2: 1200 steps/day maximum.
Week 3: 2000 steps/day maximum.
Week 4: 2750 steps/day maximum.
Week 5: 3500 steps/day maximum.
Week 6: 4500 steps/day maximum.
Progress by 1000 steps/day in each subsequent week, letting pain and swelling guide you.

Additional Considerations

Consider additional interventions such as manual lymphatic drainage, sequential compression devices, or electrical muscle stimulation devices if needed.
Carefully consider returning to work prior to six weeks post-op, as it may impact your range of motion and overall recovery.

By following this exercise regimen and working closely with your healthcare provider, you can enhance your recovery and achieve optimal outcomes. Always consult with your healthcare provider for personalized advice and recommendations.