Physical Therapy after Total Knee Replacement Surgery

When undergoing physical rehabilitation from a surgery such as a total knee arthroplasty (replacement) it is important to know what rehab pathways are available for you given the most up-to-date evidence. Typically, after a total knee arthroplasty (TKA) surgeons will prescribe home-health physical therapy. A licensed physical therapist will come to your house to help initiate early mobility and improve function of the surgical leg for about 1-2 weeks. Home health physical therapy is then typically followed by outpatient physical therapy in the clinic for another 6-8 weeks to continue progress. However, more recently we have been seeing patients in the clinic 1-5 days following surgery!

Early Out Patient Physical Therapy…..Is it too aggressive? Will it cause damage to the surgical area?

Well the truth is that it is just as safe and may be more beneficial than the traditional rehabilitation pathway.

Research Findings:

  • Patients who elected for an outpatient vs inpatient surgery saved approximately 30% on their medical bills (prior to the start of physical therapy)
  • Patients who attend outpatient physical therapy immediately following surgery:
    • Demonstrate better knee range of motion by 10 deg
    • Met their rehab goals on avg 20 days sooner

However, direct to outpatient isn’t for everyone and there are a lot of factors that you will have to discuss with your orthopedic surgeon to make sure this is the best option for you. Some of the factors included are: your past medical history, home life, caretakers/support system, transportation, convenient access to physical therapy clinic, and independence with activities of daily living prior to surgery. 

If you have any additional questions regarding Physical Therapy following a knee replacement please feel free to contact us. 

GoodLife Physical Therapy

 

References

  • Mcginn T, Chughtai M, Khlopas A, et al. Early Outpatient Physical Therapy May Improve Range-of-Motion in Primary Total Knee Arthroplasty. J Knee Surg. 2017;30(7):618-621..
  • Warren M, Kozik J, Cook J, Prefontaine P, Ganley K. A Comparative Study to Determine Functional and Clinical Outcome Differences Between Patients Receiving Outpatient Direct Physical Therapy Versus Home Physical Therapy Followed by Outpatient Physical Therapy After Total Knee Arthroplasty. Orthop Nurs. 2016;35(6):382-390.
  • Brennan GP, Fritz JM, Houck LT, Hunter SJ. Outpatient rehabilitation care process factors and clinical outcomes among patients discharged home following unilateral total knee arthroplasty. J Arthroplasty. 2015;30(5):885-90.
  • Kolisek FR, Mcgrath MS, Jessup NM, Monesmith EA, Mont MA. Comparison of outpatient versus inpatient total knee arthroplasty. Clin Orthop Relat Res. 2009;467(6):1438-42.
  • Huang A, Ryu JJ, Dervin G. Cost savings of outpatient versus standard inpatient total knee arthroplasty. Can J Surg. 2017;60(1):57-62.