William C. Shiel Jr., MD, FACP, FACR associate clinical professor of medicine at University of California, Irvine, writing in MedicineNet.com composed important questions and answers concerning total knee replacement . Listed below are some of them.
What is a total knee replacement?
A total knee replacement is a surgical procedure where the diseased knee joint is replaced with an artificial joint. The knee is a hinge providing motion where the thigh meets the lower leg. During a total knee replacement (TKR), the end of the femur bone is removed and replaced with a metal shell. Then the lower leg bone (tibia) is also removed and replaced with a channeled plastic piece together with a metal stem.
The posterior cruciate ligament stabilizes each side of the knee joint preventing the lower leg from sliding backward in relation to the thigh bone. In total knee replacement surgery, this PCL ligament is either retained, removed, or substituted by a polyethylene post.
What happens in the post operative period?
It is important for patients to continue in an outpatient physical-therapy program along with home exercises for optimal outcome of total knee replacement surgery. Patients will be asked to continue exercising the muscles around the replaced joint to prevent scarring (contracture) and maintain muscle strength for the purposes of joint stability.
Future activities are generally limited to those that do not risk injuring the replaced joint. Sports that involve running or contact are avoided, in favor of leisure sports, such as golf, and swimming. Swimming is the ideal form of exercise, since the sport improves muscle strength and endurance without exerting any pressure or stress on the replaced joint. An important device that can assist in improving leg (and hip) movement in post knee replacement physical therapy is the LegTutor. The LegTutor provides a safe and comfortable leg brace with position and speed sensors that precisely record three dimensional hip and knee extension and flexion. Rehabilitation games allow the patient to exercise Range of Motion (ROM), speed and accuracy of movement. The LegTutor facilitates evaluation and treatment of the lower extremity including isolated and combined hip and knee movements.
The LegTutor and the other devices in the Tutor system including the HandTutor, ArmTutor and 3DTutor use controlled intensive exercise practice aim to optimize motor, sensory and cognitive performance to allow the patient to better perform everyday functional tasks and improve quality of life. The Tutor system is being successfully used in leading U.S. and foreign (UK , German) hospitals and clinics and are suitable for home use through telerehabilitation.