How the Tutor System can be Used in Post Knee Replacement Therapy

 Dr. ; Associate Clinical Professor of Medicine at University of California, Irvine has written an extensive list of questions and answers about total knee replacement in MEDICINEnet.com some of which are listed here.


What is a total knee replacement?

A total knee replacement is a surgical procedure whereby the diseased knee joint is replaced with artificial material. The knee is a hinge joint which provides motion at the point where the thigh meets the lower leg. The thigh bone (or femur) abuts the large bone of the lower leg (tibia) at the knee joint. During a total knee replacement, the end of the femur bone is removed and replaced with a metal shell. The end of the lower leg bone (tibia) is also removed and replaced with a channeled plastic piece with a metal stem. Depending on the condition of the kneecap portion of the knee joint, a plastic “button” may also be added under the kneecap surface.

The posterior cruciate ligament is a tissue that normally stabilizes each side of the knee joint so that the lower leg cannot slide backward in relation to the thigh bone. In total knee replacement surgery, this ligament is either retained, sacrificed, or substituted by a polyethylene post. Each of these various designs of total knee replacement has its benefits and risks.

What happens in the postoperative period?

A total knee replacement generally requires between one and a half to three hours of operative time. After surgery, patients are taken to a recovery room, where vital organs are frequently monitored. When stabilized, patients are returned to their hospital room.

Physical therapy is an extremely important part of rehabilitation and requires full participation by the patient for optimal outcome. Patients can begin physical therapy 48 hours after surgery. Some degree of pain, discomfort, and stiffness can be expected during the early days of physical therapy. Knee immobilizers are used in order to stabilize the knee while undergoing physical therapy, walking, and sleeping. They may be removed under the guidance of the therapist for various portions of physical therapy.

Patients will start walking using a walker and crutches. Eventually, patients will learn to walk up and down stairs and grades. A number of home exercises are given to strengthen thigh and calf muscles.

How does the patient continue to improve as an outpatient after discharge from the hospital?
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.

A very effective device for 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 together with its sister devices (HandTutor, ArmTutor and 3DTutor) aim to optimize motor, sensory and cognitive performance to allow the patient to better perform everyday functional tasks and improve quality of life. The Tutors are  successfully used in leading U.S. and foreign hospitals and clinics and are suitable for home use through telerehabilitation.

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One response to this post.

  1. Thanks for sharing this information.I really enjoyed this…:-)

    Reply

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