Knee Replacement Surgery: The Procedure and Post Surgical Therapy By: Tania Marks University of California Santa Barbara November 30, 2004

Topics Anatomy of the knee Anatomy of the knee Knee Replacement Surgery Knee Replacement Surgery –Basic procedure and p rosthesis –Conservative methods of treatment –Reasons for Knee replacement surgery Post operative Treatment Post operative Treatment - Physical Therapy

Benefits of Knee Replacement Surgery Reduce Pain Reduce Pain Live comfortably Live comfortably Correct deformities Correct deformities Increase mobility, movement and strength Increase mobility, movement and strength Procedure is common and very successful Procedure is common and very successful

Anatomy of the Knee Knee is a weak joint Knee is a weak joint Femur- thigh bone Femur- thigh bone Tibia- shin bone Tibia- shin bone Cartilage Cartilage Ligaments Ligaments Quadriceps muscles Quadriceps muscles Patella tendon and patella Patella tendon and patella Quadriceps tendon Quadriceps tendon Figure 1: Side and front view of patellofemoral joint [Patient's Guide to Total Knee Surgery, 2004]

Knee Replacement Surgery Procedure Figure 2: Surgical Procedure [Collins and Pavlik, 2004]

Prosthesis Artificial Replacement Artificial Replacement Metal used for the femur Metal used for the femur Plastic used for the tibia Plastic used for the tibia Figure 3: Knee Prosthesis [A Patients Guide to Total knee replacement surgery, 2004]

Conservative Methods of Treatment NSAID- non steroidal anti-inflammatory medication NSAID- non steroidal anti-inflammatory medication –Aspirin, naprosyn, and ibuprofen Physical Therapy Physical Therapy –exercises

Reasons for Knee Replacement Surgery Knee Pain Knee Pain Osteoarthritis (See figure) Osteoarthritis (See figure) Tumors Tumors Figure 4: Before and After Knee replacement surgery of knees with osteoarthritis [Shiers, 1975]

Post Operative Treatment: Physical Therapy Goals Increase flexibility Increase flexibility Increase coordination Increase coordination Increase movement Increase movement Enhance endurance and daily activities Enhance endurance and daily activities Increase range of motion Increase range of motion

Sample Exercises and Purpose Quadriceps setting – increase muscle strength Quadriceps setting – increase muscle strength Heel slides - increase flexion and extension Heel slides - increase flexion and extension Terminal Knee Extension- increase flexion and extension Terminal Knee Extension- increase flexion and extension Figure 4: Quadriceps settings, heel slides Terminal Knee Extension Exercises [Muller and Webber Physical Therapy office, 2004]

Conclusion: Knee Replacement Surgery over the Years One of the fastest growing surgeries One of the fastest growing surgeries According to hospital database in Canada, the number of knee replacement surgeries per year: According to hospital database in Canada, the number of knee replacement surgeries per year: – = 15, 360 –2000 – 2001 = 23,130 –2001 – 2002 = 25,815