TKA Protocol

Swelling control and Range of Motion are 2 of the most important components of rehabilitating a TKA

It is important to prevent swelling instead of trying to reduce it after it happens Swelling will: Increase Pain Limit patient’s ability to flex and extend knee “Shut down” the muscles around the knee This will ultimately delay the patient’s recovery and limit how well they will perform their exercises

Knee ROM is very important and is best to start ASAP after surgery Patients are racing against the clock with scar tissue production after surgery

Patient’s activity status is: Limited Patient may get up to : Go to the bathroom Work with therapies Perform exercises

Consistently icing the knee will assist in preventing swelling. Secure polar ice wrap snugly to the knee with gray wrap or an Ace wrap. Compression will also control swelling. Provide moderate compression when securing polar ice wrap Always protect skin with TED hose and another thin layer, such as pillow case or towel.

Positioning Patient should lie in bed with surgical leg in LRU Pillow or surgical leg positioned in bed with knee fully extended You may place a towel roll under the ankle or heel, but never under the knee. Patient’s knee should be straight as possible with heel slightly off the edge.

LRU Pillow There is a new product available for patient’s receiving total knee replacements called an LRU Pillow, pronounced, “La-roo”. The pillow is designed to elevate the leg while keeping the knee as straight as possible. Patients should be in the pillow at least 4 hours per an 8 hour shift.

Total Knee Replacement Exercises

Heel Props Place heel of affected foot on a tightly rolled pillow or towel. Tighten the muscle in the front of thigh. Hold for 5 counts. Repeat 10 times. Attempt to get your knee as straight as possible

Towel Pulls While seated or lying flat, place a towel or a sheet around the ball of your foot. Pull towel towards you lifting heel in the air. You may use hand to push down on your thigh to stabilize. Hold for 5 counts. Repeat 10 times.

Heel Slides While seated or lying flat, slide your heel towards your body. To help you bend the knee further, place a towel under your thigh or around your ankle. With both hands pull towel towards your body, sliding the heel closer towards your buttocks. Hold for 30 counts. Repeat 3 times.

Leg Lifts While seated or lying flat, bend your non-operated knee in towards your body. Keeping your operated leg straight, lift your heel off of bed approximately 18 inches. Repeat 10 times. When, and only when, you can lock your knee fully straight, you will begin Leg Lifts.

Patients should perform their exercises at least 4 times per day and record in their exercise log of the, “Caring For Your Knee” booklet