Knee Replacement

john miller physiotherapist

Article by John Miller

What is a Knee Replacement?

knee replacement

Knee Replacement Surgery

Knee replacement, or knee arthroplasty, is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability. It is most commonly performed for osteoarthritis, and also for other knee diseases such as rheumatoid arthritis and psoriatic arthritis. 

Knee replacement surgery can be performed as a partial or a total knee replacement. In general, the surgery consists of replacing the diseased or damaged joint surfaces of the knee with metal and plastic components shaped to allow continued motion of the knee.

What Causes Knee Joint Deterioration?

Knee arthritis (inflammation of your knee joint) is a major cause of knee joint deterioration. The most common arthritis is osteoarthritis, which is inflammation related to wear and tear of the knee joint. 

Wearing of your knee joint is a common problem with ageing. However, certain conditions can accelerate the process of wear. 

Injury to your knee joint, surgical procedures, muscle weakness or increased body weight all accelerate the load and hence the wear and tear of the knee joint.

Rheumatoid disease, gout or infection can also increase your joint wear and tear.

Interesting fact: If you lose just 10 kilograms of weight you can reduce the load on your knees by half!

What are the Symptoms of Knee Joint Arthritis?

The obvious sign of wear and tear of the knee joint is pain. Knee pain can be achy or sharp and may be accompanied by swelling. 

Because your knees do not wear equally across the joint surface, a deformity may begin to appear over time. This can be both knock kneed or bow legged in appearance, or windswept knees (one of each). 

You may also find one or both knees lacking full movement, especially extension.

How is Knee Arthritis Diagnosed?

On examination, your physiotherapist or doctor will look for signs of limited knee movement and deformity, swelling and, importantly, knee pain. In most cases an X-ray will be sufficient to show the degree of wear and tear. An MRI may also be used to to exclude soft tissue pathology.

What is the Treatment for Total Knee Replacement?

Pre Operative Physiotherapy

Pre-operatively you may be prescribed a course of physiotherapy to better prepare your knee and its surrounding muscles for the upcoming surgery. 

Studies indicate that the better your muscle strength and knee range of movement before surgery, then the better your recovery.

Post Operative Physiotherapy

Many patients who have a Total Knee Replacement (TKR) start to feel better within a few weeks of the surgery. 

Post-operative physiotherapy is important to regain full knee motion, strength and day to day function.

Your post-operative physiotherapy treatment will aim to:

  • Reduce knee pain and inflammation.
  • Normalise knee joint range of motion.
  • Strengthen your knee muscles: quadriceps (esp VMO) and hamstrings.
  • Strengthen your lower limb: calves, hip and pelvis muscles.
  • Improve patellofemoral (knee cap) alignment
  • Normalise your muscle lengths
  • Improve your proprioception, agility and balance
  • Improve your technique and function eg walking, stair climbing, squatting and bending
  • Minimise your chance of re-injury.

Risks of Knee Replacement Surgery

Risks of knee replacement surgery include: infection, persistent instability and knee pain, knee stiffness, and difficulty returning to your previous level of activity. The good news is that better than 90% of patients have no complications post-surgery.

Interesting Fact

The first Total Knee Replacement (TKR) was pioneered by Leslie Gordon Percival Shiers (FRCS) in 1954. He refused to patent his invention, but rather allow other surgeons to modify and improve on his ideas.

Return to Activity Post-Total Knee Replacement

Most activities can be returned to following a successful knee replacement. Unfortunately, because of the nature of the knee prosthesis, it currently not recommended to return to high impact activities such as running and jumping. Less high impact sports such as golf, bowls or swimming are encouraged.

For more information about knee replacement, please ask the advice of your physiotherapist or doctor.

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Common Knee Replacement Treatment Info

  • Early Injury Treatment
  • Avoid the HARM Factors
  • Gait Analysis
  • Biomechanical Analysis
  • Balance Enhancement Exercises
  • Proprioception & Balance Exercises
  • Medications?
  • Soft Tissue Massage
  • Brace or Support
  • Electrotherapy & Local Modalities
  • Heat Packs
  • Joint Mobilisation Techniques
  • Kinesiology Tape
  • Knee Arthroscopy
  • Neurodynamics
  • Prehabilitation
  • Strength Exercises
  • Stretching Exercises
  • TENS Machine
  • Video Analysis
  • Knee Replacement FAQs

  • Common Physiotherapy Treatment Techniques
  • What is Pain?
  • Physiotherapy & Exercise
  • When Should Diagnostic Tests Be Performed?
  • What Causes Post-Exercise Muscular Pain?
  • Can Kinesiology Taping Reduce Your Swelling and Bruising?
  • Heat Packs. Why does heat feel so good?
  • How Can You Prevent a Future Leg Injury?
  • How Do You Improve Your Balance?
  • How Much Treatment Will You Need?
  • Runners: How to Reduce Your Knee Stress
  • What are the Common Massage Therapy Techniques?
  • What are the Early Warning Signs of an Injury?
  • What Can You Do To Help Arthritis?
  • What is a TENS Machine?
  • What is Chronic Pain?
  • What is Nerve Pain?
  • What's the Benefit of Stretching Exercises?
  • When Can You Return to Sport?
  • Why Kinesiology Tape Helps Reduce Swelling and Bruising Quicker
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    Helpful Products for Knee Replacement

    Total Knee Replacement


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    Knee Pain

    Common Causes

    knee pain

    Knee Ligament Injuries

    Knee Meniscus

    Knee Tendonitis

    Muscle Injuries

    Children's Knee Conditions

    Other Knee-Related Conditions

    Knee Surgery

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    Last updated 18-Jan-2018 04:40 PM

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