Total Knee Replacement (TKR) surgeries are effective only when it is preceded and followed by physiotherapy

The last few years have seen an increase in the number of Total Knee Replacement (TKR) surgeries. Rough estimates suggest that TKR surgeries in India have grown at rate of 15 per cent every year. In Hyderabad alone, the number of such surgeries being taken up every year ranges between 3,000 and 3,500.

In this backdrop, it is essential that prospective patients know the important role physiotherapy plays before and after TKR surgeries. Studies have shown that if patients undergo pre-physiotherapy sessions to strengthen their muscles around the knees, they definitely find it easy to recover after TKRs.

Patients with less muscle strength around the knees struggle hard to recover the full range of motion after undergoing TKR, physiotherapists say. Before surgery, physiotherapy should be prescribed to better prepare the knee and its surrounding muscles for surgery.

Muscle strength is often rated in the scale of zero to five, and patients who have muscle strength between zero and three should avoid TKR.

“Such patients should undergo pre-physiotherapy – first to strengthen their muscles and reach a muscle-strength scale of either four or five. If they don’t do that and undergo TKR, then the outcome will be poor or they would struggle to recover. Unfortunately, not many surgeons suggest pre-physiotherapy for such patients before TKRs,” laments sports medicine specialist M. Manjunath.

It is mandatory for the obese and those above 65 years of age to undergo muscle strengthening programmes before knee-replacement surgeries.

“For the elderly, at least four weeks of muscle strengthening is required to prepare them for TKRs. After they regain strength, their recovery post-surgery would be faster,” Dr. Manjunath explains.

Once the replacement surgery is over, post-physiotherapy sessions too are vital. The main aim of physiotherapy after surgeries is to make patients regain their full range of motion, attain muscle strength and proper gait. A minimum of 4-6 weeks of physiotherapy under a therapist, and later six months of exercises are needed to completely recover from the knee surgery.

Therapists point out that a lot of muscle is lost during knee replacement surgery and physiotherapy to regain strength is very important.

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