Minimally-Invasive Surgery (MIS) Quadriceps-Sparing Total Knee Replacement: New Quad Sparing Technique May Provide Faster Recovery for Patients with Arthritis of the Knee.
Edited By: Seth S. Leopold, M.D.
Last updated Tuesday, April 15, 2008
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Rehabilitation
What types of physical therapy do patients require after minimally-invasive (quadriceps-sparing) total knee replacement for knee arthritis?
The length of physical therapy varies based upon patient age, fitness,
and level of motivation, but usually lasts for about four weeks. Two to
three therapy sessions per week are average for this procedure.
Sometimes, even less therapy is needed; occasionally, a bit more.Can this rehabilitation after minimally-invasive (quadriceps-sparing) total knee replacement for knee arthritis be done at home?
All patients are given a set of home exercises to do between
supervised physical therapy sessions, and the home exercises make up an
important part of the recovery process. However, supervised
therapy--which is best done in an outpatient physical therapy
studio--is extremely helpful, and those patients who are able to attend
outpatient therapy are encouraged to do so.
For patients who are unable to attend outpatient physical therapy, home physical therapy is arranged.
What is the usual response to rehabilitation after minimally-invasive (quadriceps-sparing) total knee replacement for knee arthritis?
No two patients are alike, and recovery varies somewhat based on the
complexity of the knee reconstruction, and the patient’s health,
fitness, and level of motivation.
Most people walk using crutches or a walker for 2 weeks, then use a cane for about 2 more weeks.
Most patients obtain and keep at least 90 degrees of motion (bending
the knee to a right angle) by a day or two after surgery, and most
patients ultimately get more than 110 degrees of knee motion.
Most patients can return to sedentary (desk) jobs by about 4 weeks;
return to more physical types of employment must be addressed on a
case-by-case basis.
Most patients are back to full activities--without the pain they had before surgery--by about two months after the operation.
Are there risks to rehabilitation after minimally-invasive (quadriceps-sparing) total knee replacement for knee arthritis?
This is a safe rehabilitation program with little risk.How long will rehabilitation after minimally-invasive (quadriceps-sparing) total knee replacement for knee arthritis need to be continued?
Once the range of motion and strength goals are achieved, the exercise
program can be cut back to a minimal level. But maintaining lifelong
fitness should be everyone’s goal!How long after minimally-invasive (quadriceps-sparing) total knee replacement for knee arthritis will patients be able to return to ordinary daily activities?
Most patients are walking unassisted following this procedure by about a two weeks after surgery (see video).
Most patients can return to desk work, at least for part days, by about a three weeks after surgery.
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After full recovery and rehabilitation from minimally-invasive (quadriceps-sparing) total knee replacement for knee arthritis, what are the limitations on the patient?
The goal of total knee replacement is to return patients to a high
level of function without knee pain. The large majority of patients are
able to achieve this goal. However, since the joint replacement
components have no capacity to heal damage from injury sustained after
surgery, we offer some common-sense guidelines for athletic, leisure,
and workplace activities:
Recommended:
- Swimming
- Water aerobics
- Cross-country skiing or Nordic Track
- Cycling or stationary bike
- Golf
- Dancing
- Sedentary occupations (desk work)
Permitted when the patient finds them comfortable:
- Hiking
- Gentle doubles tennis
- Gentle downhill skiing
- Light labor (jobs that involve driving, walking or standing but not heavy lifting)
Not recommended:
- Jogging or running
- Impact exercises
- Sports that require twisting/pivoting (aggressive tennis, basketball, racquetball)
- Contact sports
- Heavy labor
Since the joint replacement includes a bearing surface, which
potentially can wear, walking or running for fitness are not
recommended. Some patients feel well enough to do this, and so need to
exercise judgment in order to prolong the life-span of the implant
materials. Swimming, water exercises, cycling and cross country skiing
(and machines simulating it, like Nordic Track) can provide a high
level of cardiovascular and muscular fitness without excessive wear on
the prosthetic joint materials.
How can the costs of rehabilitation after minimally-invasive (quadriceps-sparing) total knee replacement for knee arthritis be anticipated?
The surgeon and therapist should provide the information on the usual cost of the rehabilitation program.Surgery for knee arthritis at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington
If you are interested in making an appointment to discuss this procedure in Seattle, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call the Bone & Joint Surgery Center at 206-598-BONE (2663) or Eastside Specialty Clinic at 425-646-7777 to make an appointment. Our clinical center is located in Seattle Washington, USA
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