Case Study – Total Knee Replacement Prehab

July 9, 2018 | By | Reply READ MORE...

Total Knee Replacement Surgery is a surgery where a diseased / severe arthritic knee is replaced with artificial material (metal and plastic components). It is done in severe arthritic knee joint to reduce the severe pain and improve quality of life with more severe functional impairment.

Prehab includes exercises done before surgery that helps reduce the functional decline after surgery. It helps in shortening the rehabilitation process post surgery.

Mrs. Swati (Name changed) , 50 years old F, came to PHYSIOREHAB with pain in the left knee planning to undergo Total Knee Replacement (TKR). She came to PHYSIOREHAB for prehab.
On the first day, her complains were

  • Pain in the left knee 8-9/10 which increases while standing, walking, descent of stairs more than ascent.
  • Pain in the lateral aspect of thigh till the knee.
  • Constant pain making it difficult to do her Activities of Daily Living (ADLs).

On assessment, following were the findings:

Subjective:

  • Antalgic gait
  • Swelling in the left knee (medial>lateral)

Objective:

  • Tenderness
    • Medial joint line more than lateral joint line
    • Over the patella
  • Overall weak muscles of the lower limb.

X-ray findings were as follows:

  • Sclerotic margins were seen.
  • Osteophytes over the femur and patella.
  • Medial joint space reduced significantly.
  • Patellofemoral joint space reduced significantly.

Here in PHYSIOREHAB she was explained in detail the cause of pain and importance of muscles in supporting the knee joint. She was also explained how PHYSIOREHAB can help her for the preparation pre-surgery.

Based on the assessment a tailor made program was made so that she can do her ADLs with ease and for preparing the knee joint for surgery.

Initially for first 2 days focus was given for reduction of pain using release and various modalities. Post that exercises were started for muscle strengthening and pain was managed simultaneously. She used to come thrice in a week. Within 2 weeks she had 70% reduction in pain and was confident in her ADLs including walking. She used to do her set of home exercises given to her as home program and also swimming for 1-1.5 hours regularly.

cs_total-knee-replacement-prehab-01

Post one month there was 80% pain reduction and functional exercises were started with her. Now she was much confident while walking with no pain during standing and walking and reduction in pain during staircase. Also care was taken of her back as she had reduction in disc spaces of L5-S1 region. Now she used to come twice in a week.

cs_total-knee-replacement-prehab-02

cs_total-knee-replacement-prehab-03

Post 2 months she was having pain only sometimes after exertion. Able to do staircase pain free. Advanced forms of exercises were started using the reformer. Now she is continuing once a week.

This is what she has to say:

I remember the first day visit to Dr. Anjana’s PHYSIOREHAB with single agenda to make my muscles strong enough and prepare me for Total Knee Replacement Surgery. Over the various sessions I had I must acknowledge that my objective is almost achieved. I am happy to state that my knee pain is reduced very much. I AM THINKING TO AVOID TKR ALTOGETHER. I appreciate Dr Vishakha’s smiley face, her helpful nature, patience and above all wonderful human being that have helped me to achieve success in performing challenging task and exercise daily.

Thank you Dr. Shinee, Dr. Vishakha and PHYSIOREHAB once again and wish all the best.

Tags: , ,

Category: Case Studies

Leave a Reply