Adapted rehabilitation protocols for knee arthroplasty - Systematic review of the literature

Abstract

Total knee arthroplasty is a frequently met replacement procedure for patients with degenerative knee disease. The main purpose of the intervention is to provide pain relief and to promote range of motion and joint stability for patients in which conservative options such as pharmacological treatment or physical therapy can’t accomplish any more an adequate symptom alleviation. Most guidelines regarding the first stage of the rehabilitation process recommend early mobilization in order to gain as quickly as possible functional independence, and also to promote muscle strength and coordination. This should be done from the first day post surgery, depending on the patients compliance. In the subacute stage, the emphasis is put on maintaining a progression of the weight-bearing status, and promoting normal walking without the use of an assistive device. Patient education will be focused on changes that need to be made in a domestic environment and also modifications regarding social and professional activities. The third phase of the rehabilitation process focuses on limb symmetry and equal weight bearing which represent absolute objectives that need to be obtained. Balance exercises will include progression from bilateral to unilateral, and integration of unstable surfaces if possible associated with cardiovascular training. This phase of the rehabilitation process is considered to be completed once all realistic functional goals are achieved.