Weight bearing status:
- Most knee replacements are weight bearing as tolerated, unless otherwise indicated. Progression to a cane and then to unassisted ambulation at therapist’s discretion.
Exercises:
- Active range of motion: yes, encouraged.
- Active assisted range of motion: yes.
- Passive range of motion: yes, aggressive as tolerated.
- Resistive: yes, beginning at 3 – 4 weeks after surgery, prefer closed-chain exercises. Limit hamstring exercises to 10 pounds, quadriceps to 10 – 15 pounds.
- Closed chain exercises: yes.
- Stationary Bike: yes, beginning at 3 – 4 weeks after surgery.
- Prone lying to promote extension: yes.
- Standing exercises: yes.
Additional Information:
- Patellar mobilization: yes.
- Scar massage and desensitization: yes, at 4 – 6 weeks.
- Rolling: as tolerated, to operative and non-operative side.
- CPM machine: only in limited circumstances such as contracture.
- Shower: OK to wash incision at 2 weeks, no tub or pool until 6 weeks.
- Pool therapy: OK to begin at 6 – 8 weeks.
- Neuromuscular e-stim: yes, at 3 – 4 weeks, as needed.
Recreational Activities:
- Swimming/pool: 6 – 8 weeks, provided scab is gone and scar has developed.
- Golf: 4 – 6 weeks (chip/putt/short irons), 6 – 8 weeks (long irons/woods).
- Bicycle: 8 weeks
- Bowling: 12 weeks
- Driving: 3 – 4 weeks, discuss in clinic.
Total Knee Physical Therapy Protocol
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