Total knee arthroplasty rehabilitation protocol: what makes the difference?

The goals of any rehabilitation protocol should be to control pain, improve ambulation, maximize range of motion,develop muscle strength, and provide emotional support. Over 85% of total knee arthroplasty (TKA) patients will recover knee function regardless of which rehabilitation protocol is adopted. However, the remaining 15% of patients will have difficulty obtaining proper knee function secondary to significant pain, limited preoperative motion, or the development of arthrofibrosis. This subset will require a special, individualized rehabilitation program that may involve prolonged oral analgesia, continued physical therapy, additional diagnostic studies, and occasionally manipulation. Controlling pain is the mainstay of any treatment plan. The program described herein has been used at the Ranawat Orthopaedic Center over the past 10 years in more than 2,000 TKAs.