Total Knee Replacement: Returning to Activity

• Special Equipment
• Exercises After Total Knee Replacement

Special Equipment

With total knee replacement, you'll probably have to use special equipment during your hospital stay.

Polar Care Machine
Cold therapy cools your joint and decreases pain and swelling after surgery of the knee.

Continuous Passive Motion (CPM) Machine
To restore movement in your knee and leg, your surgeon will use a knee support that slowly moves your knee while you are in bed. The device is called a continuous passive motion (CPM) exercise machine.

Knee Immobilizer Brace
You will be wearing a knee immobilizer brace whenever you get out of bed to walk while your femoral nerve block is in place.

Exercises After Total Knee Replacement

Continuous Passive Motion (CPM)
This machine moves your knee slowly while you are in bed.

To use it, follow these instructions:

• Be sure the machine is in its straightest position (0°) before trying to move your leg into or out of the unit.
• When putting your leg in the machine, be sure your foot is against the foot plate and your knee is right above the bending joint of the machine.
• After placing your foot in the boot, fasten the Velcro strap.
• Fasten the thigh strap. Make sure the soft side is against your skin.
• The flexion and extension numbers should be adjusted by the physical therapist only.

Quadriceps Setting
This is a good beginning exercise as it strengthens the quadriceps muscle and helps increase your ability to straighten your knee. Be sure to do this with both legs because both legs will be weakened after the procedure. Try to do this exercise several times every hour, but keep in mind your level of comfort will determine how many repetitions you do.

• Lie in bed with your legs straight. Tighten the muscle at the front of the thigh as you press the back of your knee down toward the bed.
• Hold for a few seconds. Then relax for a short period. Repeat 10 to 20 times for each leg.

Terminal Knee Extension
This exercise also helps promote muscle activity and increases knee extension. It should be repeated 10 to 20 times.

• While lying in bed place a pillow or rolled-up towel under the operated knee to raise the knee joint to about a 40-degree angle from full extension.
• Tighten the quadriceps muscle and straighten the knee by lifting the heel off the bed.
• Hold this position for 5 to 10 seconds, then slowly lower the heel to the bed.
• Repeat 10 to 20 times.

Heel Slides (Knee Flexion)
This exercise will promote muscle activity of the hamstrings and increase the flexibility of your knee.

• While lying in bed on your back, keep your legs straight and together and your arms at the side.
• Slide the heel of your operated leg toward your buttocks while keeping it on the bed. Move it as far as you comfortably can.
• Hold this position to a count of 10 then return slowly to the starting position.
• Repeat 10 to 20 times.

Straight Leg Raising
This is another excellent exercise to promote strength in the quadriceps and the flexor muscles. Both of these will help you walk.

• Lie in bed on your back. Bend the non-operated leg, raising the knee and keeping the foot flat on the bed. Keep your operated leg straight on the bed.
• Lift your straight leg about 6 to 10 inches off the bed. Hold this position for operated to 10 seconds, then lower the leg slowly to the bed.
• Repeat 10 to 20 times.

Pillow Squeeze
This is a good exercise to help strengthen the hip abductors, or groin muscles.

• Place a pillow between the knees (or slightly above the knee joint line if pressure at this area is uncomfortable).
• Squeeze the pillow and hold for a count of 10.
• Relax for a short period.
• Repeat this exercise 10 to 20 times.

Note: Continue your pre-op Upper Body Strengthening Exercises.