Monday, September 27, 2010

Total Knee Replacements




Total knee replacement (TKR) is a surgical procedure that involves replacing the femoral, tibial, and often, the patellofemoral surface with metal and plastic to protect the articular surfaces of the bone so that integrity of the joint is maintained. Strength and fitness are two major issues facing TKR patients. While rehab is intensive following surgery, it only lasts a few weeks. Considering most people who undergo a TKR are over 65, general fitness is usually low in this age group.
The goal after a TKR is the return of pain-free functioning. Research has found that return to activities of daily living can be difficult as strength and function in TKR patients are significantly decreased without continued exercise. Low-intensity exercising, such as walking, cycling and stair-climbing, should be implemented before surgery and following the rehab process so that cardiovascular fitness and strength in the lower limbs can be maintained/increased. Strength exercises such as aquatic resistance training and lower-limb exercises should also be undertaken so that the muscles surrounding the knee joint are able to be strengthened, pre- and post-surgery.
General fitness and strength can greatly improve patient outcomes when planning to undergo a TKR. This improved fitness also increases the odds of a complication-free operation. An exercise intervention before illness occurs also decreases the risk of needing surgery in the first place. Even though there are many contraindications following a TKR, exercises that produce low biomechanical forces across the joint, such as the ones mentioned above, is an excellent way to maintain fitness and strength at any age.

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