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Sunday, August 16, 2015

Total Knee Replacement (OA Knee) Guideline

Total Knee replacement (Tukar Sendi lutut)


sorry I am so busy around this month, so just want to share a short info regarding a total knee replacement when we have a chronic Osteoarthritis (OA) at knee

OA is a chronic disease causing deterioration of the joint cartilage and the formation of new bone (bone spurs) at the margins of the joints,

Risk factor for OA knee:
  • - obesity
  • - age
  • -OA at other sites
  • - Previous knee trauma or injury
  • -Previous knee surgery
  • - Sex ( female)

Sign and Symptom
  •          -Pain
  •          -Morning stiffness
  •          -Reduced flexibility
  •          -Reduced ms strength and stability
  •          -Joint deformation ( genu valgum/ genu varus)
  •          -Reduced aerobic capacity

Mx of OA

Early stage:
Treated with
  • -nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Activity restrictions
  • Exercise        
  •  Bracing
  •  Orthotics
  •  Weight loss
  •  Injections of hyaluronic acid or cortisone

Chronic stage:
Surgery-When conservative measures fail & arthritic symptoms limit functional activity

Types of Knee replacement

     - most common type of artificial knee.
     - the artificial components inserted into the knee are not linked to each 

     - All the ligaments in knee will be removed during the surgery, this implant provides increasing stability for the knee.
Constraint or hinged
     - rarely used as a first choice of surgical options.
     - two components of the knee joint are linked together with a hinged
     -This type of knee replacement is used when the knee is highly unstable

Unicondylar knee replacement
            - replaces only half of the knee joint. It is performed if the damage is
         limited to one side of the joint only with the remaining part of the knee
         joint being relatively spared.

What Is Plan Of treatment in Physiotherapy ?
  • Mobility exs
  • Stretching exercise
  • Strengthening exs
  • Circulatory exs
  • Ambulation
  • Pt’s education
  • Discharge planning

Short Term Goals ( 1/52) (1 week)
- Improve ROM of Rt. LL. ( Rt. knee flexion at least 90 )
- Improve ms power of Rt LL from 3/5 to 4/5.
- Reduce swelling of Rt ankle.
- Independent indoor ambulation with walking frame.
- Able to lift up both buttocks during bridging.

Long term goal ( 2/12) (2month)
-Maintain muscle strength of all limbs.
- Prevent hamstring tightness.
-Able to ambulate outdoor independently with aid.


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