Total Knee Arthroplasty Physical Therapist Guide
Publication Date: June 16, 2020
Last Updated: November 8, 2022
Recommendations
Preoperative
Design preoperative exercise programs for strength and flexibility. (M)
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Provide education to patients undergoing TKA. (BP)
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Do NOT use continuous passive motion devices. (W)
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Postoperative
Encourage cryotherapy for pain management. (M)
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Teach importance of early mobility and appropriate progression of therapy. (BP)
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Include motor function training. (S)
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Implement passive, active assistive, and active range of motion exercises. (BP)
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Teach patients to position the operated knee in some degree of flexion (30 to 90 degrees), while resting to reduce blood loss and swelling in the first 7 days. (W)
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Use neuromuscular electrical stimulation. (M)
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Design, implement and teach high-intensity strength training and exercise programs within 7 days after surgery. (M)
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Provide supervised PT management, and determine the optimal setting by the patients’ safety, mobility, environmental, and personal factors. (M)
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Either group- or individual-based PT sessions. (W)
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Start PT Management within 24 hours of surgery and prior to discharge. (M)
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Provide guidance to the care team and patient on safe and objective discharge planning, patient functional status, assistance equipment, and services needed to support a safe discharge from the acute care setting. (M)
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Outcomes Assessment
Collect the KOOS JR (Table 2) as a patient-reported outcome measure and both the 30-Second Sit-to-Stand and Timed Up and Go tests to demonstrate the effectiveness of care provided. These should be collected at a minimum at the first visit and upon conclusion of care from each setting. (BP)
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Title
Physical Therapist Management of Total Knee Arthroplasty
Authoring Organization
American Physical Therapy Association
Endorsing Organization
American Academy of Orthopaedic Surgeons
Publication Month/Year
June 16, 2020
Last Updated Month/Year
July 10, 2023
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adult, Infant
Health Care Settings
Ambulatory, Long term care, Operating and recovery room, Outpatient
Intended Users
Physical therapist, occupational therapist, nurse, nurse practitioner, physician, physician assistant
Scope
Rehabilitation, Management
Diseases/Conditions (MeSH)
D019645 - Arthroplasty, Replacement, Knee, D010810 - Physical and Rehabilitation Medicine, D059825 - Physical Therapists
Keywords
physical therapy, TKA, Knee replacement, total knee replacement (TKR), total knee arthroplasty (TKA), PT
Source Citation
Diane U Jette, Stephen J Hunter, Lynn Burkett, Bud Langham, David S Logerstedt, Nicolas S Piuzzi, Noreen M Poirier, Linda J L Radach, Jennifer E Ritter, David A Scalzitti, Jennifer E Stevens-Lapsley, James Tompkins, Joseph Zeni Jr, for the American Physical Therapy Association, Physical Therapist Management of Total Knee Arthroplasty, Physical Therapy, , pzaa099, https://doi.org/10.1093/ptj/pzaa099