Physical Therapy: Partial vs Full Knee Replacement

In the world of Physical Therapy there are what are called "protocols." I think the protocols are supposed to be an outline of exercises, kind of a "one-size-fits-all" approach to healing the body from injury or surgery. Unfortunately, I think all too often they become a kind of mental crutch. There is a tendency to stop looking at each person as a unique set of variables,and just tick off the appropriate exercises, step by step.

It is because of these protocols that I did not continue with out-patient physical therapy with my first replacement. Every facility I called I asked if they had experience with PARTIAL knee replacement. The answer?  "Oh, yeah, we do knee replacement all the time." I kept thinking to myself that partial and full replacement are different surgically, and probably should be different in terms of recovery.

My first "proof"of my opinion was when I talked to my in-home therapist prior to my second partial knee: she informed me that in the past 6 months they had discovered that "active compression" of the knee was not good for the partial replacement patient.

So here's the disclaimer: I AM NOT A PHYSICAL THERAPIST, THESE ARE MY PERSONAL EXPERIENCES, HERE FOR YOUR HELP, NOT AS A REPLACEMENT FOR YOUR OWN THERAPIST/DOCTOR.

1. A lateral knee replacement needs to address the fact that the IT band has been disturbed, and will take 2-3 months to heal. Exercises that pull on it need to be approached gently.
2. Medial knee replacement the joint capsule has been disturbed, so short quad arcs, lying on your back with a pillow under the knee should probably be avoided, because they put extra pressure on that area,
3. Also heel slides for the medial knee may be too much pressure.
4. Both the heel slides and the short quad arcs can be replaced with a seated sliding back. And forth of the lower leg.

That's all my conclusions for the moment.


1 comment:

  1. UnknownJuly 15, 2020 at 7:42 PM

    Thanks so much for having taken the time and effort to create your blog. It contains so much helpful information, that I can't thank you enough.

    I've just had (one week ago) a partial replacement to the medial side of my left knee. Surgery and the Hospital stay was all very positive, but having come home, things seem to have gone steadily down hill. My entire leg seems weaker now, rather than just the knee and the therapy of gaining 90 degrees of flexion is horrid. I read your thoughts re heel slides for a medial and agree entirely. I'm better doing the seated sliding back (although painful) rather than the heel slides which create a lot of pressure.

    Thanks again, I will continue to refer back to your site for information and encouragement in my rehabilitation.

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