Can Physiotherapy Be Started Before Knee Replacement Surgery?

If so, the Orthopedist sends the patient for observation and guidance by the physician of the Specialty of Physical Medicine and Rehabilitation (Physiatrist) to start the proper Physiotherapy even before the surgery. Starting the rehabilitation program in the preoperative phase is ideal in many patients with gonarthrosis.

To establish the Physiotherapy program, it is essential that the Physiatrist knows all the patient’s diseases and assesses possible pathologies at the level of other joints and arthrosis in the knee that will be operated on. It is necessary to target the joint range of this knee, the type and degree of its deformities, and the thigh muscles’ condition (especially the quadriceps).

The patient’s functional deficits should also be evaluated, such as if they need crutches to walk or support to get up from a chair. The other knee and both hips are also focuses of special attention and the patient’s gait pattern.

And After Surgery, When Should Physiotherapy Start?

After Knee arthroplasty (ข้อ เข่า เทียม which is the term in Thai), the Orthopedist sends all relevant surgical information to the Physiatrist, and close collaboration between these two medical specialties is essential to obtain the best results. The rehabilitation of a patient who underwent not only the placement of a knee prosthesis but also a total reconstruction of this joint, which also includes soft tissue surgery (ligaments, tendons, joint capsule), will be scheduled.

This aspect is essential when there was a relevant deficit in knee extension (flexed) and joint deformity (in valgum or varum) before surgery. The rehabilitation program is always adjusted to the reality of each patient.

The Therapy should be initiated immediately on the day following knee arthroplasty while the patient is still in the hospital. When the patient is discharged from the hospital and returns home, the physiatric treatment must be scheduled immediately.