Total Knee Arthroplasy Protocol

Weeks 1-2

Goals

  • Diminish pain and swelling
  • Increase range of motion
  • Gait training and stair training
  • Get quads activated

Therapeutic exercise

  • Glut sets
  • Quad sets
  • Ankle range of motion
  • Seated or supine knee flexion range of motion (Heel slides, wall slides)
  • Straight leg raise
  • Side lying hip abduction
  • long arc quads or flutter kicks
  • Short arc quads
  • Standing hamstring curls
  • Heel raises
  • Anterior step up on to small 4" step
  • Side stepping at counter
  • Prone Hangs
  • quarter squats

Manual Therapy

  • Gentle patellar mobs all directions, emphasize superior glide
  • Posterior capsule stretch
  • Stretching of hamstrings and gastroc

Other

  • Keep heel propped up in extension with no support under back of knee as much as possible, no recliner
  • Ice 3-4 x/day

Weeks 3-6

  • Progress to independent walking and gait training
  • Half moons to full revolutions on the bike
  • Continue exercises as above and add ankle cuff weights as indicated
  • Cone high stepping or obstacle course
  • Single leg balance