Knee surgeries are performed to address many different conditions affecting the joint and nearby areas. In the case of a traumatic injury like a serious fracture, surgery may be performed right away and there will be no time for prehabilitation. Under most circumstances, however, there is time to work with a physical therapist in anticipation of undergoing the surgery. Here is a list of knee surgeries that may benefit from a course of prehabilitation:

• ACL, PCL, LCL, MCL repair or reconstruction
• Arthroscopic Meniscectomy
• Meniscus repair
• Meniscus reconstruction
• Plica removal
• Lateral patellar tendon release
• Knee replacement
• Tendon repair
• Cartilage microfracture

If you decide to work with a physical therapist to help with knee prehab issues, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

PREHABILITATION FOR KNEE SURGERY

For those who elect to undergo knee surgery, there is often a period of waiting that occurs before the surgery is scheduled. While prehabilitation is not always required, it is often a great idea to work with a therapist during this time. In the case of ACL reconstruction, for example, it may be required by your surgeon to ensure the knee is in the right stage of healing to undergo surgery and to help improve postsurgical outcomes. The goal of a prehabilitation program is to target modifiable factors associated with long term outcomes and to prepare the patient for the recovery process. Four targets of a prehabilitation program for knee surgery often include:

• Restoring knee range of motion
• Improving muscle strength around the knee and in adjacent areas
• Increasing the level of activity prior to surgery
• Patient education

My team of physical therapists will guide you through this program to ensure your knee is responding appropriately. While every patient will be given an individualized treatment plan, here are some of the components we often incorporate into a knee surgery prehabilitation program:

Decrease swelling and restore range of motion

Trouble restoring full range of motion is one of the more common post surgical complications of knee surgeries, so establishing normal range of motion before the surgery is a way to help minimize this complication. Swelling and joint effusion can inhibit muscle activation which make it difficult to restore normal strength and motor control to the knee for return to normal activity. The use of ice, elevation, manual therapy techniques and compression may be used to reduce swelling.

Start a progressive exercise program

Patients often decrease their activity level in response to the knee symptoms that lead to their needing surgery. This makes logical sense as it reduces the likelihood that they will experience pain, swelling, stiffness and so forth, but it places them in a greater deficit going into surgery. This reduction in activity often leads to the development of muscle atrophy and decreased fitness levels. Working with a physical therapist prior to surgery can help you begin to restore your strength, coordination, fitness and neuromuscular control while controlling symptoms, so that your recovery after surgery takes less time. Additionally, your PT can help you find ways to restart a generalized exercise program without flaring up your symptoms which can help improve the health of your heart and lungs and improve blood flow for tissue healing.

Patient Education

The idea of surgery can be quite scary. Having an idea of what to expect after the procedure can ease some of your anxiety and help ensure you have what you need to support your recovery. Getting to know your physical therapist before surgery will help build trust with them when it comes time for post-operative care. They can also advise you on any equipment or modifications to your home that might be necessary, help you understand what kind of help or support you will need from others, and prepare you for how your body may feel after surgery

If you will be leaving the hospital with a shiny new walker, cane, or crutches, learning how to use them beforehand can be very helpful. Immediately post surgery, when you are still feeling the effects of anesthesia, and pain and stiffness are setting in, is not the best time to learn how to use an unfamiliar device that is meant to protect your recently operated-on knee.

WE SUPPORT YOU ON BOTH SIDES OF THE OPERATING TABLE

Prehabilitation for knee surgeries is an excellent choice for those wanting to get a head start on their recovery and to help improve their chances of a good surgical outcome. My team of therapists and I would love to help you prepare for your upcoming surgery. Call the office at Evolve today to get started.