Total Knee Arthroplasty — (TKA)

Mammoth Orthopedic Institute / Mammoth Hospital PT · Karch MD; Lance Georgeson MPT

Weight-Bearing

WBAT — wean walker to crutches to cane; no torque or twisting forces

Key Restrictions

ROM 0-90 deg by wk 2; 0-120 deg by wk 6 (MUA considered if not achieved); max 130 deg at all times; CPM NOT standard care at Mammoth Hospital; micro current dressing dry until 14-day post-op visit; avoid pillow under knee; observe for DVT/infection signs

Timeline & Phases

4 phases: Phase I (0-2 wks, WBAT wean devices, ROM 0-90 deg, NMES PRN, short crank bike), Phase II (2-6 wks, ROM 0-120 deg, mini squats/step ups/balance, full revolution bike at 110 deg), Phase III (6-12 wks, ROM to max 130 deg, eccentric/concentric CKC, progressive walking), Phase IV (3-5 months, return to prior function, golf/tennis/hiking, advance balance/proprioception)

Notes

Karch MD 9/1/25 (most recent Mammoth protocol in database); CPM machine explicitly NOT standard care at Mammoth Hospital; MUA considered if 0-120 deg not achieved by wk 6; references Karch TKA protocol 2015 and Brigham and Women's Hospital TKA protocol; Lance Georgeson MPT 9/1/25

Surgeon / Author

Karch MD; Lance Georgeson MPT

Published

September 2025