Total Joint Replacement — Total Knee Arthroplasty (TKA)

Ohio State University Wexner Medical Center · L. Schmitt PT PhD; L. Tiemeier PT DPT; J. Walker PT DPT SCS OCS; K. Wayman PT…

Weight-Bearing

Goal D/C AD by post-op wk 3-6; criteria-based AD discharge (full active knee ext, strong quad iso with full tetany, 2x10 SLR without lag, effusion <=1+, 60 sec SLS, normalized gait)

Key Restrictions

DVT signs = refer directly to ED; mechanical block/clunk = refer to surgeon; lack of full knee ext by 4-6 wks = refer to surgeon; neuromuscular control is 1st priority before strengthening; cryotherapy 5x/day wk 1, 3x/day wks 1-6

Timeline & Phases

3 phases: Phase I (Day 1 - D/C of AD, 0-6 wks), Phase II (D/C AD - pain-free ADLs, 6-12 wks), Phase III (return to sport, 12-24 wks; only for patients returning to sport, requires MD clearance)

Notes

CPG format with protocol structure; ROM goals: flex 60-90 by 2 wks, 100 by 6 wks, 120 by 8-12 wks; NMES from POD 2 (10-20s on/50s off x 15 min); plyometric criteria: >80% strength, squat 150% BW, 200-250 foot contacts; return to run protocol with walk/run ratios; Forward Step Down Test appendix; aquatic therapy ~4 wks; driving 4-8 wks; extensive references

Surgeon / Author

L. Schmitt PT PhD; L. Tiemeier PT DPT; J. Walker PT DPT SCS OCS; K. Wayman PT DPT SCS; Reviewer: J. DeWitt PT DPT SCS AT

Published

December 2019