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