Ace Physiotherapy and Sports in Singapore
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ACE PHYSIO SPORTS
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Knee Replacement
Total Knee Replacement
A total knee replacement is a surgical procedure in which the damaged parts of a diseased knee joint are replaced with an artificial implant. This surgery helps relieve pain, restore stability, and improve overall knee function. To achieve the best long-term results, it is essential to follow your knee replacement with a comprehensive and ongoing physiotherapy programme. Physiotherapy plays a vital role in ensuring the success of the surgery and helping you regain full or near-full function of your knee.
The knee joint is formed by the lower end of the thigh bone (femur) and the upper end of the shin bone (tibia), with the kneecap (patella) positioned at the front to provide protection. The ends of these bones are covered with smooth, shock-absorbing cartilage that allows the joint to move freely and efficiently without friction. However, this cartilage can become worn down or damaged due to conditions such as osteoarthritis, trauma, or other degenerative diseases of the knee joint. When this occurs, movement becomes painful and restricted, often leading to stiffness and loss of function.
A total knee replacement can help relieve symptoms such as pain, stiffness, and reduced mobility in the knee joint. Depending on the extent of joint damage, surgery may involve either a partial or total knee replacement. In most cases, a total knee replacement is performed, as it provides greater long-term relief and improved function for severely damaged knees.
During a total knee replacement, the damaged ends of both the thigh bone (femur) and the shin bone (tibia) are replaced with artificial components, and in some cases, the back surface of the kneecap (patella) is also resurfaced. The procedure is performed under general anaesthesia. The surgeon begins by making an incision down the front of the knee to expose the joint. The patella is gently moved aside to provide access to the knee joint, where the damaged bone and cartilage from the femur and tibia are carefully removed and reshaped to fit the artificial implants precisely.
Once the bones have been precisely shaped, the surgeon drills a small hole into the top of the shin bone (tibia) to fit a flat metal cap attached to a stem. A curved metal component is then secured to the lower end of the thigh bone (femur). In some cases, the back surface of the kneecap (patella) is also replaced with a smooth plastic component — a process known as patella resurfacing. Each implant is carefully fixed in place using a special medical-grade bone cement. A durable plastic spacer is then inserted between the metal components to act as artificial cartilage, allowing the new knee joint to move smoothly and reducing friction during movement.
Finally, once the damaged joint surfaces have been successfully replaced with artificial components, the surgeon closes the incision using either stitches or surgical clips, and a sterile dressing is applied to protect the wound. In some cases, a knee splint may be used in the early stages after surgery to provide additional protection and to help keep the joint stable and immobile while initial healing takes place.
A total knee replacement is often necessary when severe pain, stiffness, and loss of function occur due to osteoarthritis, trauma, or other degenerative conditions affecting the knee joint. When performed successfully, a knee replacement can provide long-lasting relief and improved mobility, with most implants lasting between 10 to 15 years. The longevity of the replacement depends on several factors, including your age, surgical outcome, body weight, activity level, and most importantly, your commitment to a structured physiotherapy programme.
Physiotherapy before total knee replacement
Before undergoing total knee replacement surgery, it is highly recommended to participate in a personalised pre-surgery physiotherapy programme with acephysiosports.com . Prehabilitation helps prepare your body for surgery and can significantly reduce recovery time afterward. Your physiotherapy sessions will focus on strengthening the muscles surrounding the knee, as well as the supporting muscles in your hip, ankle, and unaffected leg. Maintaining and improving your knee’s range of motion before surgery is equally important, as it ensures your joint is in the best possible condition for a smoother and more successful surgical outcome.
Symptoms after total knee replacement
Immediately after your total knee replacement surgery, it is normal to experience pain, swelling, and stiffness in the knee joint, along with a temporary reduction in movement and muscle strength. You will be encouraged to stay mobile soon after surgery, using elbow crutches or a walking frame to assist with walking for the first few days. Depending on your condition, you may be allowed to bear partial or full weight on your operated leg as tolerated. In some cases, a continuous passive motion (CPM) machine may be used to gently move your leg while you are resting in bed. This helps improve circulation, reduce swelling, and restore movement in the knee joint. The typical hospital stay after a total knee replacement is around 6 to 10 days. Most patients can resume driving once they are able to bend their knee comfortably and operate the pedals without pain — usually around 6 weeks after surgery. Returning to work typically occurs between 6 to 12 weeks, depending on the physical demands of your job. Physiotherapy begins immediately after surgery and continues for an extended period to ensure full recovery, improved strength, and long-term joint function.
Physiotherapy after total knee replacement
It is essential to begin an intensive physiotherapy programme immediately after your total knee replacement to ensure the success of your surgery and to restore full or near-full function in your knee. Early and consistent physiotherapy also helps promote long-term joint health and extend the lifespan of your knee replacement. Physiotherapy with acephysiosports.com focuses on preventing post-surgical complications, improving mobility, and supporting a smooth and effective recovery process.
Early stages (1-3 weeks)
During the early stages of your rehabilitation with acephysiosports.com , your physiotherapy programme will focus on controlling pain and swelling, maintaining and improving the range of movement in your knee, and beginning to strengthen the surrounding muscles. You will also perform exercises to strengthen your ankle, hip, and opposite leg to provide additional support for your operated knee. As your recovery progresses, your physiotherapist will guide you through partial to full weight-bearing exercises as tolerated. Your early-stage physiotherapy programme may include:
- Gentle range of motion exercises to maintain flexibility in the knee joint
- Static quadriceps and hamstring contractions to rebuild strength
- Ankle pumps and circles to improve circulation and reduce swelling
- Gluteal and hip strengthening exercises for better leg stability
- Partial to full weight-bearing exercises under supervision
- Use of walking aids (elbow crutches or walker) for safe mobility
- Education on correct posture and gait techniques
- Breathing and circulation exercises to aid overall recovery
Middle stages (3-6 weeks)
After about a month following your total knee replacement, your physiotherapy programme with acephysiosports.com will aim to build upon and progress the exercises and activities introduced in the earlier weeks. Physiotherapy will continue to focus on managing any remaining pain and swelling while gradually improving your overall knee function. At this stage, your treatment will emphasise gait re-education, balance and proprioception training, increasing flexibility and range of motion, and further strengthening the muscles surrounding the knee joint for improved stability and control. Your physiotherapy programme may include:
- Advanced strengthening exercises for quadriceps, hamstrings, and hip muscles
- Balance and proprioception training using wobble boards or balance pads
- Gait re-education to correct walking patterns and improve confidence
- Functional training to assist with daily activities like climbing stairs and squatting
- Stationary cycling or low-resistance exercises to enhance joint mobility
- Progressive flexibility and stretching exercises for the knee joint
- Pain and swelling management through ice therapy or gentle massage techniques
- Continued education on posture and safe movement strategies
Later stages (6-12 weeks)
As you progress into the later stages of your rehabilitation with acephysiosports.com , your physiotherapy programme will continue to build on the strengthening and stretching exercises from previous weeks. The focus will now be on achieving a full range of knee movement, refining gait patterns, and enhancing balance and proprioception to restore normal movement and stability. At this stage, your physiotherapy will also include cardiovascular conditioning to improve overall fitness, as well as functional and hobby-specific exercises tailored to your individual lifestyle and goals — ensuring you can safely and confidently return to your regular activities. Your physiotherapy programme may include:
- Advanced lower limb strengthening and endurance training
- Full range of motion and flexibility exercises
- Gait re-education and walking pattern correction
- Balance and proprioceptive training using dynamic exercises
- Low-impact cardiovascular exercises such as cycling or treadmill walking
- Functional retraining for daily activities (e.g., stairs, squatting, bending)
- Sport or hobby-specific drills to support a safe return to your chosen activities
- Ongoing education to promote joint protection and long-term knee health
3 months onwards
After three months, your physiotherapy programme with acephysiosports.com will continue to focus on strengthening and stretching the muscles around your replaced knee, as well as your hip, ankle, and opposite leg to ensure balanced support and function. You will also keep progressing your cardiovascular fitness, balance and proprioception, range of movement, and functional activities that reflect your daily and recreational goals. The success and rate of your rehabilitation following total knee replacement will largely depend on your commitment and adherence to your prescribed physiotherapy programme. Regular follow-up and consistent effort are essential to achieve optimal results, full independence, and long-term joint health.
Summary
Total Knee Replacement is a surgical procedure designed to replace the weight-bearing surfaces of the knee joint, relieving pain and disability caused by conditions such as severe osteoarthritis, trauma, or degenerative diseases. Undergoing total knee replacement can significantly reduce pain, restore movement, and improve knee function, helping you regain mobility and independence. Following surgery, a comprehensive physiotherapy programme with acephysiosports.com is crucial to ensure the success and longevity of your knee replacement. Our physiotherapy approach focuses on restoring strength, flexibility, and balance, while preventing complications and improving long-term outcomes. With dedicated commitment to your personalized rehabilitation plan, you can achieve pain-free, functional movement and return to your everyday activities with confidence. For expert post-surgery physiotherapy and rehabilitation, visit acephysiosports.com or call +65 81535374 to book an appointment today.
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