top of page

What to Expect After a THR or TKR

By Sheila Borgen, PT

As we age, our joints become worn out. Some people’s joints get so worn out that they are no longer able to function and live life successfully. When the quality of life becomes negatively altered, the option of having a joint replacement may arise. Two common joint replacements include a total hip replacement (THR) and a total knee replacement (TKR).

Let’s take a look at a total hip replacement and the journey to recovery. Simply put, a THR occurs when the damaged bone and cartilage are removed and replaced with a prosthesis. The outcome is excellent with pain relief being experienced by 90% or more people. In addition, the replacement has a lifespan of up to 20+ years.

There are two approaches for hip replacements, an anterior approach, and a posterior approach. Each approach has different precautions post-surgery which will be explained by the doctor. Some precautions include not bending over to tie your shoes and not crossing your legs. Others include not stepping backward with the surgical leg.

The most important component of a THR is physical therapy intervention. The physical therapist will educate you and emphasize your specific precautions. The therapist will guide you through each level of exercise beginning with simple ankle pumps to keep blood moving and prevent blood clots. More advanced exercises, such as walking on uneven terrain and balance challenges on specialized foam will occur later.

The knee is the largest joint in the body. When it becomes damaged from arthritis or trauma, it will become difficult to walk, climb steps, and even get in and out of a car. The pain from performing these activities may lead to a TKR. Surgically, the damaged cartilage will be removed, and a metal implant will be inserted to resurface the joint. A medical spacer is also placed to create a smooth gliding surface.

Total knee replacements are just as successful as total hip replacements. The pain is significantly reduced in most cases and the ability to return to an active lifestyle is only a few short months away…..when physical therapy is utilized appropriately.

Just as after a total hip replacement, the therapist will begin treatment with seemingly simple exercises including ankle pumps to prevent blood clots and heel slides to begin bending and straightening the knee. The focus of all exercises will be aimed at improving range of motion to the knee joint, that is the ability to bend and straighten the knee fully.

There is a protocol that will be followed by the therapist that will move you through each stage of recovery with the ultimate goal of returning to an active and satisfying lifestyle.

It is critical that you actively participate in physical therapy following a knee replacement. Why?

1.   The lack of a rigid exercise program can lead to scar tissue adhesions which may lead to painful manipulation or a return to the surgery suite.

2.   Surrounding tissues and muscles may begin to atrophy.

3.   The healing process will be slowed down.

4.   Range of motion will be diminished.

5.   Chronic pain.

6.    Muscle weakness.

I cannot reiterate how important physical therapy intervention is after a joint replacement. Without a trained therapist guiding you through your recovery process, injury could occur, or too little progression could lead to more pain and physical inability than you had before surgery. With an educated therapist by your side, you have a high chance of regaining lost function and returning to activities that you have only dreamed about for quite some time!

5 views0 comments

Recent Posts

See All


bottom of page