What is a Total Knee Replacement?

An orthopaedic procedure where the articular surfaces (end of the bone) of the femur (thigh bone) and tibia (shin bone) are replaced.

A polyethylene piece is placed between the tibia and femur as a shock absorber.

In about half of cases the patella (kneecap) is also replaced.

Why get one?

The main reason people have a knee replacement is that they have most commonly over a period of time noticed

  • Increased pain at the knee joint that in the latter stages can affect sleep at night time
  • Decreased mobility to the point that they may require use of a walking aid

Outcomes anticipated from a TKR (Total Knee Replacement) are:

  • Reduction in pain
  • Increase in Function

The most common cause of this is OA (Osteoarthritis). This is where the cartilage of the joint becomes damaged and is unable to absorb the shock as well as a healthy joint.


The knee joint is made up of the Femur and Tibia with another joint at the front called the patellofemoral joint (Kneecap) encompassing the patella.

The knee is a modified hinge joint. The main movement is flexion and extension along with small amounts of internal and external rotation.

There is a thin layer of cartilage at the end of the bones and also the shock absorbers in the knee known as the cartilage.

There are large ligaments supporting the knee joint some of which are

  • ACL (Anterior Cruciate Ligament)
  • PCL (Posterior Cruciate Ligament)
  • MCL (Medial Collateral Ligament)
  • LCL (Lateral Collateral Ligament)

Who is more likely to have a knee replacement?

Risk factors that can increase your chance of a knee replacement are

  • Previous knee surgery (often to remove meniscus)
  • Previous Fracture
  • Rheumatoid Arthritis
  • Overweight

Knee Surgery/ Knee Operation:

The surgery can take about an hour and most frequently is under general anesthetic.
The actual replacement has 3 parts

Femoral Component
Tibial Component
Polyethlene shock absorbent disc
The most appropriate size and shape of the prosthesis is chosen on a patient by patient basis.

When does Physiotherapy Play a Role?

Pre Surgery:

Physiotherapy can provide you with

  • Exercises to maximise the strength in the muscles pre-operatively
  • Show you the exercises that you will be doing post surgery to ensure that you are aware of the correct technique

Post Surgery:

  • Get you up and moving within 24-48 hours of surgery
  • Strength exercises
  • Balance exercises
  • Gait Re Education
  • Increase ROM (Range of Movement)
  • Decrease Pain

Examples of common exercises post Total Knee Replacement:

  • Ankle movement exercises
  • Knee ROM exercises e.g. heel slide into Knee Flexion/extension
  • Quadricep Strengthening exercises e.g. straight leg raise
  • Hamstring Strengthening exercises e.g. Bridging

All of our team at East Cork Physiotherapy, Balance & Acupuncture Clinic have vast experience dealing with Total Knee Replacements so if you need any advice please do not hesitate to contact us.

If you would like more information, please contact us on 021 4633455 or you can book an appointment online by clicking here

We hope you enjoyed today’s blog by Kevin O’Brien, Chartered Physiotherapist.