1. Jose S. Santiago M.D.

2. Total Knee Replacement Total Knee Arthroplasty- surgical procedure to replace the weight-bearing surfaces of the knee joint - the joint surfaces of the knee are replaced with metals, ceramics, or plastics

3. Total Knee Replacement Main indication for surgery- to relieve disabling pain caused by severe arthritis Some types of arthritis: 1. Osteoarthritis- age-related “wear and tear” type of arthritis 2. Rheumatoid Arthritis- synovial membrane surrounding the joint becomes thick, stiff and painful 3. Post-traumatic Arthritis- caused by serious knee injury

4. Total Knee Replacement

5. Role of the Physical Therapist after surgery: 1. Range of Motion exercises 2. Protected weight-bearing using crutches, walker and cane 3. Continuous Passive Motion (CPM) using a CPM machine

6. Total Knee Replacement Three days after the surgery of the knee joint, Mr. Smith was instructed to get continuous passive movement and crutch walking in the Physical Therapy room.

7. P: Patient T: Therapist P: Hello. ________. T: The doctor has _____ continuous passive movement and crutch walking for you. P: What is _____________? T: It is an instrument in which your _______ will be placed and the range of the joint and repetition count is fixed. This machine ____ only the fixed range for the fixed number of times.

8. P: Patient T: Therapist P: Okay. How long will I do that? T: For _____. After that I will _____ you how to use the crutches. It is possible to walk with crutches today. P: Is it possible to ____ right now? T: Yes, it is possible. I will ____ your lower ______ in the CPM machine now. Do you feel any ____?

9. P: Patient T: Therapist P: Yes, I feel a little ____ when my knee is _______? T: Okay. I will adjust it. After sometime: T: Now we will ____ with the crutches. P: Well, can I ____ without the crutches?

10. P: Patient T: Therapist T: No. If you walk without the crutches, it will give _______ on the incision site and it may cause ______ and _______. P: Oh, I see. T: I’ll _____ how to walk with the crutches. First keep the _____ side crutch in front one step and then take one step on your _____ leg.

11. P: Patient T: Therapist T: Then keep the ____ side crutch in front one step and then take one step on your ______ leg. Do this alternately. P: But that is so easy. T: Yes. Do not press the crutches over the _____. Give power on your hands. P: Like this? T: Yes, you are right.

12. P: Patient T: Therapist P: Can I ____ alone? T: Yes, but there should be a guide _____ you always. P: Okay, sir. T: I will _____ you now. P: How ____ should I walk? T: We will go up to the _______. P: Yes.

13. P: Patient T: Therapist T: If you feel any _______ let me know. P: Okay. T: Yes. We ________ with the treatment now. See you ______. P: Thank you.