Bed position: the patient's knee is immobilised in an orthopaedic knee brace for about 48 hours, until the drainage tubes are removed.
Re-education is carried out by a rehabilitation therapist, following a protocol jointly agreed by both the orthopaedics and physiatrics Teams.
The treatment includes a sequence of phases the duration of which varies according to the patient's general conditions and the condition of the adjacent and heterolateral joints.
From the first day: flexion and extension of the tibio-tarsal joint + isometric exercises of the quadricepts and gluteus muscles.
From the 3rd day: passive mobilisation begins (and mechanical as well, with the FISIOTEK machine) + isometric exercises; the patient also begins a very careful active flexion exercise of the knee (sliding the heel). Sitting position with lower limbs outside the bed.
From the 4th day: flexion and extension exercises of the knee against gravity can begin. Muscle strengthening exercises continue.
From the 5th day: gradual increase of the load (walker, parallel bars, anti-brachial supports).
When the patient achieves a certain degree of stability using crutches, he/she will start practising climbing and going down the stairs: while climbing, he/she will put the healthy leg forward, while coming down, he/she will put the operated leg forward.
The patient is generally discharged from the hospital after 10-12 days.
When at home, the patient will have to repeat the muscular strengthening exercises he/she learned in the hospital, various times a day.
When it is possible, the use of a stationary bike is highly recommended: at the beginning, we suggest raising the seat so that the leg can easily make a whole rotation of the pedal, even though the operated leg still suffers some functional impediments.
The following days, the seat can be gradually lowered, in order to improve the bending ability of the hip.
We suggest the patient leave the first crutch, the one for the operated leg, when he/she is capable of maintaining the monopodalic support on the operated leg without suffering any unbalance of the hip. The second crutch can be left later on, when the patient is able to walk correctly.
From the 20th day: Re-education in the water can begin (hydrokinesitherapy).
The load is gradually increased up until the 60th day.
Usually, from the 60th day, the patient is allowed to walk normally.