What is a key rehab priority early after total knee arthroplasty?

• A. Ankle ROM exercises
• B. Early knee ROM and quadriceps strengthening
• C. Hip adductor strengthening
• D. Passive ROM for 6 weeks

Answer: (B)

Restoring knee motion and activating the quadriceps early after total knee arthroplasty is the main focus because these steps lay the foundation for function and help prevent common post-surgical problems. Gaining knee ROM soon reduces the risk of scar tissue buildup and knee stiffness, supports proper patellar tracking, and makes activities like walking smoother.

At the same time, early quadriceps strengthening counters pain- and swelling-related inhibition of the extensor mechanism, rebuilds knee control in stance, and lowers the chance of extensor lag or knee collapse during movement. In practice, you start with pain-free knee range-of-motion exercises (for example, gentle heel slides or active-assisted ROM) and progressive quadriceps activation (quad sets, straight leg raises with the knee extended). As healing allows, you advance to active ROM and functional strengthening. While ankle mobility and other areas contribute to overall rehab, they don’t address the key early needs of knee motion and quad control as directly. Prolonged passive ROM alone is not ideal, since early muscle activation supports better long-term outcomes.