Korean Medicine Care Before and After Total Knee Replacement
Table of Contents
When knee replacement surgery becomes necessary
When knee osteoarthritis progresses to Kellgren-Lawrence Grade IV, with the joint space almost lost, and night pain and walking impairment persist despite conservative treatment (medication, physical therapy, Korean medicine), total knee replacement (TKR) is considered. However, in Grade II–III, conservative Korean medicine treatment can substantially delay the timing of surgery.
Conservative Korean medicine strategy before surgery
- Acupuncture and pharmacopuncture: Bee venom pharmacopuncture is administered at painful points around the joint to suppress synovial inflammation and normalize joint-fluid secretion.
- Herbal medicine: Dokhwalgisaeng-tang and Gwanjeoldan slow cartilage matrix breakdown and preserve joint lubrication.
- Chuna manipulation: Gentle traction-style chuna widens the tibiofemoral joint space and disperses mechanical loading.
- Weight management: Losing 5 kg reduces the knee load by about 20 kg, improving pain by one full grade even without surgery.
Acute postoperative care (weeks 1–2)
Immediately after surgery, severe swelling and warmth appear around the knee. Administering a modified Dangguisu-san during this period accelerates blood-stasis clearance and swelling reduction. Acupuncture distal to the surgical site (ankle and foot) improves lower-limb venous return and helps prevent deep vein thrombosis (DVT).
Range-of-motion (ROM) recovery (weeks 2–6)
The goal after TKR is to achieve flexion of 120 degrees or more through gradual mobilization. Chuna manipulation that induces patellar gliding and joint-capsule release prevents adhesions and accelerates ROM recovery. Electro-acupuncture supports neuromuscular activation of the quadriceps.
Strength recovery and return to daily life (6 weeks–3 months)
Tonic herbal medicine (deer antler, Dipsacus, Achyranthes) promotes tissue healing at the surgical site, while quadriceps and hamstring strengthening exercises are carried out in earnest. Gait pattern is corrected so that loading is distributed evenly across the prosthesis. Most patients regain the ability to walk without a cane within 3 months.