Femoral or Tibial replacements

Rehabilitation for any type of femoral or tibial replacement will be different for everyone.  

Types of femoral or tibial replacement  

The femur and tibia are both bones in your legs. The femur is your thigh bone, and the tibia is your shin bone (lower leg).  

If you have sarcoma in these areas, you may have a femoral or tibial replacement. There are different types of replacements:  

• Diaphyseal replacement – this is the replacement of the midsection of the bone, either in the thigh bone or shin bone.
• Total femoral replacement – this is the total replacement of the thigh bone, hip joint, and knee joint with a prosthetic implant.  
• Proximal femoral replacement – this is the replacement of your hip and upper part of the thigh bone 
• Distal femoral replacement – this is the replacement of the lower part of the thigh bone and knee joint  
• Proximal tibial replacement– this is a replacement of your knee joint and shin bone with a prosthetic implant. You will likely need to be in a brace or cast for six weeks following this surgery.  

Hip precautions  

With total femoral replacements and proximal femoral replacements, you will need to limit how you move your hips. These are called hip precautions:  

• Do not bend your hip beyond a 90° angle. 
• Do not cross your legs or move your operated leg across the imaginary line down the centre of your body. 
• Do not twist your operated leg. 

Your OT will make sure you have the right equipment and setup at home to help you with these hip precautions.  

Physiotherapy for femoral or tibial replacement  

After your surgery, you’ll see a physiotherapist. This is usually the day after surgery. They’ll teach you exercises to do and help you to start walking with crutches or another walking aid. 

If you need to climb stairs regularly, your physiotherapist will teach you how to do this. You may still have some restrictions from the surgery though.  

Your physiotherapist will give you exercises to do at home after discharge. It is very important that you do these regularly to make sure you get the best possible outcome from your new joint. You will also be referred to ongoing physiotherapy as an outpatient as close as possible to where you live.  

Occupational therapy for femoral or tibial replacement  

An OT will see you if you have had a total femoral replacement, or a proximal femoral replacement. If you do see one, it will be while you’re recovering in hospital. They will help you by talking to you about how you can manage activities and daily life after leaving hospital.  

You might not need to see an OT if you had a distal femoral replacement or a proximal tibial replacement. Your physiotherapist will let you know if it’s needed.  

An OT can help you by:

• showing you techniques to be more independent with daily tasks  
• recommending equipment to help you at home  
• giving you advice about returning to work or school  
• giving you advice about returning to driving 
• helping you return to usual leisure activities.  

If you had a proximal femoral replacement, or a total femoral replacement, an OT can support with:  

• helping with hip precautions  
• showing you how to be independent with hip precautions  
• recommending equipment that is useful for hip precautions, for example long handled grabbers and sock aids.  

You might be referred to other members of the rehabilitation team too. Speak to your physiotherapist, clinical nurse specialist (CNS) or specialist about other forms of rehabilitation you might benefit from.