Barring having a revision surgery if the alignment of the prosthesis is off; from a rehabilitation perspective, the most overlooked region for optimizing knee function is actually the hip. The alignment of the entire leg hinges on the hip. "Knock knees" is common in those with weakness in the external rotators and abductors of the hip, commonly known as the butt muscles. If the butt muscles are weak, the femur rotates inward causing the knees to knock togther or collapse towards each other. These muscles move the knees and legs apart at the hip.
Unfortunately, some surgeons believe that after a new part is slapped in place, rehabilitation or physical therapy is not needed once the part has adequate range of motion. However, the time leading up to the arthroplasty is when weakness develops as limb is favored and protected because of pain. Strengthening the entire limb (somtimes called a functional chain) is the key to success after most orthopedic surgeries.
Dr. Christina Lasich, MD