Total knee replacement | What to expect
Knee replacement surgery is a routine surgical procedure. Despite this, it’s a major undertaking and it’s only natural that you are likely to have some questions or concerns about the road ahead. Physiotherapy plays a crucial role in facilitating a smooth recovery following a knee replacement therefore we are well placed to guide you though what to expect over the coming days, weeks and months. This guide will cover what to expect on the day of surgery and highlight the milestones that you can expect to achieve over the subsequent months.
Total knee replacement- What to expect in the first few days
Knowing what to expect on the day of your surgery and the immediate days following can help you to feel prepared and ease any apprehension you may feel leading up to it.
On the day of knee replacement surgery, you can expect to begin physiotherapy shortly after the procedure. This will involve simple exercises to get the knee moving and to ‘wake up’ the key muscles that support the knee.
As soon as you are able, you will be encouraged to sit on the edge of the bed, stand with the assistance of a frame and step transfer to a chair. At this point in time, it’s very normal once the effects of any anaesthetic have worn off, for the knee to be very sore and become increasingly swollen. It might therefore seem cruel to get you moving so soon, however, it is well known that early mobilisation of the knee lowers the risks of clots and leads to a shorter hospital stay with an overall quicker recovery. Early movement is especially important in terms of getting the knee bending.
Top tip: Ask for pain relief! The knee goes through a significant amount of trauma during the op therefore understandably, the first few days can be really quite sore. Liaise with the nursing staff and physiotherapists to ensure that you have adequate pain killers, particularly in those first few days.
You are likely to remain as an inpatient for typically 1-3 days. Prior to discharge, a physiotherapist will ensure you feel confident with walking and using stairs. You will typically be discharged walking with two elbow crutches but less mobile patients may require a frame.
Postoperative milestones in recovery
The information below outlines what to expect and the focus of physiotherapy treatment over the course of the first year following knee replacement surgery. It’s worth noting that for many reasons, some people will progress slower, and some quicker than the outlined timeframes.
In the first few days:
- Pain and swelling management
- Basic range of motion exercises aiming for 0-90 degrees or more of knee movement
- Quadriceps activation exercises
- Walking practice, usually with a frame, then crutches
- Achieve independence in transfers (e.g. to and from the bed/chair) and basic activities of daily living (e.g. dressing, washing)
- Begin practicing stairs with assistance
- Discharged from hospital typically between 1-3 days post op
Within 1-2 weeks:
- Progress to one crutch or a walking stick if balance allows
- Increase walking distance gradually
- Start more challenging strengthening exercises
- Increase confidence on stairs with support
2-6 weeks:
- Most individuals can walk independently with minimal assistance
- Introduce more functional exercises mimicking daily activities
- Start gentle balance and proprioception training
6-12 weeks:
- Driving is typically from 6 weeks (once you can safely perform an emergency stop)
- Increased activity levels with low-impact exercises like swimming or stationary biking
- Focus on normalising gait pattern
- Increase intensity of strengthening exercises
- Expand range of motion exercises
3-6 months:
- Return to most daily activities with minimal assistance
- Introduce more challenging balance exercises
- Begin low-impact recreational activities (if approved)
6 months to 1 year:
- Full recovery with most individuals able to resume normal activities, including higher impact exercises, with a continued focus on maintaining strength, flexibility and balance.
At The Physios our goal is to support your post-op recovery from the initial few days and weeks all the way to achieving your personal goals. Our team of physiotherapists will tailor a rehabilitation plan to suit your needs and guide you every step of the way. Our one to one studio rehab sessions provide the ideal environment to facilitate this. You can read more about these here.
If you have any questions regarding total knee replacements or any other injury, you can book an appointment online here, or call our friendly reception team on 0114 267 8181.
