Physiotherapy After Knee Replacement: What Recovery Can Involve

Total Knee Replacement (TKR) surgery is a common and effective procedure to address advanced arthritis. However, the surgery is only the first step. Post-operative physical therapy is essential to help regain joint flexibility, rebuild thigh strength, and restore a natural walking pattern.

Phase 1: Early Mobility (Weeks 1 to 2)

Rehabilitation begins within days of surgery, often while in the hospital. The early goals are:

• Pain and Swelling Control: Using compression, elevation, and ice.
• Quadriceps Activation: Re-educating the thigh muscles to lift the leg (straight leg raises).
• Regaining Extension: Getting the knee completely straight is a priority to allow a normal gait.
• Functional Bending: Gradually achieving 90 degrees of knee flexion using active-assisted movements.

Phase 2: Strengthening and Gait Progression (Weeks 3 to 6)

As the incision heals and pain subses, the focus shifts to:

• Increasing Flexion: Targeting 110 degrees or more of knee bend.
• Independent Walking: Transitioning safely from a walker to a cane, and eventually walking without support.
• Graded Strength: Low-impact leg presses, mini-squats, and stationary cycling.

Phase 3: Advanced Function and Balance (Weeks 6 to 12)

• Rebuilding balance and stability on uneven surfaces.
• Practicing stairs with alternate feet.
• Transitioning back to full daily activities and light exercise.

Critical Safety Warnings (Red Flags)

Contact your surgeon immediately if you notice:

• Sudden swelling, warmth, and throbbing pain in your calf (signs of a potential deep vein thrombosis).
• Increased redness, drainage, or widening gap at the incision site.
• A sudden high fever or chills.

Sources & Further Reading:

1. NICE Guidelines: Joint replacement surgery rehabilitation