Health And Wellbeing For The Over 50s

Recovery From Knee Replacement Surgery in the UK

recovery from knee replacement surgery uk

Recovery from knee replacement surgery and the necessary rehabilitation that follows, are essential stages after the operation. On average, it takes between 3 moths to one year to fully recover from knee replacement surgery. The twelve weeks following surgery are vitally important for effective recovery and rehabilitation in the long term.

Knee Replacement Recovery Time: How long does it take?

Typically, knee replacement patients can:

Studies have shown that rehabilitation exercises following total knee replacement (TKR) surgery can lead to a faster recovery (1)(2).

Read on to learn how to set goals for your recovery.

What are the Different Stages of the Recovery Timeline?

Day of Surgery – Post-Operative Day Zero - Recovery from Knee Replacement Surgery

Early mobility is crucial for your recovery. You can expect this to begin the day of your surgery (unless specified by your surgeon).

Goals

You will be expected to:

Bed Exercise

ExercisesHow To Perform?Repetition
Deep Breathing
  • Take deep breaths with your hand on your upper abdominal area.
  • You should feel your abdomen rise against your hand.
3-5 times every hour
Ankle Pumps
  • Bend and straighten your ankles to move your feet up and down.
20 times every hour
Static Quads
  • Slowly tighten the thigh muscles of the straight leg, by pulling the toes up to point towards the ceiling and pushing your knee down into the bed.
  • Hold for 5 seconds then relax. Repeat with the other leg.
5-10 times every hour.
Buttock Contraction
  • Tighten your buttock muscles for 5 seconds and then relax.
  • Try not to hold your breath.
10 times every hour.
Knee Flexion (in a lying position)
  • Use a strap around your foot to carefully bring your operated knee into the bent position.
  • Hold for 5 seconds.
10 times per day
Inner Range Quads
  • Keep a rolled towel under your knee.
  • Elevate the lower part of your leg until your knee is straight.
  • Hold for 5 seconds then relax.
5-10 times per day.
Straight Leg Raise
  • Bend your un-operated knee to help brace as you elevate a straight leg up off the bed as high as you can.
  • Hold for 5 seconds and then slowly relax.
5 times per day.

Bed exercises should be performed throughout your hospital stay and during the initial stages of your recovery.

Post-Operative Day One/Two - Recovery from Knee Replacement Surgery

The majority of patients will go home on a postoperative day.

Goals

Your goals are

Discharge Day

Hospital discharge will depend on how quickly you can progress, the physical therapy you need, your age, and your health before surgery. Your activity level will gradually increase as you recover. 

Goals

You are likely to be discharged if you meet the following goals:

Therapy GoalsMedical Goals
Get in and out of bed by yourself.Your medical inspection must be within the normal range (e.g. heart beat rate, oxygen levels, blood pressure, and temperature)
Independently perform your exercises.Pain is well managed
Independently walk short distances (e.g. to the bathroom) with a walker.The incision is healing well
Be able to climb stairs (with assistance).
Manage some of your care (e.g. getting dressed).

Activity Management Once You Are Home

Bed Transfers

Positioning in BedHow to Get In and Out of Bed
  • Keep your knee straight when lying in bed.
  • Do not place a pillow below your knee.
  • You are allowed to place a pillow under your ankle.
  • Use your un-operated leg and arms to slide your legs to the edge of the bed and shift your buttocks across the bed, while remaining on your back.
  • Fasten a cane or bed sheet around the arch of your foot to help assist your operated leg to the edge of the bed and then onto the floor. Use your other hand to push your body upright.
  • When moving, try to shift your body as a whole.
  • Reverse this procedure when getting into the bed.

Sitting And Standing In A Chair / Commode Use

The procedure of sitting and standing in a chair and commode is the same.

To SitTo Stand Up
  • Back up to the chair/commode until you feel the back of your non-operated leg touching it.
  • Reach back for the chair’s/commode’s armrests with your hands.
  • Move your non-operated leg forward.
  • Lower yourself slowly into the chair.
  • Slide to the edge of the chair/commode and move your operated leg slightly forward.
  • Push up with either both hands on the chair/commode or with one hand on the chair and the other hand on the walker.
  • As you stand, put most of your weight on your non-operated leg.
  • With both hands, hold the walker, straighten your back and stand tall.

Stair Climbing

AscendingDescending
  • If there is a railing, grasp it and hold a walking aid in the opposite hand.
  • Step up with the non-operated leg first, following the operated leg and then the walking aid.
  • Grasp the railing with one hand and walking aid with the other hand.
  • Place the walking aid on the first step down.
  • Step down with the operated leg and then follow with the non-operated leg.

Getting Dressed

To help you get dressed, your therapist may recommend some dressing aids such as:

Car Transfers (Getting Into the Front Passenger Seat)

1- 3 Weeks After Knee Surgery

recovery from knee replacement surgery uk recovery from knee surgery

By the time you’re back home, you should be able to walk for brief periods while experiencing less pain.

Goals

Chair Based Exercise

ExercisesHow to Perform?Repetition Per Day
Assisted knee bend (whilst sitting)
  • Sit upright in a chair; bend the operated leg as far as you can.
  • Cross the non-operated leg over the front of the operated leg.
  • Give a gentle push with the non-operated leg to increase the bend.
  • Maintain this position for 2-3 seconds and then relax.
10 times
Knee Extension (whilst sitting)
  • Raise your operated leg off the floor as much as possible and maintain this position for 5 seconds.
10 times
Passive Knee Extension (whilst sitting)
  • Straighten your operated leg while sitting in a chair and place it on a footstool or another chair with the knee unsupported.
  • Gently push down with your hand on the knee.
  • Try to maintain this position for 2-10 minutes.
3 times
Hamstring stretch
  • While sitting, place your operated leg straight out (focusing on keeping your knee straight).
  • Sit tall and reach forwards towards your toes on your operated leg.
  • You should feel a stretch in your hamstrings behind your thigh.
  • Hold this position for 15-30 seconds.
10 times
Heel and Toe Raises
  • Begin with the feet flat on the floor then elevate your foot through your toes and then back to the heels.
10 times
Knee flexion with hold
  • Sit on the edge of the chair and bend your knees as much as possible.
  • Hold for 30 seconds.
5 times

Chair-based exercises should be performed for at least 6 weeks.

Weeks 3-6 After Knee Surgery

During weeks 3-6 in your recovery from knee replacement surgery, you will notice a significant improvement towards full independence.

Your goals for this period will be:

Advanced Exercises

ExercisesHow to Perform?Repetition per Day
Squats
  • Hold onto a rail, with your feet a hip distance apart.
  • Keep your back straight and carefully bend your knees as if doing a half sit down.
10 times
Hamstring Curls
  • In a standing position, hold onto a rail and put all your weight over the non-operated leg.
  • Bend your operated leg backward while uplifting your foot as far as you can.
10 times
Heel Digs
  • Lie or sit with support.
  • Bend the operated leg upward.
  • Dig the heel into the bed.
  • Hold for 2-3 seconds, relax
10 times
Single leg balance
  • Hold some support if you need to.
  • Put your full weight onto the operated knee and try to lift your non-operated leg off the floor.
  • Hold for 20-30 seconds.
10 times
Step up
  • Stand while facing the stairs.
  • Put your operated leg on the bottom step.
  • Hold onto the rail, and gently try to lift your weight up on the operated leg and place your other foot on the bottom step.
  • Lower the non-operative leg’s foot back down to the floor.
10 times
Step down
  • Stand on the bottom step of the stairs, facing downward.
  • Hold onto the rail.
  • Try and lower your non-operated leg to the floor.
  • Straighten up and place back the foot on the bottom step.
10 times
Single leg heel raise
  • Hold onto some support if you need to.
  • Put all your weight onto the operated knee.
  • Elevate yourself onto your toes, lifting your heel off the ground.
  • Maintain this position for 2-3 seconds and then relax.
10 times
Balancing with feet together
  • Stand and hold some support if needed.
  • Place both feet together. Gradually let go with one hand, and then as you feel balanced let go with the other.
  • Hold for 10-15 seconds.
10 times
Balancing one foot in front of the other
  • Stand where you can hold some support.
  • Put the heel of your operated leg just in front of the toes of your other leg.
  • Gradually let go with one hand, and then the other.
  • Hold for 10-15 seconds.
10 times

Advanced exercises should be performed approximately 3 weeks after surgery. Don’t start these exercises until instructed to do so by your physiotherapist.

Weeks 6 - 12 After Knee Surgery

During weeks 6 – 12, you should be able to begin all of your usual day-to-day activities.

Your goals are to:

Digital Technologies for Remote Patient Monitoring

Remote patient monitoring technology helps patients to manage their rehabilitation and remedy possible communication gaps between clinicians and patients.

This digital technology comprises:

Below are some of the latest remote-patient-monitoring technologies:

Medical Equipment You Might Need After TKR

BedroomBathroomLiving Room
Medical Bed RailElevated Toilet Seat With Grab BarAdjustable Standing Aid For Couch
Steel Bedside CommodeToilet safety frameLeg Lifter Strap
Adjustable ShoehornNon-Slip Bath MatPortable Table
Sock AidLong-Handled Bath LoofahRaised Seat Cushion
Knee Support CushionAdjustable Shower BenchFront-wheel walker or walking stick
ReacherCrutches

If you are still considering embarking on knee replacement surgery, you may like to read our comprehensive guide to the surgery, what it involves and the cost of the procedure in every part of the UK, click on this link:

Knee Replacement Surgery: Should you Stick with the NHS or go Private?

Conclusion

Committing to your rehabilitation exercises can help your knee recover faster and in time you should regain full motion. Make sure to talk to your surgeon about all of your post-op recovery needs to be sure you have taken all the many factors of your recovery into consideration. By being aware of the different stages of your recovery timeline, following your exercise programme and heeding the advice of your surgeon and physiotherapist, you should ensure a full recovery from knee replacement surgery.