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:
- Leave the hospital within 2-3 days
- Resume most activities six weeks after surgery
- Recover 90% (three months after surgery)
- Recover 100% (six to twelve months after surgery)
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:
- Sit up in a chair and walk to the bathroom (with assistance).
- Perform bed exercises with the assistance of your physiotherapist as described in the table below:
Bed Exercise
| Exercises | How To Perform? | Repetition |
|---|---|---|
| Deep Breathing |
| 3-5 times every hour |
| Ankle Pumps |
| 20 times every hour |
| Static Quads |
| 5-10 times every hour. |
| Buttock Contraction |
| 10 times every hour. |
| Knee Flexion (in a lying position) |
| 10 times per day |
| Inner Range Quads |
| 5-10 times per day. |
| Straight Leg Raise |
| 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
- To eat both lunch and dinner while sitting in a chair.
- To complete bed exercises throughout the day as described in the above table.
- To stand up, sit and change locations.
- To walk a little further and climb a few steps with assistance (if recommended).
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 Goals | Medical 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 Bed | How to Get In and Out of Bed |
|---|---|
|
|
Sitting And Standing In A Chair / Commode Use
The procedure of sitting and standing in a chair and commode is the same.
| To Sit | To Stand Up |
|---|---|
|
|
Stair Climbing
| Ascending | Descending |
|---|---|
|
|
Getting Dressed
- Sit on the edge of a chair or bed.
- When dressing, pull your underwear and pants onto your operated leg first.
- When undressing, take your pants and underwear off your operated leg last.
To help you get dressed, your therapist may recommend some dressing aids such as:
- 1. Sock aid
- 2. Reacher
- 3. Long-handled shoe horn
- 4. Helping hand (grabber)
Car Transfers (Getting Into the Front Passenger Seat)
- Move the seat back as far back as possible.
- Back up to the car with your walking aid until you feel it behind your legs.
- Reach back and lower yourself down onto the car seat. Your operated leg should be straight out in front of you.
- Slide yourself back onto the seat until you give yourself more room to get your legs into the car. Then slide your legs into the car.
- Reverse the process to get out.
1- 3 Weeks After Knee Surgery
By the time you’re back home, you should be able to walk for brief periods while experiencing less pain.
Goals
- To walk independently using your walking aids. Gradually increase the distance.
- Be independent with washing and dressing.
- Continue with all exercises as instructed below:
Chair Based Exercise
| Exercises | How to Perform? | Repetition Per Day |
|---|---|---|
| Assisted knee bend (whilst sitting) |
| 10 times |
| Knee Extension (whilst sitting) |
| 10 times |
| Passive Knee Extension (whilst sitting) |
| 3 times |
| Hamstring stretch |
| 10 times |
| Heel and Toe Raises |
| 10 times |
| Knee flexion with hold |
| 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:
- Walking with a single crutch and gradually walking without any walking aids.
- Walking about half a mile daily (if suitable).
- Gradually climbing stairs from one step at a time to normal stair climbing.
- Complete all the above-described exercises along with the below-listed exercises. Start gently with these exercises and progress them as you feel you can.
Advanced Exercises
| Exercises | How to Perform? | Repetition per Day |
|---|---|---|
| Squats |
| 10 times |
| Hamstring Curls |
| 10 times |
| Heel Digs |
| 10 times |
| Single leg balance |
| 10 times |
| Step up |
| 10 times |
| Step down |
| 10 times |
| Single leg heel raise |
| 10 times |
| Balancing with feet together |
| 10 times |
| Balancing one foot in front of the other |
| 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:
- Walk without any assistance and walking aids.
- You can begin to walk on uneven ground if you feel confident to do so.
- Climb and descend stairs in a normal way (one foot after another).
- Walk half a mile - 1 mile daily (if you’re confident to do so).
- Resume of all of your prior activities including dancing, bowling, and golf.
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:
- 1. A Smartphone App: This not only provides patients with post-operative recovery supportive information and mentoring but also pre-surgery preparation, including pre-surgery checklists, physiotherapy coaching, and reminders.
- 2. A Wearable Activity Tracker: This keeps track of daily steps, stairs, and sleep, allowing patients to self-monitor their progress and stay engaged with the program.
- 3. A Clinician Web Portal: Using the web portal, clinicians can configure individual physiotherapy programs and can monitor patient progress remotely, enabling quality and targeted care.
Below are some of the latest remote-patient-monitoring technologies:
Medical Equipment You Might Need After TKR
| Bedroom | Bathroom | Living Room |
|---|---|---|
| Medical Bed Rail | Elevated Toilet Seat With Grab Bar | Adjustable Standing Aid For Couch |
| Steel Bedside Commode | Toilet safety frame | Leg Lifter Strap |
| Adjustable Shoehorn | Non-Slip Bath Mat | Portable Table |
| Sock Aid | Long-Handled Bath Loofah | Raised Seat Cushion |
| Knee Support Cushion | Adjustable Shower Bench | Front-wheel walker or walking stick |
| Reacher | Crutches |
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.
