Total Knee Replacement Physical Therapy

Total Knee Replacement Physical Therapy

Surgery: What to expect in the OR

To undergo total knee replacement surgery, you will first be given either general or spinal/epidural anesthesia. General anesthesia will completely knock you out whereas spinal anesthesia numbs you from your waist down. The typical duration of a total knee replacement is 1-2 hours. During the operation, the surgeon will make an incision over your kneecap to then be able to remove damaged elements of your joint and reattach the joint with a type of cement substance. After you have spent a few hours recovering, hospital staff will transfer you to a separate hospital room.

Post Op: Waking Up After Surgery

After the surgery when your anesthesia has faded, you may notice a blood drainage attached to your knee. An IV will likely be inserted in your arm to deliver fluids and pain medication. You also may have a catheter in your bladder as you won’t be able to walk to the bathroom for a while. Compression socks may be put on you to ensure proper blood flow. Some common medications administered during this postoperative period are antibiotics to prevent infection and blood thinners as a preventative measure to stop blood clots from forming.

The Beginning of Recovery

Although it may seem counterproductive to exercise after a total knee replacement, one day one (1) simple calculated movements are actually vital to regain strength and prevent complications from occurring. Physical Therapy is an excellent service that can aid you in learning the correct movements for optimal and speedy recovery. Some of these therapies will include, but are not limited to, pumping ankles for increased blood flow, light walking, breathing exercises to keep lungs clear and free from pneumonia, etc.

The Road Back to Routine

By day two (2) you will likely be able to take your pain medication orally and consume regular food. You should be able to make your way to the bathroom with some assistance. You will continue to work with a physical therapist to learn strengthening exercises and how to recognize signs of infection, blood clots, and chest congestion.

Cleansing Time

Around this time your doctor may approve you to remove your wound dressing and clean your surgical wound in the shower. Do not apply any lotions or creams unless the doctor has prescribed them. After about two (2) weeks the wound will have healed moreso and the stitches will have been removed and so cleaning in a bath will be permitted.

Returning Home

By the 3rd or 4th day post surgery, it will be time to leave the hospital and continue your recovery at home. By this time you should be able to get in and out of a chair or bed and go to the bathroom without needing help. Crutches or a walker can aid in making the transition to maneuvering around smoother. Rehab centers may also be available to continue your recovery with around-the-clock assistance.

Self-Care (1st week)

The first week at home will be a time where particular attention to self-care regarding your surgical wound is necessary. You will need to clean and replace the dressing on your wound periodically as displayed by hospital staff. Expect some swelling around the knee but if redness or other signs of infection appear, contact your doctor or hospital. Bagged ice or a pack of frozen veggies is very soothing if applied to the knee and will also help reduce swelling. Try to walk around a little every few hours and anticipate a physical therapist to come to your home to continue working on regaining your strength and flexibility.

Taking It Easy (2nd week)

In the 2nd week after your knee replacement surgery, it is best to continue to take it easy and allow arranged caregivers to do the tasks and activities you are not easily capable of doing. 

Transition Back to Normalcy

Three (3) to four (4) weeks after your surgery you should be able to transition back into your normal daily activities while using appropriate caution. Swimming and using a stationary bike are good exercises to perform during the period of time that will not put too much strain on your knee. Intimate activities are okay to resume. Kneeling to garden will start to become an option around this time but you may want to wait another month or so. Golfing and dancing are also physical activities that will not cause unnecessary harm to your healing knee, but avoid higher impact sports like jogging and basketball. 

Reduce Pain Medication Usage

By the 4th week it is advisable to cut back on pain medication. The overall pain should be greatly diminished by this point in your recovery and over-the-counter drugs like acetaminophen or ibuprofen are a sufficient and safer option. Use caution and consult with a doctor regarding these medications if you are also taking blood thinners. 


Between weeks 6-8 you can try to operate a vehicle again. Be careful, however, to ensure you have enough range of motion and lack of pain in order to press on the pedals consistently while driving. It is better to hold off another week or so if you do not feel like you can handle the impact driving can have on your newly structured knees. 

Returning to Work

In the weeks and even months after your total knee replacement surgery, going back to work will finally become an option depending on your level of healing. A main factor for returning to work is the amount of physical demand needed to complete your job: sitting jobs will require less recovery time vs. walking and/or lifting-type occupations. 

Follow-up Care

Work with your doctor to set-up visits to monitor your progress over the year following your surgery. A common schedule for follow-care is visits at three (3) and six (6) weeks, then at three (3) and six (6) months, and finally at the completion of one (1) year. Implement the care advice provided by your doctor. Be encouraged: 90% of modern-day total knee replacements are still functioning effectively 15 years later!

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