What to Expect After Knee Replacement Surgery

The following guidelines will discuss precautions to protect your new knee joint, exercises to increase your knee strength and range of motion, and techniques to manage activities of daily living to help you become an active partner in your care and recovery.

Normal Knee Joint

Your knee is a hinge joint found where the end of the thigh bone (femur) meets the beginning of the large bone in your lower leg (tibia). A healthy knee has layers of smooth cartilage that cover the ends of the femur and the tibia. The smooth cartilage acts as a cushion and allows the surfaces of the two bones to glide smoothly as you bend your knee. The muscles and ligaments around the knee joint support your weight and help move the joint smoothly so you can walk without pain.

As the knee joint degenerates, the smooth cartilage can wear down on the ends of the femur and the tibia. The smooth surfaces become rough, like sandpaper. Instead of gliding smoothly when you bend your knee, the bones grind and you have pain and/or stiffness.

Your Replacement Knee Prosthesis

To create a new knee joint, the ends of the bones forming the joint are surgically removed. They are replaced with parts similar to pieces shown here. The parts of the prosthesis are made of metal and very strong plastic. The prosthesis provides new smooth surfaces on the ends of the bones.

Guidelines for Your New Knee Joint

Safety Tips for Home

  • Use handrails on steps.
  • Wear low-heeled or flat shoes.
  • Avoid wet or waxed floors.
  • Keep your floors free of items you could trip on. Throw rugs or small objects should be kept off the floor for your safety.
  • Watch for pets or other animals that could get in your way.
  • Avoid ice or snow.

Resting

When you are resting, you should have two pillows under your calf, not behind your knee or heel. Keeping your knee straight and elevated will help decrease swelling and improve range of motion. Sleeping on your stomach or on the side with your new knee will be uncomfortable and should be avoided for several weeks after surgery.

Sleeping

When you are resting, you should have two pillows under your calf, not behind your knee or heel. Keeping your knee straight and elevated will help decrease swelling and improve range of motion. Sleeping on your stomach or on the side with your new knee will be uncomfortable and should be avoided for several weeks after surgery.

Blood Clots

Follow your orthopaedic surgeon's instructions carefully to minimize the potential of blood clots, which can occur during the first several weeks of your recovery.

Warning signs of possible blood clots in your leg include:

  • increasing pain in your calf;
  • tenderness or redness above or below your knee; and
  • increasing swelling in your calf, ankle, and foot.

Warning signs that a blood clot has traveled to your lung include:

  • sudden increase in shortness of breath,
  • sudden onset of chest pain, and
  • localized chest pain with coughing.

Notify your doctor immediately if you develop any of these signs.

Infection

The most common causes of infection following total knee replacement surgery are from bacteria that enter the bloodstream during:

  • dental procedures,
  • urinary tract infections, or
  • skin infections.

These bacteria can lodge around your knee replacement and cause an infection.

Following your surgery, you should take antibiotics prior to dental work or any surgical procedure that could allow bacteria to enter your bloodstream. 

Recovery for the First Three Months

Your focus for the first couple weeks after surgery should be on swelling management and walking. Perform the exercises we give you and walk around your house as much as you feel like you can; otherwise spend time with your leg elevated and iced.

We expect you to rest often since your body is recovering from a major surgery. After you initial checkup with your surgical team, we recommend that you start to perform exercises standing, as opposed to laying down.

You will receive instructions for exercises at your clinic visit, or your home health therapist can show you what to do. This is also a good time to think about visiting a clinic for therapy if you want, since it is acceptable to start using equipment at the clinic, such as a stationary bike.

After your six-week checkup with your surgeon, you will likely be told that you can start activities that interests you. Running and jumping are not advised after a joint replacement, but starting to ease into activities such as hiking, golfing, swimming, gardening, and the like, is a good idea.

It is important that you find an activity that you enjoy and that you can make a part of your daily routine. Formal therapy will end at some point, and having a plan for how to continue to be active and keep your joint healthy is important. Talk with your therapist about specific ideas that may work well for you.

Additional Information & Resources