Smart Moves Blog

Total knee replacement guide

February 25, 2018

home physical therapy

This guide summarizes best practices. The best care involves a combination of best practices, and the healthcare provider’s and patient’s inputs.


3 days - 3 weeks post surgery

Goals

  • Reduce swelling and pain
  • Increase knee range of motion
  • Increase strength
  • Increase independence with transfers and gait (weight bearing as tolerated with assistive device)
  • Monitor wound healing for signs and symptoms of infection

Intervention

  • Ice 10-15 minutes, multiple times a day to reduce swelling and pain
  • Exercises (with guidance of your therapist)
  • Ankle pumps
  • Heel slides
  • Quad sets
  • Short and long arc quads
  • Straight leg raise (4- way, modified as appropriate)
  • Hip flexor, hamstring and calf stretching
  • Gait: progress from walker or crutches to cane

3-6 weeks post surgery

Goals

  • Reduce swelling and pain
  • Increase knee range of motion
  • Increase strength
  • Improve balance
  • Normalize functional activities

Intervention

  • Ice 10-15 minutes, as needed, to reduce swelling and pain
  • Additional exercises (with guidance of your therapist)
  • Standing hip abduction
  • Standing knee flexion
  • Standing heel and toe raises
  • Balance exercises
  • Stationary bike
  • Functional activities training

    • Sit to stand
    • Stairs
    • Gait without assistive device, as tolerated

6-12 weeks post surgery

Goals

  • Begin endurance activities

Intervention

  • Progress strength and balance exercises
  • Begin endurance activity (walking, swimming, progress stationary biking)

3+ months post surgery

  • Continue walking, swimming, and stationary biking for aerobic conditioning
  • Begin other recreational activities (golf, outdoor cycling, impact sports such as tennis or jogging) with clearance from surgeon

Manju Thomas

Written by Manju Thomas who lives and works in New York. Follow her on LinkedIn.