REHABILITATION GUIDE
Rehabilitation after knee replacement.
Total and partial (unicompartmental) knee replacement. What to expect, stage by stage, with a printable copy to download.
This guide explains what to expect in the weeks after a total or partial knee replacement. Partial knee replacement follows the same programme, and many patients progress a little faster. Everyone recovers at their own pace, and your physiotherapist will tailor the exercises to you.
At a glance
| Weight bearing | Full weight bearing from the day of surgery, using crutches or sticks for balance and comfort |
| Walking aids | Usually reduced over 2–6 weeks, as your walking becomes steady |
| Brace | Not usually needed |
| Driving | Usually around 6 weeks, once you can perform an emergency stop safely |
| Work | Desk-based work often 4–6 weeks; physical work often 8–12 weeks |
| Normal daily activities | Most by around 3 months; improvement continues for up to a year |
Your recovery, stage by stage
In hospital Day 0–3
- You will usually get up and walk with the physiotherapists on the day of surgery or the next morning.
- You can put full weight through the leg unless you are told otherwise.
- Before going home you should be able to walk safely with your walking aids, manage stairs if needed, and do your exercises independently.
Early recovery Weeks 0–2
- Do your exercises 3–4 times a day, little and often.
- Focus on getting the knee straight and steadily increasing the bend. Many people aim for about 90° of bend by 2 weeks.
- Expect swelling and bruising. Elevate the leg and use ice packs to help.
- Take pain relief regularly, especially before exercising.
Building strength Weeks 2–6
- Outpatient physiotherapy usually starts in this period.
- Walk a little further each day and reduce your walking aids as your balance and confidence allow.
- Add sit-to-stand practice, step-ups and exercise-bike work when your physiotherapist advises.
- Your wound will be reviewed and clips or stitches removed at around 10–14 days if needed.
Returning to activities Weeks 6–12
- Most people are walking without aids by this stage.
- Return to driving, work and low-impact exercise such as swimming, cycling and walking, as advised.
- Some swelling, warmth and stiffness are normal and can continue for several months.
Longer term 3–12 months
- Strength, stamina and comfort continue to improve for up to a year.
- Low-impact activities such as walking, cycling, swimming and golf are encouraged. Discuss higher-impact sports at your follow-up.
Early exercises
- Ankle pumps
- Point your feet up and down briskly, 10–20 times every hour while awake. This helps circulation and reduces the risk of blood clots.
- Static quads
- Lying or sitting with the leg straight, tighten the muscle on the front of the thigh to push the back of the knee down. Hold 5 seconds, relax. Repeat 10 times.
- Straight leg raise
- Tighten the thigh muscle, then lift the straight leg about 15 cm off the bed. Hold 5 seconds, lower slowly. Repeat 10 times.
- Heel slides
- Lying on your back, slide your heel towards your bottom to bend the knee, then straighten it again. Repeat 10 times.
- Knee straightening stretch
- Rest your heel on a rolled towel so the knee is unsupported, and let it straighten for 5–10 minutes. Do not place a pillow under the knee.
Looking after yourself
- Wound care
- Keep the dressing clean and dry. Stitches or clips are usually removed at around 10–14 days. Do not soak the wound in a bath, pool or hot tub until it has fully healed.
- Swelling
- Rest with the leg raised, and use an ice pack wrapped in a towel for 15–20 minutes several times a day. Swelling can last for weeks or months and is common.
- Pain relief
- Take your pain relief regularly in the early weeks, as prescribed, particularly before exercising. Reduce it gradually as the pain settles.
- Blood clot prevention
- Follow the hospital’s advice on blood-thinning medicine and stockings. Keep moving, do your ankle exercises, and drink plenty of fluids.
When to seek urgent help
Call 999 or go to A&E if you have chest pain, sudden breathlessness or cough up blood.
Contact the hospital where you had your operation straight away (or NHS 111 out of hours) if you have:
- Pain, swelling or tenderness in the calf
- The wound becomes red, hot or increasingly painful, or leaks fluid after the first few days
- A temperature above 38°C, shivering or feeling generally unwell
- A sudden increase in pain or swelling, or you cannot put weight on the leg as advised
- New numbness, tingling, coldness or weakness in the leg or foot
Sources
This guide is based on Mr Umar’s practice and is guided by NICE and British Orthopaedic Association (BOA) guidance:
Questions about your recovery?
| Spire Regency, Macclesfield | Denise Rowbotham · 01625 507472 |
| The Alexandra, Spire Manchester, Spire Hale and Circle Cheshire | Danielle Heron · 07528 523911 |
This is general guidance. Always follow the specific instructions from your own surgical and physiotherapy team, as your programme may differ.