What to Expect After Total Knee Replacement Surgery

Everyone wants to know what to expect after knee replacement surgery. They all ask:

– “When will I be able to walk without a walker or a cane?”

– “When will the pain go away?”

– “When will my knee feel ‘normal’”?

– “When will I be able to do the things I enjoy?”

These are all valid questions. The whole reason you’re having knee replacement surgery is to get your life back and do the things you enjoy… without pain.

So, let’s get to it!

What can you expect after total knee replacement surgery?

You will either be hospitalized for a few days or will have out-patient surgery (you arrive in the morning, have your surgery, and then go home later the same day). Which option you get is dependent on where you live, what insurance you have, and the surgeon you’ve selected.

Starting Physical Therapy

You will start physical therapy in the hospital on the day of your surgery. The PTs will show you things like:

• How to get in/out of bed, up/down from a chair, up/down steps, and in/out of a car
• How to walk with a walker
• Basic exercises to help with bending and straightening your new knee

You will have a bandage of some sort to protect the surgical incision. You will also most likely have purple or black bruising, which is completely normal. As the weeks progress, this bruising will transition to a light tan color and go away.

Considering you just had major surgery, pain is expected. It is important to take your pain medication on a consistent schedule for the first few weeks to stay ahead of your knee pain. This will allow you to do your exercises and move around better.

You will also experience swelling. This is completely normal, and you can manage it using a compression hose, inflatable pneumatic compression sleeves, ice, and/or elevation of your leg frequently throughout the day.

Working on Range of Motion

Next, let’s discuss ROM. The 2 key motions you will be working on every day are straightening and bending. The end goal is to have 0 degrees of extension (a fully straightened knee) and 120+ degrees of flexion so that you can safely and easily resume the activities of your choice.

This is only doable if you put in the work. You will have to work on bending and straightening your surgical knee every day, multiple times per day, in order to reap the benefits of your new knee. Using a device like the GoKnee can accelerate this process, but be aware that you will still have to push yourself to levels of discomfort. This is hard, but it will result in a knee that lasts 15-20 years and a much better quality of life.

The good news is that you will be able to get in and out of bed on your own using new movement techniques. You will be able to get up and down from chairs, toilets, cars, etc. on your own pretty quickly. You will have to rely heavily on your arms to help at first—and it might not look pretty—but you will be independent. You will also start walking on your own using a walker from day one and learn specific techniques for getting up and down stairs with minimal pain and difficulty just the first week after surgery.

Think about it. There are numerous orthopedic surgeries out there that have restrictions on what you can and cannot do. With shoulder surgery, your arm is put in a sling, and you can’t use it for weeks. With ankle surgery, you can’t bear any weight on your leg, and you might have a cast on. With back surgery, you have a ton of lifting restrictions. 

With TKR surgery, there are no restrictions. There is nothing you cannot do; you are permitted to do whatever you can tolerate. The more you can tolerate, the faster the recovery. Is it a painful and challenging recovery? Yes. But is it worth it? Absolutely!

The good news is that the pain will continue to get better the more you work on physical therapy. It is reasonable to have some level of discomfort for months after the surgery. Keep in mind that your bone must grow into the new implant and this process can take up to 3 months.

Ongoing Therapy

You will either receive out-patient or home health physical therapy based on your individual needs. If you have someone who is available to drive you, then they will likely order out-patient PT. If not, then you will likely receive home health PT.

You will probably have 2-3 PT sessions per week. This will be a love-hate relationship—you will love the results but hate the process. But your physical therapist will guide you during the entire process and help you transition from the rolling walker to a cane to no device over a 4–6-week timespan. They will progress your home exercise program (HEP) based on your progress and your personal goals.

The key to TKR recovery is the HEP—what you do everyday matters most. And before you know it, you will be resuming activities that you enjoy, like swimming, getting back to work, traveling, golfing, cycling, or whatever your hobbies may entail.

It is important to remember that recovery from knee replacement surgery is a gradual process and that each person’s experience will be different. It may sound like a lot of pain and challenges, but isn’t a few months of pain worth 15-20 years of doing the things you enjoy with the ones you love?

So, what can you expect after TKR surgery? Pain, swelling, and stiffness. But with hard work, you will achieve a much better quality of life than you could have ever imagined.

Good luck on your knee journey, wherever you may be!