Physiotherapy after a knee replacement: what to expect, week by week

A knee replacement can relieve years of arthritis pain, but how well the new knee works depends a great deal on the work you put in afterwards. Physiotherapy helps you regain movement, strength and confidence. Every person and every surgeon's protocol is a little different, so always follow your own team's instructions. This guide describes what recovery commonly looks like.

In hospital: the first days

• You will usually be helped to stand and walk with a walker very soon after surgery.

• You will learn simple exercises: ankle pumps, tightening your thigh muscles, and gentle bending and straightening of the knee.

• You will practise getting in and out of bed, on and off a chair and the toilet, and often stairs before you go home.

Weeks 1 to 2: at home

The main goals are to control pain and swelling, keep the knee moving, and walk safely.

• Exercises several times a day, as your physiotherapist shows you.

• Bending: gradually increasing how far the knee bends.

• Straightening: getting the knee fully straight is just as important as bending it.

• Walking with your walker or crutches, short and often.

• Ice and elevation as advised, to manage swelling.

Many patients have physiotherapy at home in these early weeks, when travelling is hard.

Weeks 3 to 6

• Bending and straightening continue to improve.

• Strengthening exercises are progressed.

• Many people move from a walker to a stick.

• Balance exercises and stair practice are added.

• Daily activities gradually return.

Weeks 6 to 12

• Walking without an aid, for longer distances.

• More challenging strength and balance work.

• Return to many everyday activities, and often driving when your surgeon agrees.

Beyond three months

Strength and endurance keep improving for many months. Some swelling and stiffness can last for months. Low-impact activities such as walking, cycling and swimming are usually encouraged.

Tips that make a difference

• Do your exercises every day, even on days you do not see the physiotherapist.

• Take pain relief as advised before exercising, so you can move properly.

• Do not neglect straightening. A knee that stays slightly bent makes walking harder.

• Make home safe: remove loose rugs, add a raised toilet seat or a rail if needed, and keep a clear path at night.

• Measure progress. Your physiotherapist can record how far the knee bends and straightens each week, so you can see improvement.

Call your surgeon or hospital promptly if

• the wound is red, hot, leaking or the edges are opening

• you have a fever or feel unwell

• your calf becomes swollen, tender or painful

• you become short of breath or have chest pain (seek emergency help)

• pain suddenly becomes much worse, or the knee gives way after a fall

Find a physiotherapist for post-operative care

Many physiotherapists on PhysioDesk Reach offer post-operative rehabilitation at home. Search by your area, and contact them directly.

This article is general information, not medical advice. Always follow the instructions of your surgeon and treating team.