A total knee replacement (TKR) replaces damaged cartilage and bone with metal and plastic components. The surgery restores the joint surface, but the muscles around the knee need rehabilitation to regain strength, flexibility, and function. Without structured physiotherapy, scar tissue can limit your range of motion and you may not achieve the full benefit of the surgery.
Physiotherapy begins within 24 hours of surgery, often while you are still in the hospital. Goals include:
- Controlled walking with a walker or crutches
- Gentle knee bending (aiming for 60-70 degrees of flexion)
- Quad sets and straight leg raises to activate the thigh muscles
- Ankle pumps to prevent blood clots
- Wound care and swelling management (ice, elevation)
This phase is uncomfortable, but early movement is essential. Your physiotherapist will guide you through pain-appropriate exercises and ensure you are safe to walk independently.
Most patients transition from a walker to a cane during this period. Key milestones include:
- Walking without assistive devices (most patients achieve this by week 4-6)
- Stair climbing with proper technique
- Knee flexion reaching 90 degrees or more
- Stationary cycling (once flexion allows)
- Progressive strengthening with resistance bands and bodyweight exercises
By this stage, most daily activities become easier. The focus shifts to:
- Full range of motion (aiming for 110-120 degrees of flexion)
- Single-leg balance and stability exercises
- Gait normalisation (reducing limp and improving walking speed)
- Functional tasks: getting in and out of a car, kneeling, squatting
- Light cardiovascular exercise: swimming, cycling, walking on varied terrain
Most patients feel confident in daily activities by month 3. Continued strengthening and cardiovascular fitness training improve outcomes further. Many patients return to golf, swimming, cycling, and even light hiking within 6 months.
- Commit to your home exercise programme - consistency matters more than intensity
- Attend all physiotherapy sessions - hands-on treatment accelerates recovery
- Manage swelling proactively with ice and elevation
- Sleep with a pillow between your knees for the first few weeks
- Communicate openly with your therapist about pain levels and concerns
