Rehabilitation
after Knee Surgery
Knee
replacement surgery is a complex procedure, and physical knee
rehabilitation is crucial to a full recovery. In order for you to meet
the goals of total knee surgery, you must take ownership of the
rehabilitation process and work diligently on your own, as well as with
your physical therapist, to achieve optimal clinical and functional
results. The knee rehabilitation process following total knee
replacement surgery can be quite painful at times.
Your Orthopedic Surgeon and/or Physical Therapist will most
likely assign a specific protocol to you, based on your rehabilitation
needs. The following protocol is meant only to give you an idea of the
kind of exercises you might do during rehabilitation. When in doubt
about an exercise, follow the protocol outlined by your Surgeon and/or
Physical Therapist.
Early Rehabilitation
Your knee rehabilitation program begins in the hospital after surgery.
Early goals of knee rehabilitation in the hospital are to reduce knee
stiffness and maximize post-operative range of motion as well as to
help you get ready for discharge. The following steps may be taken to
help maximize your range of motion following surgery.
* Strict adherence to the CPM protocol as prescribed by
your surgeon
* Early physical therapy (day 1 or 2) to begin range of motion
exercises and walking program
* Edema control to reduce swelling (ice, compression stocking, and
elevation)
* Adequate pain control so you can tolerate the rehabilitation regimen
Outpatient Physical Therapy
Your outpatient knee rehabilitation program will consist of a variety
of exercises designed to help you regain range of motion in the knee
and build strength in the muscles which support the knee. You will
follow an advanced strengthening program, adding weights as tolerated.
A stationery cycle and walking program will be used to help increase
range of motion and stamina, and an aquatic therapy program may be
added as well.
Typical Home Exercises
Instructions in your home exercise program may include the exercises
shown below.
Consult your therapist regarding the appropriateness of the exercises
and the number of reps.
Ankle Pumps: Flex ankle up and down.
Quadriceps sets: Tighten thigh muscles and Hold for five
seconds. 
Heel slides: Flex your hip and knee. Return knee to the
straight position. 
Leg lifts: Raise leg six inches above the floor, keeping knee straight.

Knee extension: Place a pillow under your knee. Lift your foot
off the mat. 
Knee flexion stretch: Place a towel under your heel. Pull your
knee towards your chest. Hold your knee in this flexed position for
15-20 seconds. Return knee to the straight position. 
At Home
There are several things you can do at home to make your knee
rehabilitation more successful. First of all, do the home exercise
program as prescribed by your physical therapist. Next, follow these
suggestions for daily activities:
• Sitting: Use a chair with arms to help you rise to a
standing position. Avoid sitting for longer than an hour if possible.
If you must sit for a longer time, elevate the foot to avoid swelling.
• Walking: Do not put weight through the joint until you’ve been
cleared to do so by your surgeon.
• Lifting: Do not lift more than ten pounds.
• Showering: Showering is preferable to bathing because of difficulties
getting in and out of the tub.
• Exercising: Do the exercises that were recommended by your doctor and
physical therapist. Go to physical therapy as prescribed and get advice
from your therapist as to whether you’re doing the exercises correctly.
• Getting into a car and driving: Get into a car by sitting on the edge
of the seat, then pulling in the legs and turning to face forward.
Driving is usually not recommended for the first six weeks post-op.
Talk with your surgeon about driving sooner.
Long-Term Knee Rehabilitation Goals
Once you’ve completed your knee rehabilitation therapy, you can expect
a range of motion from 100-120 degrees of knee flexion, mild or no pain
with walking or other functional activities, and independence with all
activities of daily living.
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