How long is physical therapy after total knee replacement

The American Physical Therapy Association believes that consumers should have access to information that could help them make health care decisions and also prepare them for their visit with their health care provider.

The following articles provide some of the best scientific evidence about physical therapist treatment of total knee replacement. The articles report recent research and give an overview of the standards of practice for treatment both in the United States and internationally. The article titles are linked either to a PubMed abstract (summary) of the article or to free access of the entire article, so that you can read it or print out a copy to bring with you when you see your health care provider.

Harmelink KE, Zeegers AV, Hullegie W, et al. Are there prognostic factors for one-year outcome after total knee arthroplasty: a systematic review. J Arthroplasty. 2017 August 1 [Epub ahead of print]. Article Summary in PubMed.

Pua YH, Seah FJ, Poon CL, et al. Age- and sex-based recovery curves to track functional outcomes in older adults with total knee arthroplasty. Age Ageing. 2017 August 30 [Epub ahead of print]. Article Summary in PubMed.

Sobh AH, Siljander MP, Mells AJ, et al. Cost analysis, complications, and discharge disposition associated with simultaneous vs staged bilateral total knee arthroplasty. J Arthroplasty. 2017 September 13 [Epub ahead of print]. Article Summary in PubMed.

Bistolfi A, Zanovello J, Ferracini R, et al. Evaluation of the effectiveness of neuromuscular electrical stimulation after total knee arthroplasty: a meta-analysis. Am J Phys Med Rehabil. 2017 October 7 [Epub ahead of print]. Article Summary in PubMed.

Otero-López A, Beaton-Comulada D. Clinical considerations for the use lower extremity arthroplasty in the elderly. Phys Med Rehabil Clin N Am. 2017;28(4):795–810. Article Summary in PubMed.

Loyd BJ, Jennings JM, Judd DL, et al. Influence of hip abductor strength on functional outcomes before and after total knee arthroplasty: post hoc analysis of a randomized controlled trial. Phys Ther. 2017;97(9):896–903. Article Summary in PubMed.

Piva SR, Teixeira PE, Almeida GJ, et al. Contribution of hip abductor strength to physical function in patients with total knee arthroplasty. Phys Ther. 2011;91:225–233. Free Article.

Dowsey MM, Liew D, Choong PF. The economic burden of obesity in primary total knee arthroplasty. Arthritis Care Res (Hoboken). 2011;63(10):1375–1381. Article Summary on PubMed.

Piva SR, Gil AB, Almeida GJ, et al. A balance exercise program appears to improve function for patients with total knee arthroplasty: a randomized clinical trial. Phys Ther. 2010;90:880–894. Article Summary in PubMed.

Bade MJ, Kohrt WM, Stevens-Lapsley JE. Outcomes before and after total knee arthroplasty compared to healthy adults. J Ortho Sports Phys Ther. 2010;40:559–567. Free Article.

Walls RJ, McHugh G, O’Gorman DJ, et al. Effects of preoperative neuromuscular electrical stimulation on quadriceps strength and functional recovery in total knee arthroplasty: a pilot study. BMC Musculoskelet Disord. 2010;11:119. Free Article.

Topp R, Swank AM, Quesada PM, et al. The effect of prehabilitation exercise on strength and functioning after total knee arthroplasty. PM R. 2009;1:729–735. Article Summary on PubMed.

Kirkley A, Birmingham TB, Litchfield RB, et al. A randomized trial of arthroscopic surgery for osteoarthritis of the knee [published correction appears in: N Engl J Med. 2009;361:2004]. N Engl J Med. 2008;359:1097–1107. Free Article.

Minns Lowe CJ, Barker KL, Dewey M, Sackley CM. Effectiveness of physiotherapy exercise after knee arthroplasty for osteoarthritis: systematic review and meta-analysis of randomised controlled trials. BMJ. 2007;335:812. Free Article.

Moffet H, Collet JP, Shapiro SH, et al. Effectiveness of intensive rehabilitation on functional ability and quality of life after first total knee arthroplasty: a single-blind randomized controlled trial. Arch Phys Med Rehabil. 2004;85:546–556. Free Article.

Deyle GD, Henderson NE, Matekel RL, et al. Effectiveness of manual physical therapy and exercise in osteoarthritis of the knee: a randomized, controlled trial. Ann Intern Med. 2000;132:173–181. Free Article.

 *PubMed is a free online resource developed by the National Center for Biotechnology Information. PubMed contains millions of citations to biomedical literature, including citations in the National Library of Medicine’s MEDLINE database.

You’re ready to book that hiking trip. You’re ready to put after-dinner walks back into your routine. You’re ready to take your life back. You’re ready for a knee replacement. But do you feel prepared for the recovery process?

Whether you’re still talking with a doctor about options like robotic-assisted knee surgery or you’re preparing for your knee replacement surgery, the more prepared you are, the more likely you are to have a successful recovery. So, what can you expect after knee replacement surgery? What does recovery look like?

As a physical therapist who specializes in orthopedics, helping people recover after joint replacement surgeries is a big part of my job. I’ve worked with hundreds of knee replacement patients. It takes time, effort and targeted physical therapy to heal your knee and get you back to your day-to-day activities – and keep you doing what you love for as long as you can.

Below I answer some of the most common questions patients ask me about what they can expect as they recover from knee replacement surgery.

How soon can I stand up or walk after knee replacement surgery?

You’ll start standing and walking on your new knee almost immediately – just a few hours after surgery. Movement is key to a successful recovery.

At first, you’ll take short walks – for example, from your bed to the bathroom and around your room. Within 24 hours, you’ll have your first physical therapy session where you’ll be taught specific exercises to strengthen your knee and increase mobility with your new joint.

Will I need to use crutches or other assistive devices after knee replacement surgery?

Yes. And depending on the type of surgery you’ve had (e.g. full or partial knee replacement; single or double knee replacement), you’ll probably need to use an assistive device for at least a few weeks during recovery.

Assistive devices make certain activities like walking, using the restroom and dressing easier to do. They also help keep you safe.

The types of assistive devices you’ll need after knee replacement surgery depend on your condition, but common devices include:

  • Walking aids like crutches, canes or walkers
  • Shoehorns and sock aids
  • Grab bars around your home
  • Reachers and tongs
  • Raised toilet seat
  • Tub chair

The good news is some assistive devices may be covered by your insurance, so be sure to check with your insurance provider before you go in for surgery.

When can I get back to my usual activities?

The timing for getting back to typical activities varies from person to person. The one thing that doesn’t vary is the need for physical therapy to help get you there.

Here’s a high-level look of the progress you can expect to see in the first three months of recovery with regular physical therapy:

  • One month after surgery: You’ll probably start doing low-impact, daily activities like driving, returning to work, household chores and regular errands.
  • Two months after surgery: Around the seven-week mark, you can likely start enjoying low-impact physical activities again. Many of my patients love getting active by swimming, biking and taking longer walks at this point in their recovery.
  • Three months after surgery: You may be able to return to high-impact physical activity like running, skiing or other activities you enjoy. You’ll need to start slow and be gentle with yourself, but you’ll be able to work up to the level of activity you were used to.

All that said, it’s important to follow your post-op surgery instructions – including regular follow-ups with your surgeon. They’ll let you know what you’re ready for during your follow-up visits and coordinate recommendations with your physical therapist.

If you’re not sure an activity will be safe on your new knee, don’t hesitate to ask your surgeon or physical therapist.

How long will I need physical therapy after knee replacement surgery?

Physical therapy (sometimes called rehabilitation) is one of the key parts of your recovery. Physical therapists like myself use a combination of exercises, education and hands-on care to strengthen your body, teach you how to avoid injury and help you learn how to use your new knees.

You’ll start regularly working with physical therapists within the first week after surgery. At TRIA, we’ll work with you to develop a personalized therapy plan, which usually involves about three months of meeting with your physical therapist.

These first three months of physical therapy after knee replacement surgery are critical to setting you up for a successful recovery. And many of the moves you learn will be useful long-term to keep your joint feeling good.

Treatment plans are unique to each patient, but here’s what you can expect:

One to three weeks after surgery

The first few weeks after knee replacement surgery your physical therapist will focus on helping you reduce pain and feel more confident on your feet.

You’ll start working on a daily routine of strengthening and flexibility exercises with your physical therapist. During this time, you’ll also work on bending your knees, getting up from a sitting position and walking.

Typically, you’ll be able to bend your knees at a 90 degree angle, fully straighten your knee, and walk for at least 10 consecutive minutes during this stage of physical therapy.

You can expect to use assistive devices like walkers, crutches or canes during this phase of recovery. But you may be able to progress past the use of a more supportive device to only needing a cane, or nothing, at the three- or four-week mark.

If you have a sedentary job, you’ll likely be able to return to work after a couple weeks – beginning with half days and progressing from there. But ask your doctor if it’s safe for you to travel to work and sit with your knees bent for long periods of time before getting back to your normal work schedule.

Four to six weeks after surgery

After about a month, your knee strength will improve. Plus, you’ll feel more comfortable as your knee pain and swelling decreases.

Depending on the type of knee replacement you had and how your recovery has been going, you may rely less or not at all on certain assistive devices.

During this phase of physical therapy, your physical therapist might introduce more low-impact activities like swimming, cycling or longer walks. The goal will be to improve your endurance so you’re able to get back to typical daily activities.

At this phase, you will also work toward bending your knee to 120 degrees, begin climbing stairs and be able to return to light household activities and chores.

Seven to 12 weeks after surgery

Two months after recovery, you’ll probably notice you’re much more mobile than you were the first few weeks after surgery.

During this final phase of physical therapy, you’ll do more intense exercises that increase your strength and mobility. This will likely include more strenuous aerobic and strength exercises.

If you have any high-impact activities that you enjoy, your physical therapist will also teach you techniques for modifying those activities so you can safely enjoy them while you recover.

12 weeks after surgery and beyond

Now that you’re stronger and more confident moving with your new knee, the frequency of in-person physical therapy sessions may start to decrease around 12 weeks after surgery. But you’ll need to continue your physical therapy exercises at home.

At TRIA, our physical therapists will create personalized home routines to help you reach your goals to return to regular activities and hobbies. These routines will be an important part of your continued recovery after a knee replacement. Full recovery from a knee replacement, on average, can take up to one year.

Will I experience pain and what medicines are available?

Pain after knee replacement surgery is normal. Most of my patients have some level of pain and swelling for several weeks.

At TRIA, we’ll work with you to create a plan to help manage your pain. Plans commonly include a combination of:

  • Home remedies such as applying a cold compress or elevation to reduce swelling in your knee
  • Hands-on care (e.g. massages) to reduce inflammation and swelling
  • Prescription strength nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Movement strategies
  • Over-the-counter medications (e.g. Tylenol, Aleve, etc.)

How can I learn more about recovering from a knee replacement?

The best way to learn what to expect while recovering from knee replacement surgery is to talk to an expert orthopedist.

Our team of orthopedic doctors and orthopedic surgeons at TRIA are some of the best in the Midwest. We’ve performed thousands of joint replacements, and 97 percent of our patients report being able to walk down stairs without difficulty a year after surgery.

When you’re ready for surgery, our team of expert orthopedic surgeons, physical therapists and other care providers will be by your side every step of the way from your first appointment through your recovery.

How long does pain and stiffness last after total knee replacement?

A total knee replacement patient is typically looking at a one year recovery period for things to fully settle down. I should stress that doesn't mean you'll be living with constant pain for a year. But the occasional twinge or moment of discomfort could well last 12 months. Occasionally it could be two years.

How long does it take to walk after a full knee replacement?

How Long Does It Take to Walk After a Full Knee Replacement? In most cases, patients can walk without help from assistive devices like crutches or a walker within six weeks after knee replacement surgery.

Can you overdo physical therapy after knee replacement?

Don't Overdo It Although exercise is the key to healing, you could be backpedaling progress by overworking your knee. Signs of over-exercising include swelling of the entire leg and lingering pain that stretches into the evening or into the next day.

Is PT after knee replacement painful?

Physical Therapy after knee replacement surgery Will it hurt? Unfortunately, the answer is yes, it will likely hurt. It shouldn't be excruciating, but knee replacement rehab is notoriously difficult. Your body naturally wants to protect the new joint and it feels better to keep it rested and propped on a pillow.