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Total Knee Replacement Rehabilitation Protocol

The following is a brief guide to rehabilitation after a total knee replacement procedure.

  • The time-lines mentioned are approximate and actual progression depends on individual recovery.
  • Patients can weight bear as tolerated from day 1. Please use a walker or crutches till good pain control, quadriceps strength and walking mechanics are achieved.
  • Avoid pillow under knees and focus on knee extension and quadriceps exercises from day 1. Limb elevation with pillow under ankles / calves when lying is recommended.

First 2 weeks

  • Apply icepacks 3-5 times daily for 10 minutes each time.
  • Quadriceps and gluteal sets, proprioception and balance exercises (e.g. Heel-to-toe walking).
  • Straight leg raises.
  • Active and passive Range of Movement exercises.
  • Gait training.
  • Upper body conditioning.
  • Please remember to apply Ice packs thrice daily for 10 min; take pain medication as advised and follow the advice of your therapist.

2 to 6 weeks

  • Continue with the Home exercise program.
  • Progress to walking outside.
  • Progress with Quadriceps, ROM and proprioception / balance exercises.
  • Start Core strengthening exercises.
  • Hydrotherapy / Pool work-outs once incisions have healed.
  • Aerobic exercises after 4 weeks as tolerated (e.g. Static exercise bike).

6 to 12 weeks

  • Add lateral steps and step-ups.
  • Single leg stance (eccentric exercises initially).
  • Progress with all functional activities including household chores, gardening, gentle sporting activities.
  • Low impact activities only till 3 months.
  • No twisting, pivoting till 3 months.
  • Wean into a home / gym program.