The first six weeks at home after a knee replacement

Most of our knee replacement patients are in their sixties and seventies, and most go home three to five days after surgery. The first six weeks at home shape much of the recovery, so we visit daily or every other day in this period. Here is what those visits usually involve. Every plan follows the surgeon’s own protocol, which always comes first.

In the first two weeks the focus is on bending and straightening the knee, reducing swelling and walking safely with a walker. Sessions are about 45 minutes: gentle range-of-movement work, tightening the thigh muscle, ankle pumps and short walks around the house. We also check the home. A loose rug, a low toilet seat or a bed against the wall can make a big difference, and families are usually happy to move furniture once they see why.

In weeks three and four most patients move from a walker to a stick, practise stairs one step at a time and start getting up from a chair without pushing hard on the arms. The exercises get a little harder each week. In weeks five and six many people begin coming to the clinic, where the gym lets us add cycling and balance work.

Families help most by encouraging the home exercises between visits and keeping a simple chart of them. We send progress notes to the surgeon after the first, third and sixth weeks, so everyone works from the same picture.