I Just Had a Knee Replacement – What Does PT Look Like?

If you just had a knee replacement, chances are your doctor will refer you to PT. You may be thinking, “I just had surgery, everything is painful – what is going to happen at PT?”

We are going to go through a general outline of what PT may look like. Keep in mind that every surgery and outcome is different – try not to compare yourself to others who have gone through the same surgery. Even if you have the same exact knee surgery on both sides with the same surgeon, the recovery experience may look different between the two as well.

Knee Replacement Surgery

First visit: typically, we will see you in PT two or three days after your knee replacement. The goals of this first appointment are to look at your incision, measure swelling, and make sure things appear to be healing well. We will also make sure you know how to walk or get around with a walker, cane, or crutches. We may work on swelling control, pain relief, and most importantly, getting your quad (thigh) muscles to start working again. We will give you some basic exercises to start working on, but that first visit is nothing to be scared of!

For the first two weeks or so, we will focus on swelling control, range of motion, and getting your quad muscle to work well again. The most important range of motion to get back initially is extension, or getting it all the way straight. This helps you walk without a limp, and it’s usually harder to get back the longer we wait. Knee flexion, or bending the knee, typically comes around easier because we spend more time sitting with the knee bent. Typically, we want range of motion to be around 0-120 degrees by four to six weeks after surgery. Either your physical therapist or your surgeon will remove staples around two weeks post op.

Timeline: The first two weeks after knee replacement surgery tend to be the hardest two weeks. Expect to be more painful (stay on top of those pain meds and icing) and sleep may be more difficult or interrupted right now.

From two to six weeks, pain is usually better controlled, and now we can start working on more functional strengthening. This would include things like getting in and out of a chair, walking up and down stairs, getting up and down from the floor, and walking more normally. Most people are in PT for two to three months depending on how they do and what their goals are. After six weeks, the main goals are to improve endurance for daily activities, work demands, or return to your usual recreational activities. Keep in mind that it will likely take a year for your knee to feel “normal” after a knee replacement surgery and that it may swell off and on as you adjust to new activities.

You and your physical therapist will talk about and establish realistic goals for you to achieve during your rehabilitation, and when you have met those goals, you are ready to graduate from PT with your new knee!