Post – Operative Exercises After a Total Knee

Replacement Surgery

Ashutosh Hospital Vadodara

Phases of Recovery after a Total Knee Replacement Surgery (TKR):

Early Post-operative ExercisesInitial Activity PhaseAdvanced Exercises & Activities

Early Post-operative Exercises

Quadriceps SetsTighten your thigh muscle and straighten your knee. Then Hold for 5 to 10 seconds. Repeat 10 times, rest a minute and again repeat. Repeat several times till the thigh muscles get fatigued.

Straight Leg RaisesTighten the thigh muscles with knee fully straightened. Lift leg at an angle of 45 degrees and hold for 5 to 10 seconds and then slowly lower.Positions for doing the exercises – Lying position, Sitting on a Chair or bed.

Ankle PumpsRhythmically move foot up and down by contracting calf muscles. Repeat this exercise for two to three minutes, thrice an hour a day. Continue doing the exercise until swelling subsides.

Knee Straightening ExercisesPlace a small towel just above the heel and tighten your thigh. Try to straighten your knee so as to touch the back of the knee to bed. Hold for 10 seconds. Repeat several times a day.

Supported Knee BendsBend your knee while sliding foot on the bed. Hold the position for 5 to 10 seconds and then straighten. Repeat several times a day.

Sitting Supported Knee BendsExercise Position – Sitting at bed side or in a chair. Place foot behind the heel of operated knee and straighten the knee, holding the position for5 to 10 seconds. Repeat several times.

Sitting Unsupported Knee BendsExercise Position – Sitting at bed side or in a chair with feet resting on floor.Slowly straighten your knee and hold the position for 5 – 10 seconds. Then lower the knee and repeat the exercise several times.

Early Activity Phase

Weight Bearing During early Activity Phase, start bearing weight on the leg undergone TKR. Balance your weight on the crutches and your body. Stand comfortably and erect with your weight evenly balanced on your walker or crutches.

Progression from Weight Bearing to WalkingStart progressing from Standing erect to Walking.

Advance your walker or crutches a short distance; then reach forward with your operated leg with your knee straightened so the heel of your foot touches the floor first. 

Start normal walking with following the sequence of heel strike, foot flat, heel off and then toe off. Walk rhythmically and smoothly as per the guidance of your physiotherapist or surgeon.

Adjust the length of your step and speed as necessary to walk with an even pattern. Gradually put more weight on your leg. Progress from walking with a walker to walking with a cane.

Return to Activity Stage

Standing Knee BendsStand erect holding a support. Bend your knee as much as you can. Hold the position for 5 to 10 seconds. Straighten the knee and repeat the exercise several times.

Assisted Knee BendsExercise Position – Lye on your back placing a folded towel over your operated knee and drop the towel to your foot. Bend your knee and apply gentle pressure through the towel to increase the bend.

Advanced Phase Exercises

Multiple Angle IsometricsLight Isotonic Exercises – using weight-cuffs on

ankle. The exercises are used for strengthening of knee joint muscles (Quadriceps and Hamstrings)

Resisted Straight Leg RaisingClosed chain mini – squatsLungesStair Climbing

Stair Climbing and DescendingAlways lead up the stairs with your good knee and

down the stairs with your operated knee. Remember, "up with the good" and "down with the bad." 

More Advanced ExercisesStationary BicyclingStretching Exercises

Aquatic ExercisesStair Climbing

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