Patient guide
Knee Replacement Recovery Exercises & Timeline
A week-by-week guide to what to expect after a total knee replacement, with safe exercises for each phase. Written by Mr Jakub Kozdryk, Consultant Hip & Knee Surgeon, for patients recovering under his care at The Meriden, Nuffield Warwickshire and UHCW.
Knee replacement — recovery timeline
~90% excellent outcomes- Day of surgery
Surgery & first steps
1–1.5 hour operation. Spinal anaesthesia with sedation, knee nerve blocks keeping you comfortable for 16+ hours, and ice cooling. Aim to mobilise the same day.
Spinal anaesthesiaKnee blocks — 16hrsSwelling expected — normal - Day 1–2
Ward recovery & discharge
X-ray and bloods. Physiotherapy works to achieve 90 degrees of bend before discharge. Swelling may travel to the ankle — entirely normal.
Target: 90° bendAspirin 150mg — 14 daysAnkle swelling — normal - 2 weeks
Wound check with nurse
Wound reviewed. No clips or external sutures to remove in virtually all cases — intradermal dissolving stitches used. Swelling and discomfort often ongoing at this stage — this is expected and normal.
No clips to removeOngoing swelling — normal - 6 weeks
Consultant review & driving
Mr Kozdryk reviews progress, X-rays and bloods. Most patients discharged from follow-up. Return to driving if emergency stop pain-free — test in an empty car park first.
Return to drivingMost discharged here - 6–12 weeks
Range of movement & strength improving
Knee recovery is gradual — slightly slower than hip. Range of movement, strength and swelling all continue to improve. Consistent physiotherapy through this phase makes a significant difference.
Physio key in this phaseSlower than hip — be patient - 4–6 months
Return to full activities
Most patients back to their full range of daily activities — golf, walking, cycling and travel. 90% of patients report a good to excellent outcome.
Full daily activitiesGolf & cycling - Any time
Questions or concerns
Mr Kozdryk can be contacted by email at any time, or via WhatsApp in an emergency, and will personally reply within 24 hours.
Email anytimeWhatsApp — emergencies
Immediate recovery
Goals
- Protect the new knee and control swelling with ice and elevation
- Get out of bed, stand and walk short distances with crutches or a frame
- Regain active quadriceps control and begin gentle range of movement
Exercises
Ankle pumps
Lying flat, slowly point and flex the foot. 20 reps every hour while awake — reduces clot risk and helps swelling.
Static quads
Press the back of the operated knee firmly down into the bed for 5 seconds, relax. 10 reps, 3× a day. This is the single most important early exercise.
Heel slides
Slide the heel of the operated leg towards you along the bed to bend the knee, then straighten fully. 10 reps, 3× a day — aim for a little more bend each day.
Straight leg raise
Lock the knee straight, then lift the whole leg 15–20 cm off the bed, hold 3 seconds, lower slowly. 10 reps, 3× a day.
Full knee extension stretch
Sit with the heel propped on a rolled towel so the knee hangs unsupported. Let gravity straighten it fully for 5–10 minutes, 3× a day. Getting the knee flat is critical.
Early rehabilitation
Goals
- Walk further with reducing use of crutches (as advised by your physiotherapist)
- Achieve at least 0° full extension and 90–110° of flexion
- Rebuild quadriceps, hamstring and calf control
Exercises
Seated knee flexion
Sit on a firm chair, slide the operated foot back under the chair to bend the knee as far as comfortable. Hold 5 seconds. 10 reps × 3 sets.
Seated knee extension
Sit tall, straighten the operated knee fully and hold 5 seconds. 10 reps × 3 sets.
Standing hamstring curl
Holding a worktop, bend the operated knee bringing the heel towards the buttock. 10 reps × 3 sets.
Mini squats
Feet hip-width, lower a few inches keeping weight through the heels and knees tracking over the toes. 10 reps × 3 sets.
Step-ups (low step)
Lead with the operated leg going up, non-operated leg going down. 10 reps × 2 sets, once tolerated.
Stationary bike
Once you can comfortably clear the pedal — usually week 3–4 — start with no resistance, seat high. 5–10 minutes daily; a fantastic way to regain flexion.
Strength and confidence
Goals
- Walk without aids on level ground
- Return to driving (once safe emergency stop is possible — often around 6 weeks)
- Progress to longer walks, swimming and gentle gym work
Exercises
Bridges
Lying on your back, knees bent, lift hips to a straight line from knees to shoulders. 10 reps × 3 sets.
Wall sits
Back against a wall, slide down until knees are bent ~45° (progress towards 60°). Hold 15–30 seconds × 3 sets.
Sit-to-stand
From a firm chair, stand without using your hands. 10 reps × 3 sets.
Resisted band knee extension
Sit with a light band around the ankle, straighten the operated knee against resistance. 12 reps × 3 sets.
Calf raises
Rise onto tiptoes, lower slowly. 15 reps × 3 sets.
Swimming
Usually safe once wounds are fully healed and reviewed — front crawl and backstroke are ideal. Avoid the breaststroke leg kick early on.
Return to activity
Goals
- Return to non-impact sport — cycling, golf, hiking, doubles tennis, bowls
- Progress gym-based strength work under guidance
- Ongoing quadriceps and hamstring conditioning to protect the replacement long-term
Exercises
Cycling (outdoors)
Once balance and confidence allow — typically from 8–12 weeks.
Golf
Chipping and putting from ~6 weeks, full swing from ~3 months.
Hill walking
Reintroduce gradually — use walking poles for descents in the first months to protect the knee.
Lunges & step-downs
Add controlled lunges and step-downs from a higher step to build single-leg strength.
Movements to avoid early on
- Kneeling directly on the operated knee in the first 3 months (it is safe later, but often uncomfortable).
- Twisting or pivoting on the operated leg — turn by taking small steps instead.
- Deep squatting or sitting cross-legged on the floor early on.
- High-impact running or jumping sports — permanently avoid to protect the implant.
When to contact the practice
Contact your surgical team promptly if you develop increasing wound redness or discharge, a fever above 38 °C, sudden new pain, a calf that becomes hot and swollen, or shortness of breath. For urgent problems out of hours, attend your nearest A&E.
Reviewed by Mr Jakub Kozdryk, MBBS FRCS (Tr & Orth), Consultant Hip & Knee Surgeon.