Knee replacement recovery timeline
Recovery from a knee replacement is gradual and active. You’ll be up and moving within a day of surgery, and most of your recovery happens over the first three months, with smaller gains continuing for up to a year. The first two weeks are usually the hardest. This is a general guide to what to expect; your own pace will vary, and your surgeon and physiotherapist will set the plan that’s right for you.
In hospital: the first few days
Recovery starts on the day of surgery. With an enhanced recovery approach, a physiotherapist helps you stand and take a few steps the same day or the next morning, which reduces stiffness and the risk of complications.¹ You'll use a frame or crutches at first. Pain is managed with a combination of medications rather than relying on strong opioids, and most people go home within one to three days. More on this in enhanced recovery after surgery.
The first two weeks at home
This is the most demanding stretch, and it's normal to need regular pain relief and rest. The priorities are managing pain and swelling, looking after the wound, and doing your exercises.
- Ice and elevate the leg to control swelling.
- Take your pain relief as prescribed, so you can move and do your exercises rather than avoiding them.
- Do the exercises your physiotherapist gives you, several times a day. Bending the knee is the key goal, and many people reach around 90 degrees of bend by the end of the second week.
- Walk little and often, with your aids.
Swelling, warmth, bruising and disturbed sleep are all normal in these weeks. A patch of numb skin to the outer side of the scar is also common and usually fades; more on that in reducing numbness after knee replacement.
Weeks two to six
The wound is usually checked at around two weeks. Over this period most people move from crutches to a single stick and then to walking unaided, get the knee bending and straightening more freely, and return to light daily activities. Many return to desk work in this window. Driving is usually possible somewhere around four to six weeks, once you can control the car safely and are off strong pain medication, but check with your surgeon first.
The six-week review is an important checkpoint. By now the joint is moving more freely, which makes it easier to see how everything around it is recovering. Long-standing arthritis, and the surgery itself, leave the muscles around the knee weaker than usual (muscle wasting, or atrophy), and problems outside the joint itself, in the surrounding muscles and soft tissues, often only become clear once you're moving better. This is usually the point where we can pinpoint them and tailor your home exercise program to what your knee specifically needs.
It's also common to notice new or different aches around now, around the knee or elsewhere. You're moving faster, further and for longer than you have in a long time, and muscles and joints that had quietened down while your knee was bad are being used again. That's usually a normal part of getting back to it, not a sign something is wrong.
Six weeks to three months
By now the hardest part is behind most people. Walking becomes more comfortable and you can gradually build up activity and strength. More physical jobs may need a little longer before returning. Some swelling and a feeling of warmth in the knee can persist for several months, which is normal as the knee settles.
Three months to a year
Most of your recovery is usually complete by three to six months, and smaller improvements in strength, comfort and confidence continue beyond that. The scar fades, swelling settles, and the knee feels more like your own. Around the six-month mark, many people find they simply stop thinking about the knee day to day, which is a good sign that it has become part of normal life again.
Some things take the full year. If you'd been limping for months or years before surgery, the muscles in that leg will have weakened and tired more easily, and the difference in strength and stamina between your two legs usually evens out by about twelve months as you build back up. Low-impact activity such as walking, swimming, cycling and golf is encouraged; high-impact activity like running and jumping is generally discouraged to protect the joint.
What's normal, and when to seek help
Normal in recovery: swelling and warmth, bruising, a numb patch near the scar, occasional clicking from the implant, and disturbed sleep early on.
Contact your surgeon or seek medical advice promptly if you notice spreading redness, increasing pain or discharge from the wound, or a fever, which can signal infection; or pain, swelling or tenderness in the calf, or sudden breathlessness or chest pain, which can signal a blood clot and needs urgent attention. When in doubt, ask.
Helping your recovery
A few things make a difference: do your exercises consistently, keep moving without overdoing it, ice and elevate for swelling, take pain relief so you can stay active, eat well, and avoid smoking, which slows healing. Recovery isn't linear, and good days and harder days are both normal.
Common questions
How long until I can walk without aids?
Many people are walking unaided somewhere between two and six weeks, though this varies. Your physiotherapist will guide the progression.
How long will I be off work?
Desk work is often possible within a few weeks; physically demanding work usually needs longer. It depends on the job and your recovery.
When can I drive again?
Usually around four to six weeks, once you can control the car safely and are off strong pain medication. Check with your surgeon.
When will the pain and swelling settle?
The worst is usually over within a few weeks, and mild swelling and warmth can come and go for several months as the knee settles.
Will I be able to kneel?
Many people can, though kneeling often feels uncomfortable for a while, partly because of the numb patch near the scar. It tends to improve over the first year.
Speak to Dr Tsung
To discuss knee replacement, you'll need a referral from your GP or another specialist. Call reception on (07) 5676 9930 to book your first appointment, or email hello@sgco.au. New patients can pre-register online before the visit; the form prepares your records and does not book an appointment. More on knee replacement and how long a knee replacement lasts.
References
- Zhu S, Qian W, Jiang C, Ye C, Chen X. Enhanced recovery after surgery for hip and knee arthroplasty: a systematic review and meta-analysis. Postgrad Med J. 2017;93(1106):736–742.