10d (edited) • Surgery to 6 weeks
Start here: the first twelve weeks
You're here if you've had the operation and you're somewhere between day one and month three.
THE SHAPE OF IT
- Days 0 to 3: the first few days are usually the most painful. A nerve block often wears off within the first day, and the pain can arrive all at once, often at night.
- Days 6 to 8: in one study, swelling peaked around here. Later than anyone tells you. Puffier at day seven than day two is normal.
- Weeks 4 to 6: sleep is often still broken. In one study it was worst around a month in, then slowly improved.
- First month: thigh strength drops by about 62%. The muscle is switched down, not wasted.
- Around week 6: most people walk indoors without an aid. That isn't the finish line.
- Weeks 7 to 12: the weekly gains stop. What's rebuilding now is strength, and it moves month to month.
THE NUMBERS YOUR PHYSIO IS WATCHING
- Bend: the middle half of people are at 95 to 115 degrees at one month and 109 to 122 at three months. These are bands, not pass marks.
- Straight: zero degrees. Ask for this number too.
- Under 90 degrees of bend at weeks 4 to 6: ask your surgeon or physio about it rather than waiting. Stiff knees dealt with inside about three months got roughly twice the bend back. Later still helps.
RING YOUR TEAM TODAY (SURGEON'S ROOMS, THE WARD OR YOUR GP) FOR ANY OF THESE
- Calf pain, swelling or heat in one leg.
- A temperature of 38°C or more, chills or shivering: ring your team now. If you feel very unwell, confused or drowsy, call 000 · 999 · 911.
- A wound that's newly red, leaking or opening.
- Redness that is spreading.
- A knee that suddenly gives way.
- Anything getting worse instead of better.
CALL 000 (AUSTRALIA), 999 (UK) OR 911 (US) NOW, AND DON'T DRIVE YOURSELF, FOR SUDDEN CHEST PAIN OR BREATHLESSNESS, COUGHING UP BLOOD, OR FEELING FAINT OR SUDDENLY CONFUSED.
READ THESE THREE FIRST
- Find Your Stage
- Normal Pain vs Red Flag
- Your week: the week-by-week cards, 1 to 12
THE GUIDE
Knee Replacement Exercises — Day 0 to Week 6: 21 pages, with a tick sheet. It's in the Classroom, in The First Twelve Weeks course.
ASK THE GROUP
Tell us your week. What's the thing nobody warned you about?
General information, not medical advice. If something feels wrong, your own team is the call to make.
Sources: Loyd 2019 · Fatah 2020 · Mizner 2005 · Kittelson 2020 · Akhtar 2024 · AAOS OrthoInfo · NHS
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Start here: the first twelve weeks
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Knee replacement guides from a physiotherapist. Before surgery, the first twelve weeks and the first year, in order, with printable downloads.
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