Knee Replacement
Frequently Asked Questions
ðĶī UNDERSTANDING KNEE REPLACEMENTS
What exactly is a knee replacement?
A knee replacement is more accurately described as a knee resurfacing procedure. Arthritis causes the cartilage at the ends of the bones to wear down, leading to pain and stiffness. During surgery, the damaged surfaces of the femur (thigh bone) and tibia (shin bone) are carefully removed and replaced with metal components, with a durable plastic insert placed between them to allow smooth movement. This creates a new, smooth joint surface that reduces pain and improves function.
What is the difference between a total and partial knee replacement?
A total knee replacement resurfaces all major compartments of the knee. A partial knee replacement resurfaces only the damaged portion â most commonly the inner (medial) compartment. Partial replacement is typically considered when arthritis is limited to one area of the joint.
What happens to my ligaments during surgery?
The side ligaments (MCL and LCL) are preserved and continue to provide stability. The ACL and PCL are typically removed and functionally replaced by the design of the implant components.
When should I consider a knee replacement?
When arthritis-related pain begins to interfere with daily activities, limits your ability to enjoy life, or disrupts your sleep â typically after conservative treatments such as medications, injections, or physical therapy are no longer providing relief and imaging shows advanced arthritis.
How long will my knee replacement last?
Earlier implants showed about 90-95% lasting 10 years and 75% lasting 20 years. Today’s implants use newer materials with improved durability expected to last significantly longer, though long-term data is still being collected.
ð THE FIRST 10-14 DAYS â THE MOST IMPORTANT WINDOW
Why are the first 10-14 days so critical?
How your knee is managed during this period â particularly swelling control and positioning â sets the foundation for your entire recovery. When swelling is well-managed early, patients regain motion faster, improve muscle control sooner, and experience less pain overall.
What should I focus on during the first 10-14 days?
The priority is controlling inflammation. The three key components are elevation (knee above heart level), ice (with a protective barrier), and compression. Using these strategies consistently is essential.
What is the Smooth Knee Protocol?
The Smooth Knee Protocol is a recovery approach focused on minimizing inflammation early, restoring knee motion and quadriceps control, and progressing to strengthening and functional activity after the initial healing phase. It is the foundation of everything we teach at KneeRehabPros.
What can slow down my recovery?
Too much activity â especially excessive walking â in the first 10-14 days can increase swelling and stiffness and delay recovery. Your knee will give you feedback: increased stiffness or soreness the following day is often a sign activity levels were too high.
How often should I do my exercises?
About 4 times per day during the first 10-14 days. Exercises should create mild discomfort, not pain.
What should I do if I overdo it?
Reduce activity for a day or two and return to elevation, ice, and compression. This helps the knee settle before progressing again.
Should I use ice or heat?
Ice is recommended during the first 10-14 days. Heat can be introduced later (before exercise if desired), but recovery sessions should always end with ice.
ð RECOVERY TIMELINE & MILESTONES
How long does it take to feel normal after knee replacement?
Many patients begin to feel as functional as they did before surgery around 6-8 weeks. Some recover more quickly, while others may take a bit longer â every recovery is individual.
How long will I need a walker or cane?
Typically until you can perform a straight leg raise without difficulty, which may take 2-5 weeks or longer. Transition from walker to cane when you can walk without a limp.
When can I drive again?
Once you are walking normally without assistive devices and feel confident controlling your leg safely.
Will I be able to kneel after surgery?
Yes. Once your incision has fully healed, kneeling is safe. It may feel uncomfortable at first, but with gradual exposure most patients are able to kneel without significant difficulty.
âģ RETURNING TO ACTIVITIES
When is walking helpful after surgery?
Walking becomes more beneficial once you are able to walk with a normal gait pattern. Until then, excessive walking can be counterproductive and increase swelling.
When can I start using a stationary bike?
Typically after the first 10-14 days. Start gradually and monitor how your knee responds.
When can I return to golf?
Once you walk normally without assistance and can navigate stairs comfortably. Start with range work, progress to short swings, then full play.
Can I play tennis or pickleball?
Yes â especially doubles play. Start conservatively and progress based on tolerance.
Can I return to running?
Light jogging (generally under 5-10 miles per week) may be tolerated, but this varies by individual and should be approached cautiously.
ðĨ NUTRITION & PREVENTION
What should I eat after surgery?
A high-protein diet supports healing. A general guideline is about 1 gram of protein per kilogram of body weight per day.
How do I reduce the risk of blood clots (DVT)?
Frequent movement of your ankles and toes helps promote circulation and reduce clot risk. Most patients are prescribed aspirin, though higher-risk individuals may require alternative medications based on their surgeon’s recommendation.
ð PREPARING FOR SURGERY
How should I prepare before surgery?
Preparation includes setting up your home for safety and convenience, and improving your strength and range of motion beforehand. Better preoperative conditioning typically leads to a smoother recovery.