Knee Replacement FAQ
Frequently Asked Questions
Everything you need to know about knee replacement surgery, recovery, and the Smooth Knee Protocol — answered by our orthopedic surgeon and physical therapist.
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. During surgery, the damaged surfaces are replaced with metal components and a durable plastic insert that creates a smooth joint surface.
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 — most commonly the inner (medial) compartment. Partial replacement is typically considered when arthritis is limited to one area.
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 — typically after conservative treatments 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.
The First 10–14 Days — The Most Important Window
Why are the first 10–14 days so critical?
How your knee is managed during this period — particularly swelling control and positioning — 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.
Swelling is almost impossible to reverse once established. Prevention in these first two weeks is everything.
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. Combined with your four-times-daily exercise routine, these are essential to a successful recovery.
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 then progressing to strengthening after the initial healing phase. It took our outcomes from 33% of patients achieving full extension at discharge to 97%.
What can slow down my recovery?
Too much activity — especially excessive walking — in the first 10–14 days can increase swelling and delay recovery. 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. Consistency matters more than intensity.
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.
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. Every recovery is individual. Following the Smooth Knee Protocol consistently in the early weeks has a significant impact on how quickly you reach this milestone.
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. Always confirm with your surgeon before getting behind the wheel.
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.
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 increase swelling — especially in the first 10–14 days.
When can I start using a stationary bike?
Typically after the first 10–14 days. The stationary bike is excellent for regaining range of motion and is a staple of the KneeFitIn5 program.
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. Most patients return to golf by 3–4 months post-surgery.
Can I play tennis or pickleball?
Yes — 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 and should be discussed with your surgeon and physical therapist.
Nutrition & Prevention
What should I eat after surgery?
A high-protein diet supports healing — about 1 gram of protein per kilogram of body weight per day. Adequate hydration and anti-inflammatory foods also support recovery.
How do I reduce the risk of blood clots (DVT)?
Frequent movement of your ankles and toes helps promote circulation. Most patients are prescribed aspirin, though higher-risk individuals may require alternative medications.
Preparing for Surgery
How should I prepare before surgery?
Better preoperative conditioning typically leads to a smoother recovery. Set up your home for safety, improve your strength and range of motion, and consider starting the KneeFitIn5 pre-op program.
Built on the Smooth Knee Protocol
The protocol behind every answer.
Every recommendation on this page is grounded in the Smooth Knee Protocol — the clinical hierarchy developed over 30+ years that took our outcomes from 33% to 97% full extension at discharge.
1
Edema control & early ROMThe critical first 10–14 days
2
Strength & balanceOnce swelling is under control
Still have questions?
Start the KneeFitIn5 program or explore the Smooth Knee Protocol — or reach out and we’ll point you in the right direction.