Knee replacement recovery

Your knee replacement: recovery

Knee replacement is most commonly performed as an inpatient procedure in a hospital. However, as healthcare options expand and surgical techniques continue to improve, alternatives including outpatient surgery and shorter hospital stays are becoming more common. Whatever is the best option for you, your medical team will help manage your pain following surgery, and your recovery and rehabilitation will begin shortly after your release from the surgical recovery area.

Remember, the information in this section is not intended to replace professional medical advice. If you have questions or concerns, turn to your doctor for answers.

Post-operative care

After your surgery, you will be transported to a recovery room for close observation of your vital signs, circulation, and sensation in your legs and feet. After you awaken and your medical team is comfortable with your progress, you may be transferred to your room or, in the case of outpatient surgery, discharged to go home. Here are some things you may notice as you recover from your surgery:

  • A large dressing may be applied to your incision. This bandage helps to maintain cleanliness and absorb any fluid that seeps from the incision.
  • A drain may be placed near your incision in order to record the amount of drainage from the wound.
  • You may be wearing elastic stockings, or a compression stocking sleeve to help minimize your risk of blood clots.
  • A PCA (patient-controlled analgesia) device that delivers a small amount of pain medication may be connected to your IV. The unit is designed to deliver a small, controlled flow of pain medication; it This device is button-activated activates when you firmly press the button on the machineand delivers a controlled amount of pain medication. Follow the instructions of your care team on how to use the PCA device.
  • A catheter may be inserted in your bladder as the side effects of anesthesia can make it difficult to urinate.

Post-surgical pain management

It is natural and normal to feel some pain after your knee surgery. Your doctor and care team will work to reduce your pain, which may help speed the healing process and make it easier for you recover more quickly.

Short-term pain relief after surgery is usually accomplished using prescription medications. Pain relief medicines that might be used include opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local anesthetics for pain at the surgical site. You may be prescribed a combination of medicines for the most effective pain relief, as well as to reduce the need for opioids.

It is important to note that opioids are a narcotic and can be addictive. If you are prescribed opioids, be sure to use them exactly as your doctor instructs. The aim is to stop taking opioids as your pain level of pain begins to improve. If your pain doesn't improve within the timeframe discussed with your care team, be sure and tell this to your doctor.

Recovering from knee replacement surgery

Successful recovery from your surgery greatly depends on you, the patient. How quickly and how completely you recover depends on a number of factors including how thoroughly you follow your surgeon's instructions as you begin rehabilitation (usually the day after the surgery). Equally important to your recovery time is how well you stick to your therapy and rehab plan at home in the weeks immediately after surgery.

Physical therapy and rehabilitation

Depending on how quickly you recover in the hours following your surgery, it is not uncommon to be asked to begin moving your knee on the same day as your operation. Most patients will also begin working with physical therapists as early as the day after surgery, lifting, stretching and flexing their legs and bending the new knee joint. The therapist will help you learn specialized exercises to strengthen your leg and restore a full range of knee motion. The aim is to help you return to walking and other normal daily activities as soon as possible after your surgery. Once you are home, you may be prescribed a series of physical therapy sessions to take place in the weeks following your surgery.

While every patient's recovery is different, many patients are able to resume most normal activities within about 3 to 6 weeks after surgery. You should expect some pain during activity and at night for several weeks after the procedure; you should alert your doctor if the pain is severe or if it persists beyond a few weeks.

Post-surgery exercise

Your care team's post-surgical activity program may include:

  • A walking program that gradually builds up your mobility, in your home to begin with, and outside as soon as practical
  • Getting back to normal household routines - sitting, standing, climbing stairs, getting in and out of bed and so on
  • A series of prescribed exercises repeated several times a day will to help you regain your maximum range of movement and build strength in your knee.

You'll likely be able to return to driving once your knee is flexible enough to let you enter and sit comfortably in your car, and your muscle control allows you to accelerate smoothly and brake safely.

Important safety notes

Individual results of joint replacement vary. Implants are intended to relieve knee pain and improve function, but may not produce the same feel or function as your original knee. There are potential risks with knee replacement surgery such as loosening, wear and infection that may result in the need for additional surgery. Patients should not perform high impact activities such as running and jumping unless their surgeon tells them that the bone has healed and these activities are acceptable. Early device failure, breakage or loosening may occur if a surgeon's limitations on activity level are not followed.


All information provided on this website is for information purposes only. Please see a healthcare professional for medical advice. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

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The information listed on this site is for informational and educational purposes and is not meant as medical advice. Every patient’s case is unique and each patient should follow his or her doctor’s specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation.

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References

*Journey II BCS.

  1. Hall, et al. Unicompartmental knee arthroplasty (alias uni-knee): an overview with nursing implications. Orthopaedic Nursing. 2004;23(3):163-171. Accessed April 25, 2019.
    • Based on pre-surgical pain levels in UKA patients.
  2. Mayman DJ, Patel AR, Carroll KM. Hospital related clinical and economic outcomes of a bicruciate knee system in total knee arthroplasty patients. Poster presented at: ISPOR Symposium; May 19-23, 2018; Baltimore, Maryland, USA.
  3. Nodzo SR, Carroll KM, Mayman DJ. The Bicruciate Substituting Knee Design and Initial Experience. Techniques in Orthopaedics. 2018;33(1):37-41
    • Compared to non-JOURNEY II knees; Based on BCS evidence
  4. 1Short-term Range of Motion is Increased after TKA with an asymmetric bicruciatestabilized implant.AcceptedPoster Presentation, AAOS 2018 New Orleans. Kaitlin M. Carroll, Peter K. Sculco, Brian CMichaels,RichardL. Murphy, Seth A, Jerabek, David J. Mayman
  5. 2J Orthop. 2017 Jan 7;14(1):201- 206. doi: 10.1016/j.jor.2016.12.005. eCollection 2017. Bi-cruciate substituting total knee arthroplasty improved medio-lateral instability in mid-flexion range
  6.  In Vivo Kinematic Comparison of a Bicruciate Stabilized Total Knee Arthroplasty and the Normal Knee Using Fluoroscopy Trevor F. Grieco, MS a, *, Adrija Sharma, PhD a, Garett M. Dessinger, BS a, Harold E. Cates, MD b, Richard D. Komistek, PhD. The Journal of Arthroplasty, September 2017
  7. Testing concluded at 45 million cycles, ISO 14242-1 and 14243-3 define test completion at 5 million cycles. The results of laboratory wear simulation testing have not been proven to predict actual joint durability and performance in people. A reduction in wear alone may not result in improved joint durability and performance because other factors, such as bone structure, can affect joint durability and performance and cause medical conditions that may result in the need for additional surgery. These other factors were not studied as part of the testing.
  8. Iriuchishima T, Ryu K. Bicruciate substituting total knee arthroplasty improves stair climbing ability when compared with cruciate-retain or posterior stabilizing total knee arthroplasty. Indian J Orthop. 2019. doi:10.4103/ortho.IJOrtho_392_18.
  9. Smith JR, Picard F, Lonner J, et al. The accuracy of a robotically-controlled freehand sculpting tool for unicondylar knee arthroplasty. Congress of the International Society of Biomechanics. August 4-9, 2013. Natal, Brazil.
  10. Zardiackas, Lyle D., Kraay, Matthew J., Freese, Howard L, editors. Titanium, Niobium, Zirconium, and Tantalum for Medical and Surgical Applications ASTM special technical publication; 1471. Ann Arbor, MI: ASTM, Dec. 2005

Additional claim statements and support regarding Smith+Nephew implants and Robotics-assisted surgery

  • Implants that are built to last
  • LEGIONCR Knee with VERILAST technology was lab-tested for 45 million cycles (estimating 30 years of wear performance) and showed 81% less wear than similar 5-million cycle cobalt chrome implant.
    • Learn More
      • ISO 14243-3
      • VERILAST knee wear testing and results apply only to the VERILAST LEGION CR Primary Knee System only. Extended lab-testing for other VERILAST knee systems have not been performed. The results of laboratory wear simulation testing have not been proven to predict actual joint durability and performance in people. A reduction in wear alone may not result in improved joint durability and performance because other factors, such as bone structure, can affect joint durability and performance and cause medical conditions that may result in the need for additional surgery. These other factors were not studied as part of the testing.
  • Smith+Nephew implants may offer a more normal feeling knee
    • Based on JOURNEY II BCS knee implant
    • Learn More
      • Verstaete MA, Van Onsem S, Zambianchi F, et al. Multi-centre evaluation of knee kinematics during different activities for anatomic total knee design. Poster presented at: 2nd World Arthroplasty Congress; 19-21 April, 2018; Rome, Italy.
      • Sharma A, Dessinger G, Cates H, Komistesk R. In vivo kinematic comparison for subjects having a bi-cruciate substituting TKA vs the normal knee. Poster presented at: 2nd World Arthroplasty Congress; 19-21 April, 2018; Rome, Italy.
      • Kosse NM, Heesterbeek PJC, Defoort KC, Wymenga AB, van Hellemondt GG. Improved maximal flexion after minor adaptations in implant design bicruciate-substituted total knee arthroplasty. Poster presented at 19th Congress of the European Federation of National Associations of Orthopaedics and Traumatology (EFORT); May 30 – June 1 2018; Barcelona, Spain.
  • 89% of patients were able to take the stairs again after surgery.
    • Based on JOURNEY II BCS knee implant patients
      • Iriuchishima T and Ryu K. Bicruciate substituting total knee arthroplasty improves stair climbing ability when compared with cruciate-retain or posterior stabilizing total knee arthroplasty. Indian J Orthop. 2019. DOI:10.4103/ortho.IJOrtho_392_18
  • A robotics-assisted knee replacement with Smith+Nephew implants may get you back in the game six months sooner than traditional knee replacement surgery
    • Based on UKA patients
      • Canetti R, Batailler C, Bankhead C, Neyret P, Servien E, Lustig S. Faster return to sport after robotic-assisted lateral unicompartmental knee arthroplasty: a comparative study. Arch Orthop Trauma Surg. 2018;138(12):1765-1771
  • Over 90% of patients who had a Smith+Nephew knee replacement surgery returned to work within 6 months.
      • Harris AI, Luo TD, Lang JE, Kopjar B. Short-term safety and effectiveness of a second-generation motion-guided total knee system. Arthroplast Today. 2018;4:240–243. 1
  • Robotics-assisted surgery with Smith+Nephew implants may lead to a faster rehabilitation and shorter recovery time than traditional knee surgery when following your doctor’s recovery plan and physical therapy recommendations.
    • Claim 19 & 20 (PCS REC.015)
  • Due to its improved accuracy, Smith+Nephew robotics-assisted UKA has lower revision rates* compared to conventional techniques
    • Shown in clinical studies with follow-up of up to 5.5 years
      • Batailler C, White N, Ranaldi FM, Neyret P, Servien E, Lustig S. Improved implant position and lower revision rate with robotic-assisted unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2019;27(4):1232-1240.
      • Battenberg AK, Netravali NA, Lonner JH. A novel handheld robotic-assisted system for unicompartmental knee arthroplasty: surgical technique and early survivorship. J Robot Surg. 2019;14(1):55-60.
      • Gregori A. 5 Yr Experience Semi Active Robotic Partial Knee Replacement: The Financial Impact. Poster presented at: SICOT;October, 2018; Montreal, Canada.
  • A study has shown Smith+Nephew robotic technology has demonstrated faster return to sport (4.2 vs 10.5 months) when compared to conventional techniques*
        • *n= 28 (n=11 robotic procedures), p<0.01
          • Canetti R, Batailler C, Bankhead C, Neyret P, Servien E, Lustig S. Faster return to sport after robotic-assisted lateral unicompartmental knee arthroplasty: a comparative study. Arch Orthop Trauma Surg. 2018;138(12):1765-1771
  • Robotics-assisted surgery with Smith+Nephew implants may help patient get discharged sooner
    • Study of UKA patients
      • Sephton BM, et al. EKS Arthroplasty Conference. May 2-3, 2019; Valencia, Spain.
      • Shearman AD, et al. EKS Arthroplasty Conference. May 2-3, 2019; Valencia, Spain.
  • Robotics-assisted surgery with Smith+Nephew implants may provide patients with a smoother recovery
    • Based on JOURNEY II family of implants
      • Mayman DJ, Patel AR, Carroll KM. Hospital Related Clinical and Economic Outcomes of a Bicruciate Knee System in Total Knee Arthroplasty Patients. Poster presented at: ISPOR Symposium; May 19-23, 2018; Baltimore, Maryland, USA.
  • Robotics-assisted surgery with Smith+Nephew implants may help patients regain function faster
      • Shearman AD, et al. EKS Arthroplasty Conference. May 2-3, 2019; Valencia, Spain.

Additional statements and support regarding Knee Replacement

  • More than 90% of people who have knee replacement surgery experience dramatic relief in knee pain and are better able to perform common activities.
    • Based on pre-surgical pain levels
      • American Academy of Orthopaedic Surgeon website, http://orthoinfo.aaos.org/topic.cfm
  • The majority of patients experience profound improvements in their physical activity after having knee replacement surgery.
    • Based on pre-surgical activity levels
      • Brandes M, et. al., “Changes in physical activity and health-related quality of life during the first year after total knee arthroplasty.” Clin Orthop Relat Res. 1991 Dec;(273):151-6. https://www.ncbi.nlm.nih.gov/pubmed/20981812 Accessed Wednesday, April 17, 2019