This TKR guide is part of our patient-focused care to provide you a specific post-operative protocol that you should follow to restore strength and mobility to your knee and a gradual return to everyday activities which are important for your full recovery after knee replacement. You should already be familiar with some advice and exercises during your hospital stay. Should you have any questions on the exercise activities, please seek advice from your doctor or therapist.

General Information

• Early post-operative exercises such as ankle pumps, knee presses, and bed-supported knee bends will help increase circulation to your legs and feet which is important for preventing blood clots in leg veins. These exercises do not only strengthen your muscles but also improve your knee movement.
• To help decrease swelling and pain, you should apply cold compress to your operated knee for 10-15 minutes while lifting the leg on supporting pillows after leg exercising, stand upright, or walk.

Proper lying posture

• Lie on your back: Elevate your leg while keeping your knee straight. Avoid pillow support under your knee.
• Lie on your side: Lie on your normal side with pillow support in between the knees. Avoid lying on the side of the operated knee.

Getting into a car

• Stand with your back facing the side of the car, legs touching the side of car seat. Gradually lower yourself onto the seat and slide towards its center. With knees close together, lift your legs up and at the same time swing your body and legs into the car.
• Start with short walks spreading throughout the day and slowly increase your walking distance. A sudden increase in your walking activity may cause more swelling, stiffness, and pain. A proper gait aid will be given/advised during your recovery period at the hospital.
• Pain medication should be taken as prescribed. It is important that your pain is controlled so that you can complete 2-3 exercise sessions each day and gradually increase your walking distance.
• Other precautions: avoid deep squat, knee twist.

Post Knee Replacement Exercise
Exercise 10 – 20 times / activity. Improper exercises could increase risk of injury, please check with your doctor or physical therapist before performing any exercise. In case you experience knee pain or swelling after exercise, you should stop the activity and contact your doctor or physical therapist.

1. Knee Presses - Lying on your back, place small pillow or rolled towel under your ankle, press knee down, hold for 10-20 seconds, then gradually release.
2. Ankle Pumps - Lying on your back, place small pillow or rolled towel under your ankle, then flex your foot up and down.
3. Straight Leg Raises - Lie on your back with the un-operated leg flexed, straighten the operated leg and slowly raise it up to no more than 45 degrees then lower it down keeping the leg straight during the entire leg movements.
4. Knee Bends - Lie on your back, slide your heel as close as possible towards the buttock, and then straighten the leg out.
5. Side Lying Hip Abduction - Lie on the normal side, move your leg up and down.
6. Bridge Exercise - Lie on your back with knees up, hold your tummy, lift your bottom up then hold and release.
7. Sitting Knee Straight - Sit on the side of a bed or in a chair with heel resting on a low stool, straighten your leg up.
8. Sitting Knee Bends - Sit on the side of a bed or in a chair with the thigh supported, use the opposite ankle to help bend the operated knee as much as possible without causing pain.
9. Sitting leg lifts - Sit on a steady chair, lift your operated leg up and then put it down.
10. Standing knee bends - Stand with support for stability and bend your knee backward.
11. Standing Hip Abductions - Stand with support for stability, swing your leg out sideway.
12. Backward Leg Kicks - Stand with stability support and stretch your operated leg backward.
13. Knee Ups - Stand with stability support and lift up the knee.

Please check with your doctor or physical therapist before performing any exercise. In case you experience knee pain or swelling after exercise, you should stop and contact your doctor or physical therapist.

How to Put On Pants after Knee Replacement Surgery
Always dress the operated side first when putting on pants.

1. Prepare the pants using a reacher and hands.
2. Put on the operated side first.
3. Pull your pants up.
4. Wear the pants on the other leg.
5. Stand up and pull up your pants (put weight on the non-operated leg).

Home Modifications for Post Knee Replacement Surgery

Home Environment

• Stay on the ground floor if possible.
• Easily accessible bathroom near your bedroom or use portable commode.
• Place a steady chair with armrest in every room including shower area.
• Avoid bending too low and reaching too high.

LIVING ROOM & BEDROOM

• Remove loose wires or cords from walkways.
• Remove rug or carpet.
• Fix any uneven flooring or doorway.
• Install more lighting in corners and throughout walkways.

BATHROOM

• Grab bars: Install secured grab bars in your bathroom.
• Raised toilet seat: Raising toilet seat will keep you from flexing your knee or hip too much and helps you stand up from a sitting position.
• Non-slip mat: use non-slip or rubber silicone mat in the tub or shower/wet area to avoid falls / slips.
• Standard shower chair: Always sit on a chair when showering. *This is to prevent prolonged weight bearing, slip and fall.
• Dry/Wet Zone: Separate dry and wet zones in your bathroom. Place a non-slip mat in the wet area.

ASSISTIVE DEVICES

• Reacher: Help you pick up things from the floor, put on your pants, and take off your socks.
• Shoehorn: Help to put on shoes.
• Long handled sponge: Help to wash legs, feet, back, and hard to reach areas.