Total Knee Replacement: What It Is, How It Works, and How Physiotherapy Helps You Recover

Total knee replacement (TKR) — also known as total knee arthroplasty — is one of the most effective surgical procedures for relieving chronic knee pain and restoring mobility in people with advanced osteoarthritis, rheumatoid arthritis, or traumatic joint damage.

But surgery itself is just one step in the recovery journey. A structured, targeted approach — including physiotherapy, movement education, and progressive strength training — is essential to regain function, reduce pain, and ensure long-term success.

What Is Total Knee Replacement?

Total knee replacement is a surgical procedure in which the worn or damaged surfaces of the knee joint are removed and replaced with artificial components made from metal and plastic. The goal is to recreate a smooth, pain-free joint surface that allows walking, climbing stairs, and daily activities without debilitating pain.

Who Typically Needs This Surgery?

Total knee replacement is usually recommended when:

• Chronic knee pain limits daily activities

• Pain persists despite conservative treatments

• X-rays show advanced arthritis or structural damage

• Quality of life is significantly affected

Example: A 68-year-old gardener with severe knee pain that limits walking and standing for more than 10 minutes may be a candidate when other treatments no longer provide relief.

What Happens During Surgery?

During the procedure:

1. The surgeon removes damaged cartilage and bone from the knee joint

2. The ends of the femur (thigh bone) and tibia (shin bone) are shaped

3. Metal and plastic components are placed to form a new joint surface

4. The patella (kneecap) may also be resurfaced

Most patients spend a few days in the hospital before starting rehabilitation.

How Physiotherapy Supports Recovery

Physiotherapy is central to successful recovery from total knee replacement. It bridges the gap between surgery and regaining functional movement in everyday life.

Early Mobilization and Functional Movements

In the first days after surgery, a physiotherapist will assist you to:

• Sit safely on the edge of the bed

• Stand with support

• Walk short distances using walking aids

Early mobilization helps:

• Maintain circulation

• Reduce stiffness

• Prevent complications like blood clots

Reducing Pain and Swelling

Therapists use gentle techniques and advice to help manage:

• Post-surgical pain

• Swelling and inflammation

• Guarding (protective stiffness)

This may include:

• Compression

• Ice or cold therapy guidance

• Pain-free movement training

Strengthening and Range of Motion

After the initial healing phase, therapy focuses on:

• Restoring knee flexion and extension

• Strengthening quadriceps, hamstrings, and glutes

• Improving balance and gait mechanics

• Movement retraining

• Targeted foot and ankle rehabilitation when needed

Example: A progressive program might start with gentle knee bends and heel slides and progress to standing squats and step-ups over several weeks.

Functional Training & Return to Daily Living

Rehabilitation progresses toward functional goals such as:

• Walking independently

• Climbing stairs

• Getting in/out of chairs and cars

• Maintaining fitness without pain

Physiotherapists tailor progressions based on each person’s goals and responses.

Practical Tips for a Faster, Safer Recovery

• Follow your therapist’s exercise schedule

• Use ice and elevation to manage swelling

• Wear appropriate footwear

• Progress activity gradually

• Avoid high-impact activities until cleared

When to Contact Your Healthcare Team

Seek prompt advice if you notice:

• Increasing pain and swelling

• Fever or wound redness

• Sudden inability to bear weight

• Numbness or loss of movement

How to protect your Knee Replacement

• Maintain proper strength and mobility by participating in regular light exercise

• Avoid falls and injuries

• Avoid high impact activity, such as jumping and running

• Maintain a healthy body-weight.

Expert Physiotherapy for Knee Pain and Recovery

Total knee replacement is a big step, but ongoing support and tailored physiotherapy can make all the difference in your recovery. If you’re preparing for surgery, recovering from knee replacement, or experiencing chronic knee pain, get in touch to discuss how customized movement education and physiotherapy can support your goals.

📞 Call +356 9921 2441 to book an assessment or get advice.

👉 For more expert insights on movement, pain relief, rehabilitation, and physiotherapy, visit our main blog page.

Reference List

1. NHS – Knee Replacementhttps://www.nhs.uk/conditions/knee-replacement/

2. Mayo Clinic – Total Knee Replacementhttps://www.mayoclinic.org/tests-procedures/knee-replacement/about/pac-20385274

3. Cleveland Clinic – Knee Replacement Surgeryhttps://my.clevelandclinic.org/health/treatments/21238-total-knee-replacement

4. American Academy of Orthopaedic Surgeons (AAOS) – Knee Replacement Informationhttps://orthoinfo.aaos.org/en/treatment/total-knee-replacement/

5. Journal of Orthopaedic & Sports Physical Therapy (JOSPT) – Rehabilitation After Knee Replacementhttps://www.jospt.org/doi/10.2519/jospt.2014.5339

6. Physio-pedia – Total Knee Replacement Rehabilitationhttps://www.physio-pedia.com/Total_Knee_Replacement

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