What to expect in the first 6 weeks after a knee replacement

The range of motion you achieve in the first 6 weeks after a total knee replacement strongly predicts your long-term function. This window is uncomfortable, but it is also the most important phase of your rehabilitation. Consistent daily work — not heroic single sessions — is what produces a great outcome.

Focus on swelling control, achieving full knee extension (a straight knee), and 0–90° of flexion. Walking with crutches or a frame is normal. Ice and elevate for 20 minutes, 3–4 times per day, especially after exercise.

Progress to 100–110° of flexion, wean off walking aids and begin climbing stairs one step at a time. Quad sets, heel slides, straight leg raises and seated knee bends should be performed 3–5 times daily — short, frequent sessions outperform long, occasional ones.

Target 115–120° flexion, walk unaided indoors, return to driving (with surgeon clearance) and progress to longer outdoor walks. Functional strengthening, stair training and balance exercises start to dominate the programme.

Calf pain, swelling or warmth (possible DVT). Fever or wound discharge. Sudden loss of range of motion. Pain that is worsening rather than improving week over week. Any of these warrant urgent medical review.