The First Week After Knee Replacement: What Actually Matters
Most patients think Week 1 is about resting. It's the opposite. Here's the exact hour-by-hour protocol we run for our post-op patients in Bengaluru.
Written by Dr. Yashwanth · BPT, MIAP · Founder & Clinical Director · Chief Physiotherapist
You've just had a total knee replacement. The surgery went well. Now the real work begins — and what you do in the next 7 days determines whether you're walking unaided at Week 6 or still on a walker at Week 12.
Day 0–1: Manage swelling, protect the wound
- Ice pack × 20 min every 2 hours (never directly on skin)
- Elevate the leg above your heart when resting
- Ankle pumps: 20 reps every waking hour — prevents blood clots
- Quad sets: press the back of your knee down into the bed × 10 reps every 2 hours
Day 2–4: Regain knee flexion (this is the biggest predictor of long-term function)
You need to hit 90° of knee bend by end of Week 1. Miss this window and scar tissue starts to solidify. Physio at home means we can do supervised bending every day — no missed clinic appointments.
Day 5–7: Walk with the correct pattern
Most patients start compensating with a hip hike or a stiff-knee gait. Once these patterns lock in, they take months to unlearn. Physio-supervised walking with the right assistive device (walker → crutches → cane) is critical.
Red flags: call your surgeon immediately
- Calf swelling, redness, or pain (possible DVT)
- Wound oozing, bright red streaks, or fever above 38°C
- Sudden shortness of breath (possible pulmonary embolism)
- Uncontrolled pain that painkillers can't touch
Why home-visit rehab matters here
Getting to a clinic on Day 3 post-op is exhausting and risky. Home visits mean the exercises happen in your bedroom, on your bed, with you fresh — not depleted from a 40-minute Bengaluru cab ride.
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