Helpful Tips for the First Week After a Total Knee Replacement Surgery

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The first knee replacement surgery took place in 1968 and since that time it has become more common with an estimated 600,000 total knee replacements (TKA’s) occurring annually in the United States. It is one of the most successful operations in all of medicine thanks to advances in the materials and surgical techniques used. These improvements have resulted in shorter hospital stays; however, this means that more responsibility is placed on the patient in managing their own recovery. The toughest period can be the first week after surgery so we thought it helpful to provide the following tips to help you make it through.

Keep the Joint Moving

This is arguably the single most important piece of advice to remember. Maintaining continual, mild movement of the joint is critical for several reasons. First, and this may sound counterintuitive, the movement will help to improve pain. Normally we may think that we need to rest joints and muscles to help relieve pain, but recently repaired joints will actually hurt less with motion. The gentle movement also serves to circulate blood and prevent clots and reduces swelling. Just keep this in mind – “The more you move, the faster your recovery will be.”

Focus on Knee Extension Range of Motion First

Knee extension also called the knee straight, is the most crucial motion that you need to focus on during your post-surgery recovery. After a total knee replacement, your leg will be prone to remain in a bent state and therefore resistant to being straightened out. However, investing the time into knee extension/straightening will be essential to building and maintaining knee stability, decreasing stress on the supportive ligaments around your knee, and to ensure proper functionality of the quad muscle.

Manage Swelling

While some swelling can actually be a good sign during recovery, too much swelling can increase pain and knee stiffness and lead to a decrease in range of motion. Therefore, knowing how to manage your swelling will be of the utmost importance. Just remember the acronym M.I.C.E. – that stands for Movement Ice Compression and Elevation. Your doctor will likely prescribe medications that will help in controlling inflammation so be sure to take them as directed in order to keep your swelling in check. You can also keep swelling at bay by applying ice and pressure (compression bandage) to the knee when you are resting it. Additionally, elevating the knee when you are resting can help temporarily reduce blood flow to the joint and thereby help to decrease swelling.

Get the Muscles Working

Surgery essentially shuts muscles “off” and it is your job during your recovery period to turn them back “on” and get them to working again. Don’t worry so much about building strength, focus instead on continual movement. You should bend, straighten, and squeeze the muscles at least once every waking hour. This will help them gain more function and gradually increase strength.

Don’t Ditch the Walker too Early

Everybody wants to ditch the walker early on because it reminds them of their own mortality. However, we highly encourage you to keep your walker at least until you are no longer limping. If you get rid of the walker before your body is ready, you could very well end up walking with a bent knee that will lead to scar tissue formation, muscle contractures, and damage to other joints nearby. So stick it out with the walker or a cane for a little while longer than you’d like and you’ll be rewarded by having fewer mishaps down the road.


The first week after a total knee replacement can be the toughest time period of the entire recovery process. However, if you implement the strategies we’ve outlined above you will be better equipped to handle whatever challenges you encounter and you will be well on your way to quickly regaining your knee function and quality of life.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.


1515 NW 18th Ave, 3rd Floor
Portland, OR 97209