Important Tips and Tricks Regarding your Total Knee Replacement Surgery
Written by the Rehabilitation Department at Hospital for Special Surgery
Total knee replacements are common with more than 600,000 procedures performed each year in the United States. Hospitals and doctors have been great about educating patients regarding their surgery before and after the procedure occurs. However, patients still have questions about their total knee replacement surgery and how to perform everyday tasks. Questions such as “What exactly was done in my knee?” “What is the best position to sleep at night?” “What is the best way to go up and down stairs with a cane?” “Which exercises are best to perform right after the surgery?” Patients may have forgotten what was told to them, lost the paper education sheet given to them or just need reinforcement regarding techniques that were taught to them.
What exactly was done to my knee during my Total Knee Replacement Surgery?
A total knee replacement is performed when arthritis or other injury damages the knee making it painful and difficult to complete everyday tasks. A doctor will surgically remove any affected parts of the bones that make up the knee and replace it with metal or synthetic implants to allow for pain-free movement. Please refer to this link for more details regarding a total knee replacement procedure.
What is the best position to sleep at night?
The positioning of your body during rest is one of the most important things to be aware of during your recovery phase. Your knee is stiff after total knee replacement surgery and may be difficult to bend or straighten all the way. Regaining full extension within 2 weeks after surgery is a priority. This will allow for proper gait mechanics, increased muscle activation and pain-free walking. Therefore, you should lay on your back with your leg out straight and your knee pointing up to the ceiling. You should place a small towel roll underneath your heel to allow gravity to assist your knee in regaining full extension.
You should avoid sleeping on your side with your knees bent. This will only make it more difficult to straighten your knee throughout the day. You can see other important precautions and positions here.
What is the best way to go up and down stairs with my cane?
When going upstairs, it is important to always hold a handrail if available and place the cane in your opposite hand. You should go slow, taking one step at a time and use your non-operative leg to step up onto the step first. You will then step to the same step with your operative leg and cane. Repeat this pattern throughout the entire flight of stairs. This is called a step to gait pattern. You should not attempt stepping up step over step until you are cleared by your physical therapist to do so.
When going downstairs, it is important to always hold a handrail if available and place the cane in your opposite hand. You should go slow taking one step at a time, but this time use your cane and the operative leg to step down first. Then you can take a step to the same step with your non-operative leg. This is also called a step to gait pattern. You should not attempt stepping down step over step until you are cleared by your therapist to do so.
What exercises are best to perform right after surgery?
It is important to start your physical therapy exercises right away. Most hospitals will have a physical therapist come to visit you after your procedure within 24 hours. The best exercises to perform post total knee replacement surgery are:
1. Ankle Pumps: Lay flat on your back and pump your ankles up and down as if you were pressing on the gas of a car.
2. Quadriceps Sets: Lay flat on your back with a small towel roll under your knee and press your knee into the towel roll, squeezing your quad muscle and keeping your heel on the ground.
3. Gluteal Sets: Lay flat on your back and squeeze your buttocks together and hold
4. Seated Knee Exercise: Sit in a chair, slowly straighten your operative knee and then slowly return knee down to starting position.
5. Assisted Knee Bending: Sit in a chair and bend your operative knee back as far as it will go. You can assist in bending with your good knee.
6. Assisted Knee Straightening: Sit in a chair and use your non-operative leg under your operative leg to assist it in straightening as far as it can go.
It is always important to have a doctor and physical therapist on your team when recovering from a total knee replacement. You can find a physical therapy clinic that is located in your area and in your insurance network through the
You can also find more information regarding your total knee replacement and or other injuries through the Hospital for Special Surgery microsites located on the