What to Expect Your First Year After a Total Knee Replacement

Getting Back to Normal

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Knee replacements used to be very invasive, requiring several days in the hospital. But with advancements in surgery, total knee replacements are now minimally invasive and completed with robotic-assisted technology. This means you get to go home the same or next day and experience a more rapid recovery.

It is essential to recognize that there is still a lot of healing throughout the first year after your knee replacement. From your incision healing, regaining your mobility and strength, walking without a walker, and then getting back to doing what you love, it is a long but exciting journey.

To help guide you through this recovery process, let’s look at what happens throughout the first year, breaking it down by important milestones. But first, here are a few key things to remember:

  • You must stay ahead of the pain by taking pain medication as prescribed and icing frequently.
  • Physical Therapy will be painful, but it is necessary to help you regain your function.
  • And most importantly, keep in mind that you will eventually reach your goals; it may be painful and a lot of work, but the outcome is more than worth it.
Knee replacements

What to Expect During your First Day after Knee Replacement Surgery

When you wake up after surgery, you most likely won’t be experiencing pain as local anesthetics may still be in effect. You will follow a multi-modal modern pain protocol right away to help manage your pain throughout your recovery. This includes having IV or oral analgesics while you are still in the hospital and then continuing with oral medications throughout the beginning stages of your rehabilitation.

These medications may include opioids, acetaminophen, and anti-inflammatories. Other natural pain-relieving modalities include cryotherapy, elevation, and compression. Aspirin is also a critical medication that will begin during your first day after surgery. This should be taken daily for the first month to help decrease any risk of developing a blood clot.

You won’t see your incision yet because of the bandages. Still, your incision will be fully closed with a sterile dressing and bandage. You will also be wearing sequential compression devices (SCD)s on both legs to help control the swelling and prevent blood clots.

After surgery, you will be able to transfer to a sitting position. Then you may begin walking with a walker. If everything goes well in terms of pain, you will be allowed to go home on the day of surgery. Under some circumstances, you may have to stay the night. If that is the case, you will have Physical Therapy that day in your room where they will help you transfer, walk, and learn the best positions to place your knee into while you rest.

Whether you get to go home the day of surgery, or the day after, you will want someone to drive you back home and most likely stay with you for the first two weeks. Getting into the car as a passenger can be challenging, as you may have to bend your knee further than you have in a while. Have your driver come in the most spacious car available, scoot the seat back, and carefully transfer into the vehicle.

What to expect during your first day after knee replacement surgery

What to Expect During your First Week after Knee Replacement Surgery

Throughout the first few days back home, you will notice more pain. And you will also start to see swelling and bruising. It is important to stay consistent with your pain medication, cryotherapy, SCDs, and elevation to manage these symptoms. This is emphasized, not just for your comfort but for your ability to go through Physical Therapy successfully.

During the first or second day at home, you will begin Physical Therapy, either at home or in a clinic.

Either way, during this time, it is imperative to gain full function of your quadriceps muscle, the ability to straighten your knee completely, and the ability to bend your knee. This will allow you to regain your independence and return to the things that you love to do.

The bandages will stay on for at least a week. At this point, you will have your first check-up with your surgeon to ensure healing is going well.

There are a few key things to remember during this first week:

  • You will continue to walk with a walker.
  • Avoid any twisting forces to your knee.
  • You may want to sleep with a pillow or wedge to help elevate your leg. Avoid sleeping with the pillow under your knee.
  • During this time, you do not want to keep your bandage wet, so carefully bathe.
  • Stay ahead of the pain. Take your pain medication as prescribed. This will allow you to perform your Physical Therapy with less pain and more mobility.
What to expect during your first week after knee replacement surgery

What to Expect During your First Month after Knee Replacement Surgery


Pain management is still a priority. For the first four weeks, the SCDs will be discontinued, and you