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Total Knee Replacement

The following information has been written in line with the Physiotherapy and Surgical teams at the James Paget University Hospital. If you have had your operation at another hospital, you should refer to the information and advice you were given as it may differ from the information below.

What is a total knee replacement?

A total knee replacement is a major operation that involves replacing both the top and bottom parts of your knee joint with an artificial joint.
 
In most cases, your kneecap is not replaced.

Why have I had a total knee replacement?

Every case is different, however, in a lot of cases people will choose to have their knee joint replaced because of osteoarthritis (for more information on osteoarthritis click here) that hasn’t improved with physiotherapy, and/or has become increasingly difficult to live with.

What should I expect after having a total knee replacement?

This is a really important question and it is useful for you to know what is normal after having your knee replaced. We’ve broken the answer down into things that are found most commonly:

 

What can I do to help my knee recover?

Reassuringly, there are lots of things that you can do to help get your knee going and start your recovery.

Firstly, it is important to know what is normal. Therefore, if you haven’t already, please read the ‘What should I expect after having a total knee replacement?’ section.

 

I’ve been given a walking aid to help me walk but I’m not sure how to use it.

No problem. Please click on the picture of the walking stick and you will be taken through to our walking aids page. Don’t forget to come back here for more useful information about your knee recovery.

Is there anything I should look out for?

After any operation, it is important for you to be aware of what is normal (see above) and perhaps, what is not. Below is a list of things that should be raised to your doctor, surgeon or practise nurse if you experience them after your surgery. If you have previously had a Deep Vein Thrombosis (DVT), you should familiarise yourself with the list and monitor yourself for any issues.

Generally feeling unwell and/or a temperature following surgery

Red, painful, swollen calf or calves

Entire leg considerably swollen

Painful groin or back of your thigh

Inability to move your foot with or without numbness below the knee

Sudden change in breathing i.e. finding yourself breathless, coughing up blood or a new pain in your chest – this could indicate a medical emergency and you should call 999 or go to A&E


If your wound edge becomes red, oozy and/or painful, please contact the ward that you were admitted to for your surgery. Please do not contact your GP. You will be asked to come into the hospital for a review by your consultant or their team.

What does a good result look like after a total knee replacement?

As you would expect, everyone is very different, but after a total knee replacement it is hoped that the pain you felt before your operation would have improved, and your ability to use the new knee would also have progressed i.e. being able to walk easier or get out of the chair with less effort.

It is very likely that the movement of your new knee would have improved, but it is very well worth knowing that most new knees do not move as fully as they might have done before the operation. In other words, a good result for a new knee would be a bend to about 90 degrees and be as close as possible to being fully straight. There is often a large variation in how much movement comes back after a new knee, but if it is less painful and you can do more with it, it still means you’ve got yourself a good result.

How can I get the best out of my new knee?

Use it and enjoy it! Recovery after a total knee replacement can sometimes be a bumpy journey and will take time. Often, you may not really get a good idea of just how good the result is until you are 12 months after the operation. 

If you want to make sure you get the very best out of your new knee, getting or keeping yourself fit and strong will make sure that you, your body and your new knee are in the best shape to enjoy it. You will find a selection of strengthening exercises below that you may be interested in to really try to get your knee strong enough to do most of what you want it to do.

FAQ

Below are some of the common questions that are asked when talking about total knee replacements that haven’t been covered in the information above.

A: No, not really. As long as you are sensible and listen to your body, you should be able to do anything that you want to with your new knee.

A: It is really not unusual to find that your knee looks different after the surgery. It will be swollen or you may have lost some muscle bulk in your legs before the operation, both of which will make your knee look different.

A: We are all different. It is often not useful to compare yourself to others, even if you’ve had the same operation. How difficult your knee was before the operation, your strength and how well your pain is controlled are just a few things that will vary from person to person. Recovery from a major operation takes time and it's best to think of this in terms of months rather than weeks.

A: As explained in the previous question, we are all different and so are your knees. Even though having a knee replaced is technically the same operation, given that it is done on a different knee means that it’s not exactly the same, therefore it is unlikely the result will be exactly the same. Things like your age, strength, fitness and general health all change over time and will play a role in influencing how you get on after your operation, including if it’s your second one.

A: Generally it is recommended you can return to driving six weeks after a left total knee replacement or allow eight weeks after a right total knee replacement due to the power required to brake. However, it is each individual’s responsibility to ensure they are fit to drive. You should ensure you can confidently and without any hesitation perform an emergency stop before even considering driving on public roads.


It is always recommended to contact your insurance company one month before you return to driving to ensure your insurance is valid. This advice is the same if you drive an automatic car.

A: Firstly, there is no such thing as a normal walking pattern, only what is normal for you. It often takes some time to get the right amount of movement and confidence to walk as normally as you hope to. Make sure you don’t rush things and continue to use a stick (if you have been issued with one) or crutches to make sure your walking quality is good before discarding them. Quality beats quantity!

A: Technically, you are safe to kneel on your new knee but most people don’t have the required amount of movement to kneel comfortably, therefore they choose not to.

A: Yes it is. Your new knee would have been put in place extremely firmly and it is incredibly rare for it to loosen. Occasional clicks and cracks are quite normal for joints, including newly replaced ones.

Exercises

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