Complete Post Total Knee Replacement (TKR) Rehabilitation Protocol

By Dr. Rashmita Karvir-Kekre (PT) Joint Replacement & Orthopedics August 2026

Undergoing Total Knee Replacement (TKR) surgery is a major step toward eliminating severe arthritic pain. However, surgical success accounts for only half of the journey—the remaining 50% relies entirely on structured, early, and disciplined post-operative physiotherapy.

Why Early Post-TKR Physiotherapy is Essential

Without targeted physical therapy, joint stiffness, arthrofibrosis (scar tissue buildup), quadriceps inhibition, and muscle wasting can restrict knee bending (flexion) and extension. Early rehabilitation aims to:

  • Restore 0° full knee extension and achieve 110°–120° knee flexion.
  • Reactivate dormant quadriceps and hamstring muscles.
  • Reduce post-surgical joint swelling and edema through lymphatic drainage.
  • Re-establish normal walking gait patterns without a limp or walker dependence.

Week-by-Week Post-TKR Recovery Roadmap

Phase 1: Days 1 to 2 Weeks Post-Surgery (Acute Healing Phase)

During the initial days, the focus is on pain control, swelling management, active ankle pumps to prevent Deep Vein Thrombosis (DVT), and isometric quad setting exercises.

  • Ankle Pumps: 20 repetitions per hour.
  • Quadriceps Sets: Press the knee down against a rolled towel under the knee, hold for 5 seconds, repeat 10 times.
  • Heel Slides: Gently slide the heel toward the buttocks to initiate knee bending up to 90 degrees.
  • Straight Leg Raises (SLR): Lift the leg straight off the bed once quad lag is eliminated.

Phase 2: Weeks 3 to 6 (Range of Motion & Functional Strength)

In this phase, patients transition from walker support to an independent cane, aiming for 100° to 110° knee bending.

  • Seated Knee Flexion stretches and wall slides.
  • Step-ups and step-downs to rebuild stair-climbing confidence.
  • Stationary cycling with zero resistance to facilitate joint fluid circulation.

Phase 3: Weeks 7 to 12 (Advanced Balance & Full Mobility)

The goal shifts to achieving full functional independence, high-level balance, squatting mechanics, and unassisted walking for extended distances.

Specialized Care at Health 360 Clinic Vasai West

Dr. Rashmita Karvir-Kekre (PT) provides customized home-based and in-clinic post-TKR physical therapy across Vasai and Palghar district. Treatment plans integrate gentle manual patellar mobilizations, cold therapy, electro-stimulation for quadriceps lag, and progressive resistance training.

Explore our complete range of Post-Surgical Rehabilitation Services.

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Disclaimer: Follow your orthopedic surgeon's specific weight-bearing guidelines. Exercises must be monitored by a certified physiotherapist.