“DR. TREVOR” STEFANSKI, M.D.
Minimally Invasive Specialist

Knee Replacement

Physical Therapy Protocol

Knee Replacement Recovery: Physical Therapy and Activity Guide

Knee Replacement Recovery
Physical Therapy and Activity Guide

With Dr. Trevor Stefanski’s modern advances and techniques, including minimally invasive, muscle-sparing, ligament-sparing, and atraumatic approaches, the vast majority of patients can achieve an optimal outcome without the need for formal physical therapy. These techniques are designed to minimize tissue damage, reduce pain, and promote faster recovery. Your progress will be evaluated at each post-operative visit to ensure you are on track. If at any point additional physical therapy is needed, we will tailor the plan to meet your specific needs and help you achieve your recovery goals. Here is a home exercise and activity guide to keep you on track:

Weeks 1–2: Early Home Recovery

Goals:

Reduce swelling, manage pain, and restore initial mobility.

1. Compression and Elevation

  • Use a compression bandage or Velcro wrap from your foot to mid-thigh.
  • Elevate your leg for 40 minutes every hour (toes above the nose).

2. Icing

  • Apply ice to your surgical leg for 40 minutes every hour to reduce swelling.

3. Physical Therapy

  • Perform these exercises every hour while awake:
    • Seated knee flexion/heel slides: 10 repetitions.
    • Knee extension (passive/assisted): 10 repetitions.
    • Ankle pumps: 10 repetitions.
    • Walk 5–10 steps/hour.
    • Heel hangs: 10 minutes, 3x/day.
  • Limit stair climbing as much as possible.
  • Focus on range of motion (ROM) exercises with a goal of 0–110° by Day 14.

4. Step Count Goals

  • Week 1: 750 steps/day maximum.
  • Week 2: 1,200 steps/day maximum.

5. Other Tips

  • Avoid strengthening exercises (e.g., squats or lunges) until cleared by your surgeon.
  • If swelling or ROM doesn’t improve, consider additional interventions like lymphatic massage or a compression device.

Weeks 3–6: Progressing Recovery

Goals:

Build strength, increase mobility, and reduce swelling.

1. Compression and Elevation

  • Continue using a compression bandage or device.
  • Elevate your leg for 40 minutes, at least 3x/day.

2. Icing

  • Ice your leg for 40 minutes, 3x/day or more if needed.

3. Physical Therapy

  • Gradually stop using assistive devices (e.g., crutches or walker) as tolerated.
  • Perform range of motion exercises 6 times/day for 5–8 minutes each session.
  • Continue isometric quadriceps sets (tightening your thigh muscle) but avoid strengthening exercises like squats until after 6 weeks.
  • Focus on achieving maximum ROM (ideally matching your intraoperative ROM) by the end of Week 4.

4. Step Count Goals

  • Week 3: 2,000 steps/day maximum.
  • Week 4: 2,750 steps/day maximum.
  • Week 5: 3,500 steps/day maximum.
  • Week 6: 4,500 steps/day maximum.
  • Gradually increase by 1,000 steps/day each week, using pain and swelling as your guide.

5. Returning to Work

  • Avoid returning to work before 6 weeks if possible.
  • Standing, stairs, or lifting too early may increase swelling and slow recovery.

Additional Tips for Recovery

  • Maintain an anti-inflammatory diet and continue any recommended supplements.
  • Monitor for signs of excessive swelling or limited ROM. Contact your surgeon if these occur.
  • Focus on following the prescribed plan to ensure the best possible recovery and long-term success.