One Month Post-Op Total Knee Replacement - Expectations, common findings and physical therapy

Total knee replacement is tough. Many patients wonder where they should be by their first post-op appointment. In the first month many patients have pain, difficulty sleeping and a lot of physical therapy. Here I will go over the common findings for patients when they present for a one month post-op check-up after their total knee replacement.
0:00 Introduction
0:20 Expectations at 1 month after TKA
1:00 narcotic pain medication
1:05 using acetaminophen or Nsaid
2:07 Knee will feel warm
2:21 lateral numbness
2:52 Knee will look round
3:33 Scar mobilization and desentization
3:57 Most patients do not need the cane
4:26 Physical therapy and transistion to a home program
4:48 Flexion
5:19 Extension
6:16 Icing
6:25 Heat before exercise to warm up
6:50 When its safe to swim or use the hot tub
Watch this video to learn about getting straight: • BEST exercises for Get...
Learn more about bending: • Flexion Exercises afte...
and here: • Using a Stationary Bik...
Antibiotics for the dentist?: • Do You NEED Antibiotic...
Sex after surgery: • Sex after Total Hip or...
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#health #totalkneereplacementsurgery #kneerehab #arthritis

[@marypepin2835]

You have been more helpful than my own surgeon. Thank you for all of these videos. They are so helpful.

[@dradamrosen]

Happy to help!

[@marypepin2835]

@@dradamrosen it’s been so difficult…. Thank you

[@lmboh8585]

Today is my one month anniversary of my TKR surgery. I am 0 - 116 degrees with nagging headache-like pain, along with the accompanying shocks and twitches of healing and awakening. It is amazing to me how well I am doing. I walk outside with a cane due to low stamina, but I walk around the house without one most of the time, and work diligently at my physical therapy. It is neither as difficult nor as painful as I imagined it to be. I had severe osteoarthritis for many years prior to surgery. I am very glad I had it done. I know that in a year I will be walking and exercising with little to no problems.

[@whizbang7130]

Thank you for this. I am five weeks post op and have all these symptoms. Glad to know this is all normal.

[@dradamrosen]

Glad it helped. Sometimes peace of mind is the best medicine.

[@judylivingston8145]

I used a walker for a month and a cane another month....and PROUD IF IT..( m y surgery was due to injury/ fall , not yrs of arthritis pain) so had a fear of falling again

[@emanalsiniy5844]

Great, great information. Thanks

[@eddackerman8503]

Thank you so much ,very helpful!

[@michellehackett3850]

Excellent information ! Looking forward to my TKR in April and PT.

[@mikebrewerbrewer9711]

I had a revision. 1st knee didn't graft to tibia. The revision is much more painful than the 1st replacement Lil over year ago. 1 month in today on revision and still on a Cain. And taking oxycodone for pain. Pray this one works right.

[@jameslathren6100]

I had knee replacement surgery one week ago. This is the MOST helpful information I have had.

[@dradamrosen]

Glad you found it helpful. Good luck with your rehab.

[@marycoopman6565]

Your videos have been so helpful, 17 days post op and I’m working hard at my part of the process using all the information you’ve provided and specifics from my team. Watching videos way more than once. So happy to have found and started watching 4 months pre-op so I knew what to expect. 🙏

[@LazyJack2003]

Very helpful! Thanks!

[@dradamrosen]

You're welcome!

[@vtxdaryl]

Thanks for sharing your knowledge.

[@dradamrosen]

Glad it was helpful!

[@HeidiSue60]

Based on another video of yours, I did both range of motion exercises the extension and flexion, on the hour every hour for one full day. That was 7/18 this past Monday and today is 7/22 Friday. Tues was my 3 week mark. That night and the following day my pain was almost to the same level as it was my first few nights home from the hospital. It has persisted throughout this entire week, day and night like spasms or waves of level 7-8 pain. I have not gone back to doing those exercises every hour because I don’t want to have that kind of pain. I paid for it for too long. With my physical therapist I was able to achieve 102° in the second day of my second week. And I just did my flexion exercises and got to 102°. I’m going to aim for 110° by the time I go in for my six week check up with the doctor on August 8. But I just can’t make myself do the exercises every hour. Similar to my arthritis prior to the operation… If I walked any distance greater than say 30 feet, I couldn’t hardly move the next few days. It feels like overdoing it and I don’t want to overdo it and then not have any range of motion on the following day(s)

[@GaryForgingOn]

This was so good. Thanks for commenting on my video and what you say here is spot on and so true. Thanks

[@dradamrosen]

You are so welcome

[@danielsonscott3038]

Although i'm candidate to TKR in both knees shortly I refuse my self to have it done, this procedure is extremely invasive for me, i'm afraid of it! I've heard good n bad stories!

[@marijabu]

Thanks so much.

[@dradamrosen]

You're welcome!

[@TheRealSigma69n1qqa]

Hi! I just had my total knee replacement on my left knee exactly a month ago & your video really is very helpful. Now, I know where I am now & the things I need to improve more on myself. Though I m not totally pain free yet, but pain is manageable now. I walk with a four legged cane hoping to walk in a one legged cane soon. After your video, I will do more exercises in strenghtening my leg. Thanks again.

[@sumsharp]

thank you for this information. Good to know where I stand in terms of recovery.

[@dradamrosen]

Glad it was helpful!

[@Southprong59]

Good video Dr. Rosen.

[@dradamrosen]

Glad you liked it!

[@erichumber3831]

I had total right knee 3 weeks ago and this is no joke. The pain is brutal sleeping is very difficult. I still have to take oxycodone at night otherwise I won't sleep. Can't sleep on my side only on my back. You'll see people tell you that they're great after 10 days or two weeks they're all lies. At least it's over now

[@dradamrosen]

Yes, rough course but it does get better with time and therapy. Wishing you a speedy recovery.

[@johnhughes1394]

Your description of all these symptoms and motions are very accurate. Helpful to me at almost one month post- op to know what I am experiencing is normal and to be expected. Thank you

[@dradamrosen]

Glad you found it helpful

[@karensinger9134]

You said to use the heating pad 5 minutes before surgery. I think you meant before exercises?!

[@marycoopman6565]

So happy to find your channel. I’m pre-surgery and expect to schedule within the year. The information you provide and have provided is fantastic and I feel very prepared to do a lot of work from day 1, in the first 6 weeks and beyond. I would love to have my old beautiful legs available for short skirts and shorts… and although the scar of surgery is not so much an issue, the round bulbous knee wont be flattering. Is that something that will or can improve over time? As my knee became knock-kneed I’ve put vanity in the freezer… would love to take it back out. Any chance?

[@boondog8504]

4 weeks and one day after right leg TKR. Was walking unaided on Day 2, driving on Day 5. Walked 3 miles yesterday, going up and down stairs unaided, been doing full revolutions on bike for 2 weeks. Scar is imperceptible. Quit the pain meds on Day 7. No pain, just discomfort, especially at night. I am happy. ROM is 125.

[@dradamrosen]

Sounds like you are a rock star! Great job.

[@paisleyjane9606]

I thought I was doing pretty well. Now I feel terrible about my slower progress! "Should" seemed to be a word that popped up in approximately half the sentences my mother-in-law ever spoke to me. Maybe that's why I'm a bit triggered.

[@AaronD711]

Had my TKR on the 22nd and have noticed a vast improvement on the pain factor and overall usage of the leg. I have stiffness but push through that and have approx 96 degrees of flex at this point in time. Thinking I need to push it a bit more to obtain full bend. Your videos have been a great help when it comes to the " what about this" questions. Thank you for making them!

[@dradamrosen]

Glad you liked them. Wishing you a speedy recovery.

[@christiearnold2781]

Just finished 3 weeks. I do feel more human but still hurting quite a bit. I'm behind on straightening and bending but my knee was very stuck before so I have alot of work to do. Just can't wait for this hot, nagging pain to ease. Thank you for these videos. They do help.

[@dradamrosen]

Keep it up the good work.

[@eytanfichman7623]

I've scheduled surgery in June. Your videos are helping me know what the range of reasonable expectations might be - much appreciated.

[@dradamrosen]

You are very welcom

[@kevinjoyce1825]

Dr Rosen videos have been so helpful in my recovery. I had Bilateral Total Knee Replacement on 3/14/23. I have followed my surgeon AND Dr Rosen's videos to guide my recovery and PT. I been very regimented in do my PT especially the 2 exercises Dr Rosen recommended (using a chair) every hour on the hour. At 4 weeks I'm 123/1 and 125/0 ROM. Do your exercises! It helps with the pain.

[@Rosie-wj1le]

This is the BEST video for one month post TKR. I am 4 weeks out. I have 100 percent extension and 125 percent flexion. it involves a lot of hard work and every day is a challenge. I do my PT exercises every day in spite of the stiffness. I ice and elevate several times a day. And I use vitamin E on the scar. This video is very helpful and realistic. Thank you, Dr. Rosen.

[@dradamrosen]

Thank you for the kind words glad to hear it was helpful!

[@MobiFlames]

It been 1 month after total Knee Replacement but my grandfather is unable to get full extension is any way I can get it as before surgery he was on bed completly and knee always on 90° pain in both extension and flexible as of now after Surgery flexion is 100°

[@992turbos8]

I’m 5 weeks post op with a 0-130 , with slight feeling returning to the area ,my biggest concern is the Deep pink almost burgundy colour incision . I’m assuming this is caused by increased blood flow but some may be alarmed , what’s your thoughts ?

[@janetshappard4461]

With me I have a subtaytor fusion on tub right and a triple fusion on left but I'm trying my best

[@sierrasky2491]

At 1 month i am still using walker. I will transition to outpatient physical therapy at 6 weeks and co tinue for 1 more month.

[@Dbatem]

I am starting my fourth week after TKR. I’m in great physical shape and in my mid-50s spent four days in hospital, which was supposed to be day surgery knee swelled up like a balloon allergy to nerve blocker. could not bend my knee more than 10% upon release from hospital. Stitches couldn’t be removed until two days ago as I was not healing …extremely painful. pain is a real thing got put on a nerve blocker pill. At this point, I regret getting it done. ROM 5%_and 90%

[@dradamrosen]

Yikes. Sorry to hear. Hope things get better.

[@susanmitchell4377]

Was doing great immediately following surgery but something happened to irritate MCL so now I feel like I’m going backward!

[@garyp1432]

Same with me in the 1st 2 weeks my surgeon was calling me iron man I’m now in my 3rd week and need more pain killers and more swelling and it’s a bit worrying.

[@lukasfrancodesales9975]

Why do infection happen few weeks after knee replacement surgery. Possible causes.

[@damodaranp7605]

How many months will it takes to walk without limping after tkr?

[@cherimontana6868]

I’m 7 weeks out from Total knee replacement. I did not have a one month check up. I will have a two month check up via a phone call.

[@defrost8648]

Cheri, have you had any post-op check-ups? I’m still 2 weeks out from my TKR, but already have a 2-week follow-up and a 2-month follow-up scheduled.

[@jangriffin-fi1yx]

Me too was given info when first saw Orthopaedic Surgeon. Good luck when you have yours, mine is months time. Hope all goes well for all ​having TKR 🙏

[@henriettayeboah9749]

Am 8 months post op on my right knee and 2 months 3 weeks on the left one. I have lower back pain so is difficult for me to walk for more minutes. What should I do my ROM is ok says the therapist.

[@Diana-007]

Very helpful video thank you, I have what feels like a broad very tight band around the top and bottom of my knee, I’m now at nearly 4 weeks, pushing past the “band” to bend is extremely painful when I attempt this, it almost feels like my knee has been stitched too tightly, has anyone else experienced this? 🥰🏴󠁧󠁢󠁳󠁣󠁴󠁿🇬🇧

[@mikehewlett6376]

Hi Diana, I’m just 11 days post op, this is my second knee replacement, the first…my right…was done just over 2 yrs ago and the post op night pains were awful but I found flexing( ROM) of the knee to 90 degrees and , as each week that passed, beyond 90 was “relatively “ not too excruciating. This second knee…my left…feels different in that the night burning and awful pains I don’t have but the flexing is very painful. I can’t say my flexing problem feels like a tight band but boy the the thigh muscle is tight and my shin hurts too when I’m flexing towards 90 degrees. I guess all surgeries and all joints are different . I used Dr Rosens videos last time and am doing so again as there is no post op care here in Spain! It’s difficult isn’t it to judge how much pain we should push ourselves through but I’m a great believer in listening to your body. I’ll continue doing the knee bends towards 90 degrees and just let my leg pain tell me when I’m at my present limit. Good luck with your physio, keep pushing yourself 😊

[@Diana-007]

@@mikehewlett6376 hi Mike, thanks for your reply, I’m now 18 weeks post op and doing grand, the tightness I spoke about at 4 weeks thankfully went by week 6 my Consultant reassured me this was a normal occurrence though horrible sensation. As he said this is a marathon not a sprint and it will take up to a year to feel the knee is totally “normal”. I had to go private here in the UK the waiting list was just way too long and life is too short! List times are getting better now I hear!. Thankfully the cost included 6 months physio but basically its the same advice as the great videos you find on KZbin, just a bonus of someone keeping an eye that your doing the exercises properly! You must be in the really painful phase I remember that clearly, so early days, hope you get through that soon and the range improves as you know it will, yes listen to your body best advice I got from my physio, no pushing through the pain till it really hurts, very counterproductive. Wee tip one of my friends who is a GP gave me a great gift instead of the usual flowers! Its a small heavy duty plastic disc called the Ortho~Glide it was designed by an nhs doctor and approved by the NHS for use for encouraging lower limb exercise , it really improved my bend (ROM) can’t praise it highly enough, you place your heel in the indent on the disc then gently slide your leg back and forth, you can use it on any surface and I even used it in bed on the bad days, best pressie ever and when I looked it up for more background info I found it was only £10 on Amazon. I’m like you and will need the other knee done but waiting till the memories fade a bit more 😂 but probably end of the year. Good luck to you 🤞 I’m sure you will enjoy the benefits of two great knees soon! 😊

[@melindabucy8459]

I had my second TKR and everything has gone wrong my knee is so swollen I cant not even bend my knee. 😢 The pain is unreal.

[@kathythorene5873]

I had a total knee replacement surgery in February and my 2nd TKR in November. I am glad that I viewed your video before my first surgery it was very helpful and my recovery went well. With my 2nd surgery I ended up with a foot drop and that is challenging but with PT I know it will get better. Thank you for the information it has made a difference.

[@dradamrosen]

Sorry to hear about the foot drop. Glad that you found the info helpful.

[@aaronmooney1573]

This is very helpful information but seems a bit aggressive. Are the majority of TKR patients off a cane at 4 weeks? Maybe I’m just behind but at 4 weeks today, I am still using a cane for any walking outside of my home. Ie. Grocery store, deli visit, neighborhood walks around the block

[@Bansheae]

Quad muscle strength and leg stability I think determine this

[@aaronmooney1573]

@@Bansheae thanks for your comment! That absolutely ended up being the situation. I am nine months postop now and my quad muscles are back to full strength. Most of the times I forget I even have a knee replacement. I have no restrictions. I am mountain bike racing, training in the gym, fly fishing and hiking with my new pain free knee. When I’m warmed up, I can get close to 140° of flexion and have 5° of hyper extension. Getting my right knee replaced was the best decision I’ve ever made! I’m 53 and was hesitant due to my age. But nonstop pain swelling and a daily limp made me realize I had to do it. All of my issues with stability and strength early on when I was using a cane we’re definitely due to some quadricep extension lag which just took time, patience and lots of PT.

[@ishratlatif3924]

I am from Pakistan.Cant bend even 90 degrees after 3 weeks.I could do 110 before surgery.Are there any differences due to surgery techniques.

[@user-gi9dt6if1d]

I understand everyone is different and heal differently. I am six weeks post op. I do PT three times a week and it is difficult at times to get to the number they want me at right now which is 110 or more. Last Monday l reached 110 degrees but this week is not getting that number. I see my surgeon Monday April 22 to see where my range of motion is. If it's not where she thinks it should be....she wants to manipulate my knee. (She puts me to sleep and pops my knee where it will bend) I don't want that done. I am asking her for more PT before this manipulating is done. My knee is swollen and hard on the right side of knee cap and is numb. I can not get an answer to why it's hard in that area. However l try my best to do my exercises at home and for the therapist. My knee feels as if it' has a mind of it's own and will not cooperate at times. Like l hit a brick wall...it just will not go any further. It is very painful and believe me it's no walk in the park by no means. I try hard along with the therapist to get my knee to bend like it supposed to but it will only go so far then stop and when we try to push a little bit further it feels like it's going to break. Hurts really bad. I don't take anything for the pain unless I absolutely have to. I ride the pain out. Cry, yes l cry it hurts so bad. But I realize I am not the only one who has had this done. I do what I can do and that's all l can do. My prayers are with all of you who have had this done and those who are awaiting surgery. Don't get discouraged. Brighter days are ahead.

[@dradamrosen]

Sorry to hear. This is my video about manipulation (MUA) you might find helpful -kzbin.info/www/bejne/Z2a6l2OZedR5gKs

[@chadi6536]

Doctor, I took my mother to my doctor. She had the operation, and he told her that she has fibrosis in the muscle and knee, and what is the solution, Doctor?

[@czi2011]

I was discharged from hospital almost 3 weeks ago. The surgeon told me that he adjusted my joint „very tight“ (how he did that and for which reason I did not understand). Started with PT 4 days later and I was just at 75 degrees. After 4 times PT I could reach 95. I feel my pain level is very high (maybe at 7/10). Home exercise is no fun at all. Maybe I am just a wimp?😅

[@yf4012]

No, you are not! I hope you’re doing much better now.

[@user-gi9dt6if1d]

No you are not a wimp. It does hurt and it hurts really bad. I can relate to your pain. I can not get my knee to bend where it needs or close to where it needs to be. Last week I was at 110 this week barely got to 98.

[@user-gi9dt6if1d]

I am six weeks out from my tkr

[@czi2011]

@@user-gi9dt6if1d be patient with yourself. Everyone is different. Close to 8 months now, still some tension, but I am happy to have decided pro operation. Be as consistent as possible with prescribed exercises as long as you can tolerate the pain. I felt the recumbent bike and usage of a stability ball in my bed gave me a huge progress.

[@freckles7184]

I’m at 0/130 at 4 weeks! 😳

[@jimbob4456]

That is awesome.