The document outlines a comprehensive guide for post-operative exercises following total knee replacement surgery, detailing recovery phases that include early post-operative exercises, initial activity phases, and advanced exercises. It provides specific exercises for strengthening and increasing mobility such as quadriceps sets, straight leg raises, and weight-bearing activities, along with guidance for progression from crutches to walking. Additionally, it emphasizes the importance of following proper techniques for activities like stair climbing and includes advanced exercises for further rehabilitation.

1. Post – Operative
Exercises After a Total
Knee Replacement
Surgery
Ashutosh Hospital Vadodara

2. Phases of Recovery after a Total Knee
Replacement Surgery (TKR):
 Early Post-operative Exercises
 Initial Activity Phase
 Advanced Exercises & Activities

3. Early Post-operative Exercises

4. Quadriceps Sets
Tighten your thigh muscle and straighten your knee.
Then Hold for 5 to 10 seconds.
Repeat 10 times, rest a minute and again repeat. Repeat
several times till the thigh muscles get fatigued.

5. Straight Leg Raises
Tighten the thigh muscles with knee fully straightened. Lift
leg at an angle of 45 degrees and hold for 5 to 10 seconds
and then slowly lower.
Positions for doing the exercises – Lying position, Sitting
on a Chair or bed.

6. Ankle Pumps
Rhythmically move foot up and down by contracting calf
muscles. Repeat this exercise for two to three minutes,
thrice an hour a day. Continue doing the exercise until
swelling subsides.

7. Knee Straightening Exercises
Place a small towel just above the heel and
tighten your thigh. Try to straighten your knee
so as to touch the back of the knee to bed.
Hold for 10 seconds. Repeat several times a
day.

8. Supported Knee Bends
Bend your knee while sliding foot on the bed. Hold
the position for 5 to 10 seconds and then straighten.
Repeat several times a day.

9. Sitting Supported Knee Bends
Exercise Position – Sitting at bed side or in a chair.
Place foot behind the heel of operated knee and
straighten the knee, holding the position for5 to 10
seconds. Repeat several times.

10. Sitting Unsupported Knee Bends
Exercise Position – Sitting at bed side or in a chair
with feet resting on floor.
Slowly straighten your knee and hold the position
for 5 – 10 seconds. Then lower the knee and repeat
the exercise several times.

11. Early Activity Phase

12. Weight Bearing
During early Activity Phase, start bearing weight on the leg
undergone TKR. Balance your weight on the crutches and
your body. Stand comfortably and erect with your weight
evenly balanced on your walker or crutches.

13. Progression from Weight Bearing to Walking
 Start progressing from Standing erect to Walking. Advance your
walker or crutches a short distance; then reach forward with your
operated leg with your knee straightened so the heel of your foot
touches the floor first.
 Start normal walking with following the sequence of heel strike, foot
flat, heel off and then toe off. Walk rhythmically and smoothly as per
the guidance of your physiotherapist or surgeon.
 Adjust the length of your step and speed as necessary to walk with an
even pattern. Gradually put more weight on your leg. Progress from
walking with a walker to walking with a cane.

14. Return to Activity Stage

15. Standing Knee Bends
Stand erect holding a support. Bend your knee as
much as you can. Hold the position for 5 to 10
seconds. Straighten the knee and repeat the exercise
several times.

16. Assisted Knee Bends
Exercise Position – Lye on your back placing
a folded towel over your operated knee and
drop the towel to your foot. Bend your knee
and apply gentle pressure through the towel to
increase the bend.

17. Advanced Phase Exercises
 Multiple Angle Isometrics
 Light Isotonic Exercises – using weight-cuffs on
ankle. The exercises are used for strengthening of
knee joint muscles (Quadriceps and Hamstrings)
 Resisted Straight Leg Raising
 Closed chain mini – squats
 Lunges
 Stair Climbing

18. Stair Climbing and Descending
Always lead up the stairs with your good knee and down
the stairs with your operated knee. Remember, "up
with the good" and "down with the bad."

19. More Advanced Exercises
 Stationary Bicycling
 Stretching Exercises
 Aquatic Exercises
 Stair Climbing