Patients are usually given a sheet of exercises and told to do them. Few are told which ones decide the outcome and which are supporting work. The difference is worth knowing, because effort is limited in the first weeks and it should go where it counts.
A knee that does not straighten fully changes how you walk, overloads the quadriceps and tires you out. It is also the thing that becomes permanent if it is neglected early.
This is why patients are told to put a rolled towel under the ankle rather than under the knee, and to practise pushing the back of the knee down into the bed. Those two unglamorous exercises matter more than most of the rest.
Most patients reach sixty to ninety degrees in the first few days, around 100 degrees by four to six weeks, and most of their final range by three months. Pushing hard into pain does not accelerate this and often increases swelling, which itself restricts movement.
Heel slides, sitting knee bends and a stationary bicycle, first rocking and then full revolutions, are the practical tools.
Straight leg raise is the first milestone. Then sit to stand, step ups, and progressive resistance. Strength is what lets you manage stairs, get out of a low chair and walk without thinking about the knee.
The hip muscles matter more than patients expect. Weak hip abductors change how the knee loads with every step.
Ice and elevation are not comfort measures. A swollen knee bends less and inhibits the quadriceps, so controlling swelling directly improves range and strength.
Swelling that is worse in the evening than the morning is normal for several weeks. Swelling that increases steadily, with warmth and redness, is not.
Walker to stick to no support, in that order, guided by confidence and balance rather than pride. Walking with a limp because the stick was dropped too early builds a habit that takes longer to unlearn than it took to form.
Supervised physiotherapy is usually most intensive for the first six weeks. Home exercise should continue for at least six months, and basic quadriceps work is worth keeping for life. Most functional gain happens by three to six months, with gradual improvement up to a year.
Inconsistent physiotherapy, poorly controlled pain in the first fortnight, and starting from a very stiff or very weak knee are the three commonest reasons recovery stalls. All three are addressable.
A detailed rehabilitation guide is available here: https://www.mayurajcc.com/knee-replacement-guides/physiotherapy-after-knee-replacement
Call promptly for fever, increasing wound redness or discharge, calf pain and swelling, a sudden loss of movement that had been improving, or a knee that becomes hot and markedly more swollen after having settled.
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