- Knee pain affecting your life day and night?
- Unable to do what you love doing due to limited movement?
- Wondering if knee replacement surgery could be the answer?
Around 85,000 Total Knee Replacements (TKR) are done in the UK every year (1), but doesn’t mean a total knee replacement is right for everyone. As your orthopaedic consultant will explain, you should only consider it when all other non-surgical treatments (painkillers, anti-inflammatories, physiotherapy) and arthroscopy no longer work to relieve pain and improve mobility.
Five key mistakes after knee surgery
After total knee replacement surgery, there are five key mistakes that our specialist orthopaedic consultants have seen patients make – and want you to avoid! They are:
- Not knowing what knee surgery actually involves
- Doing too much or too little after surgery
- Neglecting their physiotherapy
- Not following their pain management plan
- Ignoring physical warning signs
1. Not knowing what a total knee replacement actually involves
Knee replacement surgery is a major intervention. You need to be aware of the time it takes you to recover and rehabilitate your muscles and joints to maximise the benefits of surgery. This will affect all parts of your life, including your ability to walk, drive and when you can return to work. You’ll probably need extra help at home too. However, all that is so worthwhile to get back your mobility and be pain-free again.
You’ll need to sort out your home layout, who will help you and get leave from work long *before* your surgery date. Your surgeon will help with advice about this. Don’t underestimate the amount of help you’ll need; for example, the NHS website recommends:
“Do not do household tasks that involve lifting or moving anything heavy (like vacuuming) for the first 3 months.” (3)
Make sure you have some emotional support too; recovery can seem a long, lonely road if you’re doing it on your own.
In a nutshell, don’t rush into or insist on surgery unless you are willing to commit at least six months of your life. However the rewards are usually amazing, giving you back your mobility and freeing you from pain.
2. Doing too much or too little
After surgery, your body is in recovery mode. So, you can’t push yourself as hard as you might want to do. As one consultant put it, there is less “wriggle room” than when you’re 100% fit and healthy!
- Doing too much and trying to get ‘back to normal’ or back to work too fast, will hinder your recovery.
- Doing too little physiotherapy-led exercises won’t help either. Knee surgery is no excuse to sit around.
Focussing your energy on your physiotherapy exercises as advised helps you get the best results from your surgery and gets your new knee working at its best for you. You will need to put in a lot of effort.
It’s a case of making steady progress and this includes accepting that there may be days when you don’t seem to progress. The main warning sign (more on these later) is if you feel you are regressing, not progressing.
3. Not doing your physiotherapy
Key to your recovery after knee surgery is the physiotherapy regime from your consultant. It is a strict regime that you will need to do every day for weeks.
The three main goals of physiotherapy are:
- Stretches to gradually and progressively increase your range of motion
- Build your muscle strength
- Improve your endurance
The key period for increasing the range of motion (how you can move your knee) is the first six weeks – and it starts on the day of your surgery. Do this right and you have the best chance of establishing a better range of movement.
From week 6 to 12, you need to push forward with therapy to ensure that movement is lasting. Neglecting physiotherapy at this point can cause scar tissue to build up, which will restrict movement and set you back.
You should also attend all physiotherapy sessions and maximise their input. Even missing one can affect your progress.
This physical side of recovery and rehabilitation is hard work sometimes, but the rewards are a pain-free return to normal life with increased mobility. That’s worth working for.
4. Not following your pain management plan
Pain management is an important part of recovery. Effective pain management should enable you to do your physiotherapy more easily, sleep better at night, to walk around and be part of (non-physical) family events.
Pain management also includes dealing with post-operative swelling. This can include home treatments such as elevating the knee, icing and compression. If your knee swelling does not reduce, or becomes hot and red, this is a warning sign.
Your pain management plan will include follow-up appointments with your surgeon and his team. Do NOT skip these, even if you feel your knee is perfectly fine and it’s all going well. Your consultant will want to check that the physiotherapy is building the strength and range of movement and other checks that their decades of experience know are important for a successful outcome.
5. Ignoring your body’s warning signs
After knee replacement surgery, you need to monitor your own healing as well as your physiotherapy progress. Following wound care advice is also crucial to avoid infection and aid healing.
Warning signs that things are not quite as they should be may include:
- Your knee or calf remains red and swollen
- The surgical wound or knee is hot to the touch
- You have a fever
If you have any concerns, call your Joint Reaction consultant. That’s what we’re here for. By spotting issues early, we can help you continue to make good progress and keep on the path to post-operative success.
And finally, Dame Judi Dench on knee replacements
Yes, really! In 2017, the actress talked to her consultant surgeon about her own experiences of having a knee replacement. (4)
“I thought I’ll have this (replacement) done and then I’ll give it two months perhaps before I’ll feel really kind of better. Well. not surprisingly, I felt a great deal better much sooner than that … it was glorious to be able to swim and not have that pain.”
“I think you mustn’t make the mistake (and) think that it’s going to be absolutely pain-free and wonderful straight away. I can’t reiterate enough about the physio. The more you do, and the more you can do a regime, then the easier it’s going to be for you … If you really want to get (your knee) working again then you must teach it how.”
Book a consultation with our orthopaedic specialists
This article on mistakes patients make after a knee replacement is for your information only. It is in no way intended as a substitute or replacement for professional medical advice. When you first see your Joint Reaction knee specialist at your consultation, he will talk through your issue and discuss any previous diagnosis, medications, scans or physiotherapy you may have received for your condition. He may also send you for scans and tests to help him reach an informed and detailed diagnosis. If surgery is recommended as a result, he will then guide you through the procedure.
For more details, or to book an appointment with an orthopaedic surgeon near you, call us on 01252 851285.
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SOURCES:
(1)
Porteous, A., & Wilton, T. (2025). National Joint Registry 22nd annual report 2025. National Joint Registry. https://reports.njrcentre.org.uk/Portals/0/PDFdownloads/NJR%2022nd%20Annual%20Report%202025.pdf
(2)
Sutton, P. M., & Murray, J. S. (2025, February). The National Joint Registry 22 years on: What have we learned about knee replacements? Knee Arthroplasty, Orthopaedics and Trauma, 39(1), 74–80. https://www.orthopaedicsandtraumajournal.co.uk/article/S1877-1327(24)00141-6/fulltext
(3)
NHS England. (2023, March 9). Recovering from a knee replacement. https://www.nhs.uk/tests-and-treatments/knee-replacement/recovery/
(4)
Monk, J. (2017, May 3). What I wish I knew about total knee replacement with Dame Judi Dench [Video]. YouTube. https://www.youtube.com/watch?v=i56y6BE3vxw