3 Month Post Total Knee Replacement

What to Expect at 3 Months

By 3 months, most patients are walking without walking aids, have returned to driving (if right knee: confirm with Dr Liew), and are comfortably managing most daily activities. Some residual swelling after exercise or activity is completely normal and will continue to settle.

As we discussed before the surgery, the 3 month mark is not a fully recovered mark. I would normally expect you to feel better than before the surgery, but you will still have a few sensations that are almost universal at this time point.

The first is stiffness after you have been in one position for a while - for example, after sitting in the car for a long time, you will find that the first 5–10 steps is stiff, and then it improves so you can walk freely. The second is some aches and pains in the afternoon or evenings if you have been a little more active that day. These are completely normal - don't worry. We expect both of these to disappear by the 6–9 month mark post-operatively.

Physiotherapy exercises should continue - strengthening the quadriceps, hamstrings, and hip muscles remains important throughout the first 12 months. If you have not yet started hydrotherapy, you may do so from 4 weeks post-operatively.

Activity and Exercise

Low-impact activity is encouraged: walking, cycling, swimming, and gentle stretching are all beneficial. High-impact activities - running, jumping, heavy lifting - should be avoided long-term to protect the implant and minimise wear.

Most patients return to golf (walking, not riding) at 3–4 months. Other sport timelines depend on the specific activity and your individual recovery - discuss with Dr Liew at your next review.

What Can I Do?

I am often asked what activities are appropriate at this stage. Three months is a good time to reflect on the journey so far and to start looking ahead. We performed this surgery and went through this journey together to unlock activities and comfort that you didn't have before - so try to test it out now.

Whilst you are able to do almost everything you can think of, you still need to be sensible and build up to things gradually. The one exception worth discussing is running.

Whilst some of my patients do end up running - and do it safely - most won't. Running is one of those activities that you are theoretically able to do, but it is thought to cause implant-related issues over time. When I say running, I mean running long distance - not running across the road, or moving quickly during a game of tennis. If you don't run long distance, you have nothing to worry about.

If you are planning to run - say a local 5km - I would highly recommend working with a running coach first. The key is learning not to land as a heel striker, but to land as a midfoot or forefoot striker to reduce the stopping forces on the implant with each step. Simply heading out for a light jog with poor technique isn't a great idea.

For everything else - feel free. Hiking, swimming, tennis, snow skiing (though perhaps don't take up skiing for the first time after your knee replacement), cycling, golf, and more are all fine. Just continue to avoid high-impact activities and build up gradually.

Kneeling

As you know, the reason I use a curved incision is specifically to try to allow you to kneel. When I used to make the incision the traditional way - back in 2018 and earlier - I found that many patients were unable to kneel comfortably afterwards. Kneeling is an important part of everyday function, so I looked at all the evidence I could find, and eventually travelled to Switzerland to speak with a very accomplished surgeon who recommended I try a lateral curved incision. That is what I have been doing ever since, and it has given my patients a far higher ability to kneel.

Whilst kneeling after a knee replacement is never completely "normal" in terms of sensation, you cannot do any damage by doing it - so feel free to start kneeling now.

My recommendation is to begin on soft surfaces to desensitise the unusual feeling first - cushions, a couch, or the bed are ideal starting points. After a while, most patients are able to kneel comfortably on carpet and grass. On harder surfaces such as concrete, a kneeling pad is recommended.

Frequently Asked Questions